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03-105346 • • 4110 t . , ,t r'e _itll V1'av' � Community Devzlopment Services Building - Commercial Permit #: 03 - 105346 - 00 - CO 33530 1st Way S Federal Way.`VP. 98003-6210 r � Ph:'-53.66L,0re Fax 253.661.4129 Inspection request line: :33.835.3050 Project Name: ST FRANCIS SURGERY AND LAB REMODEL Project Address: 34515 9TH AVE S Parcel Number: 750451 0020 Project.Description: TI-Remodel of in patient lab and portions of in-patient surgery,and new storage room plumbing and mech encluded. Owner Applicant Contractor Lender Hospital lisp StFrancis Hospital Bsp StFrancis SELLEN CONSTRUCTION NONE 2002 ADV DEP PD 5282869 DLCO"?ADV DEP PD 5282869 SELLEC*372ND 6/1/05 PO BOX 9970 SEATTLE WA 98109 NONE Includes: Census categ•. ry: 437-Comme #1 #2 �7 #3 #4 LOcc:panty Croup: 1-1.1 i _ - _ 1- -— j Constx,:tion Type: Type 1-FR L — 1 � Occ�;l.ancy Load: J = — — -= _---i ,. [-Floor Area(Sy.Ft.): — —NI L. — -11J Boil ling Pre-con.Meeting Reyuir•cd No Census Category 437-Co r.rnerci;.i alt/add Fire 8 ;i'.'der Yes iicchanical. Yea Number o1 St•:ries 1 "errnit for Building Shell Only No Plumbing Yes Special;nspecticn Required Yes Zoning Design..tion OP Plumbing Fixtures Description g `quantity . Description jQuantlty '= •;,peso lantity, Drali ; 'i 6 Lavato'iea 11 Other Plum nog 1 ixturcc 3 [Shower,: 11 2. I Sinks-— ------- - p 2- Water Closcts —-- __----1[--3 Mechanical Fixtures Doscripticn ([Quantity Description jQuantitN L ; Description ___1,-Q_la —.-- Air Handling Units -------1 �It J PERMIT EXPIRES July 21,20C4. Permit issued on January 23,2004 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. /— I a Owner or agent:_ `:, _ — Date: 0_,\0 0 • INSPECTION LOG el DATE INSPECTOR OK CORR/REJAREA AND TYPE OF INSPECTION 3/40t/ g,' t'/A6 .t/Gic• .ani o/t'rv.¢i.Z, w-gr-.sior o,C ,4'r 4a ,f /3 Z/z �,..-6 ,I'z 4 . 1"0a,4yw /(4 k AID Jv6-17---(40e-- e- mo n s 4'44-/f-,7 /3 zzo F /0' 7-0 1 _...--c \.} -716,.‘,....i1/ki -r-2",- ZO‘-/ /s - //-v '-c J ff�y i/ ©A 3 -z.+' /0 - 2 c�- 6 ''G c,.Jl A 24 1p c.-,t(5%f rit e 6 ' //0 Z-t /.3-7/m) /3- 1(4s) 3-//d /3-//e-o4/ /3-(/)-3,, ,3-// /e-Z / - a c.J ' p/..w+b, /0c-E34/:-e 13-l/o-2 ) f /7/0>4//0e) 1 - a9 i3 - ilv 6,j 8 - 7/0.3 /3-//e5-7 6 d 1 - 2 2. - 41 G ✓ wt it /3-//07, 1 /3-///0j /.3 —1/a e• > /3 -//a 1 /3 -/O a) ,d- /to 3 ) /3 _1/•c1�cS ,� /0 - z 6 - 0 /___c-,_ ) , I.) � /@ /3 -//d ,1 /3 ///6) /3- /7o ) /3/ 61 q) 3 o 2 /3- /03 /.3 --1/0s_' 1/- 17 0 y z 5 7 J,& e° wit/ l3 l/17f, g /?>, 6 -- (/ Z 6-iilU,, I1IVIIi 177'.. . bill ri;i2f ( Ar 8006 / 61103 / I3f/O pini)/ g//oJ , 5 //di( 4-74 tf..4i, _ plez0Z # 42- /(dyi f (y1 ) y/4). c1�r 4 c d'1 fJ//CIa.A . 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" CITY OF r FederaiWay BUI ING DIVISION INSPECTION RECORD INSPECTION REQUEST PHONE#: 253-835-30.50 • PERMIT #: 03-105346-00-CO OWNER'S NAME: I-Ifx;pitLI Bsp StFrancis KTE ADDRESS: 34515 9TH S ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL • DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPR 37ED ) DRAINA.:JE: Linc ) Connection DO NOT POT_JR SLAP UNTIL THE ABOVE IS iZOVEt' ( ) UNDERFLCOR FRAMIT:,3 P_OUGi-1 1;7V ( a Watt:tipin,, • - r . . . • • 1:117, T 7,1 /'"" s-77 E ,• i'I . ROVED FlIOR'FO ':3 'W'1!;f IHE ABOV:: APPROV:21., PRICY..TO APPLYING SH11',..,If. TK ( ) ( ) SUSPENDED CEILE`:(.1 IL A•',10VE MUST BE APPROVED PRIOR 1.0-FAPING OR INSTALL-L- 7! ( ) ELECTRICAL 7iNAL ) PLANNINC L ( ) PUBLIC,WORKS FINAL ( ) FIRE FINAL THE/-1.BOV r _)E;Al)PROVED PRIOR TO BUILDING DEPARTMENT FINAL ( ) BUILDING FINAL IPA DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED RECEIVED —�A CONSTRUCT I ION PER IT APPPLICON 011111.14.t...011111.14.t...."CITY OF + � DEC 0 8 2Q03 APPLICATION NUMBER: *61P-3- L-- Q 5-3=(10- GC Federal Way CITY OF FEDERAL WAY APPLICATION NUMBER: - _ BUILDING DEPT. !APPLICATION NUMBER: **The following is required information-Please print(in ink)or type** \/74` "\ Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. ■ PROPERTY INFORMATION :( - _ SITE ADDRESS: ',.5*--/S P4(Ar C/4(' S007/I i ASSESSOR'S TAX/PARCEL #: - FCv0741-G w,.Y w.4. 9'o a 3 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): S-4fd'. /04,4 to...x,.—C C'o'E/t f', '(E' ,r„4. , 7 G'7/f i G • PRO]ECT/INFORMATION - TYPE OF PROJECT(This application): i/BUILDING /PLUMBING 'MECHANICAL 0 DEMOLITION ❑ ELE RICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM —1-): -.•' - .(7sd••�� G..ie PROJECT DESCRIPTION(Provide detailed description): 21-~04 t o q( r 0 It.7. v NT OF f>- -f4.te,,. : <-5-k,A ore Ay / .Z,..,_CC vol- 6 �¢ A.E�.. f7;IP ,,4-Gc /20 omaI PROJECT NAME:S r X A1' C J•J csU/t_6 617 L"td /C ,5f-A-70 re ■ PEOPLE INFORMATION . PROPERTY OWNER: NAME: I DAYTIME PHONE fr&/4 .cjrc lr.-. /-11.46 7W- f rf7f,t,c i (?Say )9e2 -I(835— MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): �t / 7/7 Ct'°. '',/' f'l/tfc% r/1 cO,'R.4 IA/.A . 715,0 ( -02/9 7 CONTRACTOR: NAME: I DAYTIME PHONE: ,S'C//C.... Co..,c''7 4"C 7fo..-- po 6 )b'o r -7//7 MMA�llING ADDRESS(STREET ADDRESS;CITYSTEVENING P ATE.ZIP): �- HONE: vc o -2 f'ti cr.r G.¢/ C de . /V . riermec 4,..,i, ( )a:01/:Ile- CITY 1, e'CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: 78/0 -071740A NUMBER: 'I- `- -- 1 �- o - v a- / O/Yrsr -00 -&Li (.2•i. ) FOS' - ,----------/ e2/7 CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE: C C o / . E//c c - 3 7 2 /✓a f !' / / ,.2o orl (copy of card required) I APPLICANT: NAME: DAYTIME PHONE: s T. PR 4.•-az-sr 1o.r/'- 7 't- (a2r3 )4' ‘ -o8<3ct MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): q� EVENING PHONE: i I/7/7 '-r-C9. 't J ��s/At6�r/ /4-c4 -- LV4, l ��o,-. pQ7 ) fel/416r I RELATIONSHIP TO PROJECT: FAX NUMBER:: - �0 f� o ARCHITECT ❑TENANT 9COTHER ( DESCRIBE)O 14-'it-- /e. (a5J) 746 I 'c-MAI Aq DRESS:, I / / Sit v( ENN..„ /ate"@ CONTACT PERSON FOR THIS PROJECT: kf PROPERTY OWNER 'APPLICANT ❑ CONTRACTOR Crr I,.(rr ,--0„..t - -■ DETAILED BUILDING INFORMATION - EXISTING USE: #6J,S010‹ EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: Ala O J� ,� PROPOSED VALUATION FOR IMPROVEMENTS: $ l/S31/ erS9.r SPRINKLERED BUILDING? yvES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES 0 NO WATER SERVICE PROVIDER: WKEHAVEN o HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER: LgMKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ — • ■ PROJECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: :; ■ FIXTURES Indicate number of each type of fixture MECHANICAL Value of Mechanical Work: $ AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISe.