07-105708 I A. s
City of Federal Way BuilPnQ - Commercial Permit 07-1 I R a 0-CO
Community Development Services I b
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-26091 1 nspecti• "eques 1 e: (253) 55-3050
Project Name: CHILDREN'S HOSPITAL-SPORTS MEDICINE
Project Address: 34503 9TH AVE S Suite 300 el Nu ib : 750451 0050
Project Description: TI-Tenant improvement of existing 598sq ft to de removal epi, . ent of ceiling
grid,light fixtures & diffusers; removal of existing s & doors - . finished in space.
Construction type is assumed by type II-A. Fire-rate otecti f penetrations required.
Owner Applicant Contract• Lender
MEDICAL REAL ESTATE BOB SARFF N CONST' CTION 1EDICAL REAL ESTATE
SERVICES,LLC CHILDRENS HOSPITAL @ ST SE. *372N, ./1/20 SERVICES,LLC
105 CENTRAL WAY SUITE 203 FRANCIS :• 970 i 105 CENTRAL WAY SUITE 203
KIRKLAND WA 98033 PO BOX 5371/ . SEA / 9810 KIRKLAND WA 98033
SEATTLE WA 9810
Census C. tory: 437 mmerc 1 ttd conversion
Includes: # #3 #4
Occupancy Class: \ \
Constructio Type: •e II-
Occupancy
d: 11
Floor Area(s • .59 0 0 0
Addltio l rr dllor atiol t-
esti nkler System in Building'?• Yes Mechanical to be Included? No
f Stories 3 Permit for Building Shell Only No
g to be Included Yes New/Additional Sq.Feet-Total 0
Occu #1 -Use Professional Zoning Designation OP
Services/Offices
Plumbing Fixtures
Sinks 1
PERMIT EXPIRES Saturday, November 7, 2009
Permit Issued on Wednesday, November 7, 2007
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 accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: .iS 4("4,0y Date: II / 7 /0 7
F7,u&/ec(
- ' -4k THIS CARD IS TOAXIMAIN ON-SITE t
CITY OF � �- Community Developn rent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-105708-00-CO
Owner: MEDICAL REAL ESTATE SERVICES, LLC
Address: 34503 9TH AVE S Suite 300
FEDERAL WAY, WA 98003
This card is part of your required inspection documents. 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.
O Footings/Setback(4110) ❑ Re-steel(4215) ❑ Plumbing Groundwork(4190)
Approved to place concrete Approved to place concrete or grout Approved to cover
By Date By Date By Date
— 0 Slab/Concrete Floor(4255) 0 Underfloor Framing (4285) ❑ Floor Sheathing(4105)
Approved to place concrete Approved to sheath floor Approved to install flooring
By Date By Date By Date
s
V it
O Rough Plumbing(4230) ,❑ Fire/Draft Stops (4095) NOTE Prior to scheduling a Framing(4120)
Approved Approved • inspection;Electrical,Plumbing&Mechanical
Rough-in and Fire/Draft Stop inspections must be
By Date By Date signed-off and approved. IBC 109.3.4/UBC 108.5.4
El Framing(4120) CI Insulation(4150) .
❑Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By CIAA,„_,.. Date kl...�-$" --? By Date • By 'Date Z/ /
❑ Suspended Ceiling Grid (4265) ❑ Final-Fire Department(4060) 0 Final-Planning(4070)
Approved to drop tile Approved Approved
ByDate B DateByDate
� 4 .5 L'�-`1m-o y�Au�. gi7/Qs
❑ Final-Plumbing(4075) 0 Final-Building(4050)
Approved Approved
By Date Bytd.i Date f.—/8,o a
For inspector reference only
0 Rough Electrical 0 • FINAL-Electrical
Approved Approved
By Date By Date
CITY RECEIVED• •' - ` 0 5 ZD
Federal Way PERMIT SF MF OME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICK T 1 6 2007
33325 8TH
FEDERAL
UE AY,WA SOUTH•PO BOX 9718 APPLICATION TD ii ��
FEDERAL WAY,WA 98063-9718
253-835-2607•FAX 253-8V` 'OP Pe
7.1
wwu�.cituo ----QtR9U_mm BUILDING DeptRAL AY
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
L� • PROPERTY`, INFORMATION 2
SITE ADDRESS_ 3 1 5 D 3C 31- 1 V G 4D• SUITE/UNIT# J 0
ASSESSOR'S TAX/PARCEL# '75 0 4 5 I - D O 5' D LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
I. PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
TeNNNT 1 t ? I2-ov61u1 )T of EXISTING '9(ii S.2 FT To I»G(-uP�
'- P'lt J kL "(i%% k `/-.SPl k t'1c r .6F C./Li] t1(- D , 1-1‘i Hi- FIKib 4 vIf siz5 � L
o'F E2Q cifi LJA U.h At 1901)P7 -P11,1D NEW F I,'.i \-1 GS IN1 5`Q1cuu
PROJECT NAME(Name of Business or Owner Last Name) GN I L D R--eN S 1-I►
D' P IT? L - SIA)P--1-S rle D IC..1/JE
Nu PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER /..16 D►GA L- RcL E15ilie 14.,a5 i....1--•L• (2ob) g l o - $1 I A
MAILING ADDRESS rt2-4
,STATE,ZIP E-MAIL ADDRESS
i D5 (�n1TRhLWkY 5vri5 203 1 1. N D,W A 9803
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
5ELLgN coNSTR-VC(lonl _146viN PETER-Sv/sf (lob ) 6bS - 1100
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
221 wc,511..at4.g SEN. Raba R91D 5e.k-rr wA 9810'1 ( ) -
CITY OF FEDERAL WAY BUSINESS LIC NSE NUMBER 1EXPIRATION DATE FAX NUMBER
2o-o0-10i5S - 0061. 12" 31 - D1 ( lob ) 623 - 520(o
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
55LL!✓G* 312 No nb- 01 - 2009
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
G141LPfLe&IS I-oSP1rt''L 'dog SAsf (20(o ) 987 - 21100
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
P.o. BoX 5371 / T-I 5 -1-ri , AA 1s'bS — ( ) -
RELATIONSHIP TO PROJECT 0311 FAX NUMBER
0 Architect )(Tenant' ❑Agent ❑ Other (2047 ) 98-7 - 214$
PROJECT NAME ..... PRIMARY PHONE E-MAIL ADDRESS
CONTACT ook 61.-Son,I (2010 ) 441 - 4151 ta15011 e wiawVw+.cnw►
LENDER NAME
N ISIN Per RCW 19.27.095:
Lender information is required(f project value exceeds$5,000
MAILING ADD S CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE OUT ?All eNT (,,i.1 N 1 L PROPOSED USE D UTTNT))E/JT L t 1 t.i t L
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ MoD l()o 0 .°-'5')-
SPRINKLERED BUILDING? )(YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture to be instailPd or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SE=1J REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS ironer)
ELECTRIC WATER HEATERS I SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 reli' ce of the city, including its officers and employees, upon the accuracy of the information supplied to
the city as a part of his applicat''n. /'p
SIGNATURE.- ,i/ i h 1' 'r/ LiDATE /F
/k
r w• operty Owner and/or Authorized Agent
❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑YES ❑NO
_
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100-August 16,2007 Page 2 of 4 k\Handouts\Permit Application