13-105017 �.rtoF . • S PERMI'IPPLICATION
Federal Way
RECEIVED
_
PERMIT NUMBER— - I 0 b 0 1 C 7 - v O NOV O V •�g2ARCi2T0 ATE I z A a A 3
SITE ADDRESS CITY OF FEDERAL WAV SUITE/UNIT#
CDS
33501 1st Way S., Federal Way, 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL*
$ 300,000 OP 9 2 6 5 0 4 - 0 0 1 0
TYPE OF PERMIT X BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT VM Federal Way GIM Renovation
PROJECT DESCRIPTION Converting existing medical records space into 6 exam rooms, toilet room
Detailed description of work to and staff area.
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Virginia Mason Medical Center 206-341-0435
MAILING ADDRESS E-MAIL
1100 Ninth Ave Jeri.Pierce@vmmc.org
CITY STATE ZIP
Seattle WA 98101
NAME PHONE
GLY Construction 425-463-4958
MAILING ADDRESS E-MAIL
CONTRACTOR 200 - 112th Ave NE, Suite 300 Dave.Snaring@gly.com
CITY STATE ZIP FAX
Bellevue WA 98004 425-453-5680
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
GLYCOI#09018 09 / 30/ 2014 20-00-101644-00 BL
NAME PRIMARY PHONE
Lee Hall 425-778-1530
APPLICANT MAILING ADDRESS E-MAIL
21911 76th Ave W, Suite 210 lhall@tgbarchitects.com
CITY STATE ZIP FAX
Edmonds WA 98026 425-774-7803
NAME PRIMARY PHONE
PROJECT CONTACT Applicant
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING E1,4 OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
-.,
SIGNATURE: -A___ 7( DATE
/7- 8 i�
PRINT NAME: Lee Hall
Bulletin#100—January 1,2013 Page 1 of 3 k:AHandouts\Permit Application
0 VALUE OF MECHANICAL GVORK
MECHANICAL PERMIT $
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
` AIR CONDITIONER FIREPLACE INSERTS HOODS Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
No Water District Public $ 12,006,900
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Medical Yes r No E Yes ❑ No
Office 302,738
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
in Square Feet Type Stories
TOTAL BUILDING 83,333 sf B, A-3 V-A 2
TENANT AREA ONLY
PROJECT AREA ONLY 1,381 sf B (Clinic, outpatient) V-A 2
Bulletin#100—January I,2013 Page 2 of 3 k:AHandouts\Permit Application
• -f wilding - Com ne'rcial
CityFederal Way Permit #: 13-105017-00-CO
Community y&Econ.Dev.Dev.Services
33325 8th Ave S z
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: VIRGINIA MASON-GENERAL INTERNAL MEDICINE (GIM)
Project Address: 33501 1ST WAY S Parcel Number: 926504 0010
Project Description: TI-Convert existing medical records space to(6)exam rooms,restroom and staff area.
Plumbing and mechanical on separate permits.
Owner Applicant Contractor Lender
VIRGINIA MASON CLINIC LEE HALL G L Y CONSTRUCTION INC OWNER IS LENDER
1100 9TH AVE S T G B ARCHITECTS GLYCOI*01809(9/30/14)
SEATTLE WA 98101-2756 21911 76TH AVE W PO BOX 6728
EDMONDS WA 98026 BELLEVUE WA 98008-0728
S l
Census Category: 437-Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type V-A
Occupancy Load
Floor Area(sq.ft.) 1,381 0 0 0
Additional Permit Information
Existing Sprinkler System in Building? Yes Mechanical to be Included? No
Number of Stories. 1 Permit for Building Shell Only? No
Plumbing to be Included? No New/Additional Sq.Feet-Total 0
Occupancy#1-Use Professional Zoning Designation OP
Services/Offices
No Fixtures Associated With This Permit!!
CONDITIONS:
Separate electrical permit required
PERMIT EXPIRES Monday, July 7, 2014
Permit Issued on Wednesday, January 8, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordanc: ith the laws, rules and regulations of the State of Washington
and th- '‘ of Federal Way.
Owner or agent LDate: 1 o/c f
c) ( yi < 1)6 (/ 1-7 r -
tFiNALEQ
0 414k THIS CARD IS TO AIN ON-SITE
CITY°F '"" Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-105017-00-CO Address: 33501 1ST WAY S
Project: VIRGINIA MASON CLINIC FEDERAL WAY, WA 98003-6208
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
0 SWM Precon Site Mtg(4400) Initial Erosion Control(4365) ❑ Footings/Setback(4110)
Approved To bi done prior to breaking ground Approved to place concrete
By Date By Date py Date
O Foundation Wall(4115) 0 Drainage/Downspout(4040) Re-steel(4215)
Approved to place concrete Approved to backfill Approved to place concrete or grout
By Date By Date By Date
'
0 Slab/Concrete Floor(4255) Underfloor Framing(4285) 0 Floor Sheathing(4105)
Approved to place concrete Approved to sheath floor Approved to install flooring
By Date By Date By Date
Shear Walls(4245) Roof Sheathing(4220) 0 Fire/Draft Stops(4095)
Approved to install siding Approved to install roofing Approved
By Date By Date By Date
O Interim Erosion Control(4370) Prior to scheduling a Framing inspection Framing(4120)
Approved Electri , bi & enRough �and Approved to insulate
Fire/DraftcalStopPluminspectionsngM
mustchabeical signed-off inand
By Date . approved IBC 109-3.4 By Date a —Li` 1
I
0 Insulation (4150) 0 Gypsum Wallboard Nailing(4130) '0 Suspended Ceiling Grid (4265)
Approved to install wallboard Approved to install mud&tape Approved to drop tile
By Date By (111,,,,,_, Date g._to —1t4 By 0\ . Date a 1„,s.1 1
▪ Final-Fire Department(4060) ❑ Final-Planning 0 Final Erosion Control(4375)
Approved Approved Approved
By Date By Date By Date
,
0 Final-Building(4050)
Approved
,STT Date„g— \Z.--
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date