( ) COMPIZE�SOR(S) FURNACE(S) DUd (S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC o GAS PLUMBING BATHTUB(S) LAVATORY(S) URINALS) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VAC-GUM BREAKER(S) o ELECTRIC o GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS-PIPE-OUTLET(S) SINK(S) WATER CLOSET(S) MISC.(gfrCf /'41' INIER.CERTOR(S) SUMP(S) p/vIve, r - ■ DISCLAIMER/SIGNATURE BLOCK I certify under penalty of perjury that the Information furnished by me Is true and correct to the best of my knowledge,and further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold harmless the City of Federal Way as to any daim(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 of Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information suppli to the city as a part of this application. NAME/TITLE: ./! Q /L e-C• r'O.. J Fit 4"e($°' /t"'" DATE: /C72 - PROPERTY OWN R EKAPPL CANT o CONTRACTOR ..,FOR:OFFICE USE ONLY: CI„NEW ,` .o ADDITION - ii ALTERATION o REPAIR xTENANl IMPROVEMENT CENSUS "LOT,SIZE 4fic,, -. ;ZONING DESIGNATION:_, ; a BUILDING SHELL ONLY?. DYES ❑ NO COMP PLAN DESIGNATION;# -' r' ' 'BASIC PLAN? o YES o NO ”- SECTION , TOWNSHIP".- `RANGE ' _° NEW ADDRESS REQUIRED?` ❑ YES ` ❑ NO PLATTED LOT?" "'ID YES o"NO CHANGE OF USE? ❑YES' NO - COMMUNITY DEVELOPMENT SERVICFS•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www,dtyofederalway.com • • Co ostruetion Permit Fee Calculation Sheet *******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT. CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!******* Building,mechanical,and fire prevention system fees are based on the following schedule. TABLE A TOTAL VALUATION FEE FACTOR (1)$1.00 to$500.00 (1)$30.00 (2)$501.00 to$2,000.00 (2)$30.00 for the first$500.00 plus$4,00 for each additional$100.00or fraction thereof,to and including $2,000.00 (3)$2,001.00 to$25,000.00 (3)$90.00 for the first$2,000.00 plus$18..00 for Cad?additional$1,000.00 or fraction thereof,to and including$25,000.00 (4)$25,001.00 to$50,000.00 (4)$504.00 for the first$25,000.00 plus$13.00 for each additional$1,000.00 or fraction thereof,to and including$50,000.00 (5)$50,001.00 to$100,000.00 (5)$829.00 for the first$50,000.00 plus$9,00 for each additional$1,000,00 or fraction thereof,to and including$100,000.00 (6)$100,001.00 to$500,000.00 (6)$1,279.00 for the first$100,000.00 plus$7,00 for each additional$1.000.00 or fraction thereof,to and including$500,000.00 (7)$500,001.00 to$1,000,000.00 (7)$4,079.00 for the fist$500,000.00 plus$6,00 for each additional$1,000.00 or fraction thereof,to and Including$1,000,000.00 (8)$1,000,001.00 and up (8)$7,079.00 for the first$1,000,000.00 plus$4,50 for each additional$1.000.00 or fraction thereof. Bold number Is the base fee for the specified Increment Jtalfdzed•underlined number Is the fee per additional specified Increment PLUS: Add 65 percent of the base building permit fee for plan review fee. Add 25 percent of the base mechanical permit fee for mechanical plan review fee. Add 15 percent of the base building permit fee for Fire District#39 surcharge,commercial only. Add$4.50 for WA State Building Code Council,plus$2.00 per unit for duplex&above. **Electrical,plumbing,and mechanical fees are calculated separately** - ■ BUILDING - PROPOSED VALUATION: FEE FACTOR FROM TABLE A: Number: (a) Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (1) Estimated Plan Review