07-106060 a
S
g - Commercial Permit •07-1 06060-00-CO
DintAunity Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: CHILDREN'S HOSPITAL- X-RAY
Project Address: 34503 9TH AVE S Suite 300 _ Y Parcel Number: 750451 0050
u..
Project Description: TI-Interior modifications to 237 square feet within existing tenant space,including
partition walls,ceiling grid modifications,door replacement and casework to create X-ray
room. Includes plumbing for the relocation of one sink.No mechanical.
Owner Applicant Contractor Lender
MEDICAL REAL ESTATE BOB SARFF SELLEN CONSTRUCTION MEDICAL REAL ESTATE
SERVICES,LLC CHILDREN'S HOSPITAL SELLEC*372ND(6/1/2009) SERVICES,LLC
105 CENTRAL WAY SUITE 203 PO BOX 5371/T-1 PO BOX 9970 105 CENTRAL WAY SUITE 203
KIRKLAND WA 98033 SEATTLE WA 98105-0371 SEATTLE WA 98109 KIRKLAND WA 98033
Census Category: 437- Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type: Type II-A
Occupancy Load:
Floor Area(sq. ft.) 237 0 0 0
-4.4i::,.,,,,,,,,,, 1 ? ''" Pe a" R4 ''°
r
Building Pre-con.Meeting Required? No Existing Sprinkler System in Building? Yes
Mechanical to be Included? No Number of Stories 3
Permit for Building Shell Only? No Plumbing to be Included? Yes
Special Inspection(s)Required? No New/Additional Sq.Feet-Total 0
Occupancy#i -Use Professional Sensitive Areas?(Wetlands/Slopes,etc) No
Services/Offices
Zoning Designation OP
Plumbing Fixtures
Sinks 1
PERMIT EXPIRES Friday, December 18, 2009
Permit Issued on Tuesday, December 18, 2007
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and th use will be in accordance with the laws, rules and regulations of the State of Washington
deete City of Federal Way.
Owner or agent: Date: /2 - /'' O 7
V`n /V �
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1 1 q
f‘IN\l'''' '' o1//aV 4
THIS CARD IS TO E MAIN ON-SITE ,
CITY OF ommunitygitp P Develo ment Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835.-3050
PERMIT#: 07-106060-00-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.
❑ Footings/Setback(4110) 0 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) ❑ 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
0 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
0 Framing(4120) ❑ Insulation(4150) ❑Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By (l Date )..._.1.L. By Date By Date
❑ `Suspended Ceiling Grid(4265) ❑ Final-Fire Department(4060) ❑ Final-Planning(4070)
Approved to drop tile Approved Approved
By Date By Date By Date
❑ Final-Plumbing(4075) ❑ • Final-Building(4050)
ApprovedApproved
By Date !e Date ,Z_ /-.!>g.
•For inspector reference only
O Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
Federal Way PERMIT
Mt. ,4,-, RECEIVIO il_t - LoO_ _ 0 .6_ 0
conlNrororrYDEVELOPMEnrrsERvrces 05 2��7 SF MF&ME EL PL DE EN FP
33325 FEDERTH AL
A SOUTH•63 971 9718 NOV- ,LI CATI O N dFEDERAL WAY. 9•PO B7187.253-835-2607 FAX 253-835-260 // / / /07_uww.cituo((deralu�au.com �ITY OF FEDE A /`(//,
BUILDING DEPT.
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
L} C (� ....6• PROPERTY INFORMATION
SITE ADDRESS 3 1 ..J O 1 T'd 4 S j�A\16 5. SUITE/UNIT# .J O 0
ASSESSOR'S TAX/PARCEL# -7 S O I - 0 0 5 v LOT SIZE(sf7
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
\
• PROJECT INFORMATION
„
TYPE OF PERMIT -BUILDING PLUMBING 0 MECHANICAL
"`
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
1-SN i. NT ) \P R-o.)6 6nrt oc 6)(.1, -n,.3 21-51 SQ T. Pa-o l e e_T ()ti c.L.t.)o6 S
-r1.1 V- rlov/-i- k INFtL- of t✓X15TlnK.L wPLLS REri_pce MEN-L- of -rvao
D D D 9-', I N e yJ GPcSe W o R-V- r Ac14[) (litSTATtom- At rl o/J O F Nevi x-17--o,N
6auI PMEt4 i�
PROJECT NAME(Name of Business or Owner Last Name) �H Ir v 11--E N'S \\OL J?\TML - X-1 :{
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER MVO ICA L -e/cl- ESTATe 561ZV lc•647 1 L..L..L. (2010 )°It o - 8 2►g
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
1O5 GErrTt+L \,JA'i Sv115 203 Y4 P LPD 1 \t-\A 9$1033
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
'S L-LEN (-0NST(L0c:r1or.) f-Evj1J PC1C6V-G,oNI (206) 8o5 - 7/oo
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
221 ' ri."1c., MIL. N, POPC g97o S rri_ewt.. `i8161 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
2a- oD - 1osl55 - DO 6L 12-31 - 0/ (Zo(a ) 623 -510 la
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
SE-LLSL * 312N6 0(0- (A- 2009
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
OA)LtA-EN'S PtObP ii t- 5013 SAR.cF (Z04, )987 - 1110o
MAILING ADDRESS CrrY,STATE,ZIP CELL PHONE
P.o. ,ox 5311 1 T- 1 5 -crt e 1 ti.)A 9$1105- ( ) -
RELATIONSHIP TO PROJECT U 37 I FAX NUMBER
0 Architect )(Tenant 0 Agent ❑ Other J (Zo(O )<\ - 114s
PROJECT NAME PRIMARY PHONE //�� E-MAIL ADDRESS
o
CONTACT TbtOLS oN (Zola ) 4-AA11 - 41' I i-o1Soln Q r►'IG14tom.CA"-,
NAME Per RCW 19.27.095:
/`V Lender Information is required if project value exceeds$5,000
MAILINd AtSDR ern STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE 0 uT PAT'I e/v1 (A...4 nl 1 t-- PROPOSED USE D L7T PP 16NIT_M MGI. i( 1 G.
dd
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 101 D.oO
SPRINKLERED BUILDING? )(YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
CL02.3rD 4 E / D Y - I'? 7
4
4i • PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD /
AL.--FL...l /a i._(c S' l % `1
ADDITIONAL FLOORS(DESCRIBE) .--
DECK(❑COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTINGPROPOSED SF TOTAL SF TOTAL SF
""`NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of facture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Vnlun of Mechanical Work$ (A 'PY OF BID OR ESTIMA 't BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORA"k C•r, RS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS F • •CE INSE• HOODS(Commerdal)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SLib REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
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 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. l
SIGNATURE: �/ / DATE ,1/ v/b '/)
Prope I er. -. . Authorized Agent
❑NEW o ADDITION ❑ALTERATION ❑REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY? 0 YES NO BASIC PLAN? ❑YES �NO
w „
ZONING DESIGNATION �j CHANGE OF USE? ❑YES f NO
NEW ADDRESS REQUIRED? o YES ,. NO UP/SEPA/SU? ❑YES �,NO
PLATTED LOT? n YES INO DEMO PERMIT REQUIRED? ❑YES cgi NO
Bulletin#100—August 16,2007 Page 2 of 4 k\Handouts\Permit Application