Fee: (2) Estimated FW Fire Department Surcharge: (3) (COMMERCIAL ONLY) ■ MECHANICAL: PROPOSED VALUATION: j 7, 5 7 Z FEE FACTOR FROM TABLE A: Number: 7 (a)Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (4)1i t{L! 2c( : '1 5 Estimated Plan Review Fee: (5) (/ 0(j , /( ■ FIRE PREVENTION SYSTEM .. PROPOSED VALUATION: FEE FACTOR FROM TABLE A: Number: (a) Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (6) Estimated Plan Review Fee: (7) . _. - ■ PLUMBING Base Fee Number of Fixtures $26.00+{ 3 S"- X$9.00/fixture}= 131 5i/• (8) Estimated Permit Fee mated Permit Fee c//. X .65 = �f o� i• t� (9) Estimated Plan Review Fee Miscellaneous Fixture Charge:(10) SU Y • (Page.-- rn - s)(1)+ • - • it — ■ ELECTRICAL t 'S - . TABLE B - NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES _Single Family _Service or feeder only .. 57.00 #of Thermostats(First-$43.00;add'n-$13.00ca) (Firs 00 ft1-$85.50;Each ad ' _00 ft2-$27.50) _Service . . ceder $93.00 _#of Low voltage fire or burglar alarms square Feet: _ First 2500,ft1-$50.00:Each add'n 2500 ft2-$13 00 f _Each outbuilding •• age $35.50 MOBILE HOME/RV P P. •. Square heet: (Inspected wi • ervic _f of service or fees- s *Per WAC 296-46-910(5)(b)(i R ii) _Each ou •• ding or garage... $57.00 (First service/ ser-557.00, :dd'n service/ _#of Signs(First sign-$43.00;add'n sign • (I. cted separately) feeder-. each) $20.00 each) Swimming pool,hot tub,spa $85.50 Yard Pole meter loops $57.00 i 1 Li NE MULTI-FAMILY . ,OMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL (Ioclu. three wets or more) Altered Service or Feeders II Service ' eder Amps Service or Add'n 0 to 200 5 93.00 i _Up to 200 amp... $ 93.00 27.50 Feeder _201 -600 216.50 _201 -400 amp...--.... ... 115.50 57.00 Oto 100 5 93.00 $ 57.00 _601 -1000 126.50 _401 -600 amp 8.50.... 78.50 _101 -200 115.50 72.50 _over 1000 363.00 _601-800 amp 21: A 108.50 _201 -400 216.50 85.50 _#of circuits _Over 800 amp 2.•. 1 216.50 _401 -600 252.50 101.00 ,l 1 I-5 circuits-$72.50:Add'n circuits,$6 ea; ALTERED SINGLE/MULTI •MIL _601 -800 326.50 138.00 V.-- (When inspected separ. y from the rvices.) _801-1000 399.00 166.50 TEMPORARY SERVICE Service or Feeder _Over 1000 434.50 232.00 Residential/Multi-Famiiy/Commerci.''ndustrial _0 to 200•.r.. ..$ 71.50 _Over 600 volts surcharge 72.50 _ -100 $ 57.00 _201 - I amp 115.50 _Mast or meter repair 78.50 _101- 72.50 _o r 600 amp 74.00 �` _201-400 85.50 _Mast or meter repair -3.00 _40 . 9 . 115.50 • _#of circuits I _over 600 12)... (1-4 circuits-$57.00;Add'n circuits$6 ea) . If a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps,a plan review is required.Fee is 35%of permit fee+$72.50.Add'I plan review for other submissions is$85.50/hr. .. f FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLES(B) • NUMBER OF UNITS(C) TOTAL(D) i I •I I I I I ' I I r TOTAL COLUMN(D): Total Column CD) Estimated Permit Fee: (12) Estimated Permit Fee from line 12 Estimated Plan Review Fee: $72.50 + ( X.35) = (13) ,<. ■ DEMOLITION ..... Estimated Permit Fee: (14) Bond Amount: (15) , ■ ENGINEERING: : Estimated Permit Fee: (16) Bond Amount: (17) -:,••.OTHER FEES--1-.. - .. .. Mitigation Fee: (18) (20) (22) SBCC Surcharge: (19) (21) (23) • Total (Pages One&Two): line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24) Bulletin #100-December 23, 2002