04-104055 y ,
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City of Federal Way
Community Development Services Building - Commercial Permit #: 04 - -00 - CO
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: EWEN,DR
Project Address: 32114 1ST AVE S SuiteC-101 Parcel Number:926450 0030
Project Description: TI-Remodel of existing medical office for new dental office. Work includes some wall demolition;
wall construction; moving one restroom lay,includes 1 plumbing fixture.Minor lighting changes.No
other plumbing&no mechanical on this permit. All wor
Owner Applicant Contractor Lender
R S SHAH LLC 1 OLYMPUS CONSTRUCTION*ROB OLYMPUS CONSTRUCTION*ROB ASHLEY EWEN
14915 NE 75TH CT OLYMPUS CONSTRUCTION OLYMPCI136Q5 11/4/04 10610 NE 26TH ST
REDMOND WA PO BOX 50082 OLYMPUS CONSTRUCTION BELLEVUE WA 98
98052-6808 BELLEVUE WA 98015 PO BOX 50082
Includes:
Census category: 437-Comm #1 1F #2 #3 j #4
Occupancy Group: B j
Construction Type: _ Vi3
Occupancy Load: 22
Floor Area(Sq.Ft.): 2186
1st Floor Proposed Sq.Feet. .2186 Census Category ............... ,437-Commercial alt/add
Fire Sprinklers. ....... 1 ................ No Mechanical _ No
Number of Stories 1 Permit for Building ShelOnly., ,., No
Plumbing Yes Will Certificate of Occupancy be Issued? Yes
Zoning Designation PO
Plumbing Fixtures
j Description Quantity Description Quantity Description ijQuantiyl
Lavatories
y t
1
CONDITIONS:
This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES April 12,2005.
Permit issued on October 14,2004
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.
Owner or agent: L i
g Date: /
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City offedewal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the Uniform Building Code certifying that at
the time of issuance,this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: EWEN,DR Permit number: 04- 104055 -00
Address: 32114 1ST S SuiteC-101
#1 j #2 H #3 #4
Occupancy Group: B
Construction Type: VB _ J
Occupancy Load: 22
OFloor Area(Sq.Ft.): 2186
Owner R S SHAH LLC 1
Name: 14915 NE 75TH CT
Address: REDMOND WA
98052-6808
Building Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which experience has shown most severely
affect the health and safety of the general public. Although the City has made as complete a review and inspection as is reasonably possible(within budgetary time
and personnel limitations),the City neither guarantees nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance
with each and every ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon which it is
situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
DATE INSPECTOR AREA AND TYPE Vat INSPECTION
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THIS CARD IS TO 'MAIN ON-SITE
,CITYOP !ommunity Developm t Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104055-00-CO
Owner:
Address: 32114 1ST AVE S Suite C-101
FEDERAL WAY, WA 98003-5760
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.
0 Footings/Setback(4110) ❑ Foundation Wall(4115) 0 Drainage/Downspout(4040)
Approved to place concrete Approved to place concrete Approved to backfill
By Date By Date By Date
❑ Re-steel(4215) 0 Plumbing Groundwork(4190) 0 Slab/Concrete Floor(4255)
Approved to place concrete or grout Approved to cover Approved to place concrete
By Date By Date By Date
❑ Underfloor Framing(4285) 0 Floor Sheathing(4105) 0 Shear Walls(4245)
Approved to sheath floor Approved to install flooring Approved to install siding
By Date By Date By Date
❑ Roof Sheathing(4220) 0 Rough Plumbing(4230) 0 Fire/Draft Stops(4095)
Approved to install roofing Approved Approved
By Date By L-k ... Date if/"i i/i ' By Date
NOTE: Prior to scheduling a Framing(4120) ❑ Framing(4120) 0 Insulation(4150)
inspection;Electrical,Plumbing&Mechanical Approved to insulate Approved to install wallboard
Rough in and Fire/Draft Stop inspections must be
signed off and approved. IBC 109.3.4/UBC 108.5 4' l i
By1Date i/ By Date
.❑Gypsum Wallboard Nailing(4130) Suspended Ceiling Grid(4265) 0 Final-Fire Department(4060)
Approved to install mud&tape Approved to drop tile Approved
e
`By -:, Dated ,/� v of 11,y4-21--,s Date /Z--/o,-v By Date
❑ Final-Planning(4070) ❑ Final-Public Works(4080) 0 Final-Plumbing(4075)
Approved Approved Approved
By Date By Date By Date
0 Final-Building(4050)
Approved
By Date
logocc
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The 'ollowi • is rsd i 'rmation-an Inco „lets • • •lication will not be . -- CiPAIEL-riu.t `n i or .j, .
III PROPERTY INFORMATION
SITE ADDRESS: 32114 1st Ave. South, Federal Way, WA 98003 SUITE/UNIT:Suite# C-101
ASSESSOR'S TAX/PARCEL#926450-0030-05 LOT SIZE: 1.604 acres
LEGAL DESCRIPTION:Lot 38 west, Campus Office Park, Division 1, Lot 38A and 38B, KCSP 1078067 Rev Record
#7904160752
• PROJECT INFORMATION
TYPE OF PERMIT X BUILDING X PLUMBING 0 MECHANICAL
0 DEMOLITION ❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onh)
Tenant Improvement remodel, Medical Office to Dental Office
Enlarging one restroom to be ADA compliant, Moving two short walls, one for sterilization
and one for the staff room. All other walls exist.
Plumbing and wiring the operatories to convert the medical office into a dental office.
PROJECT NAME Name of Business or Owner Last Name: Dr. Ashle A. Ewen
a PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER Sudhir Shah 520.730.7892
MAILING ADDRESS CITY,STATE,ZIP
14915 NE 75th Court Redmond,WA 98052
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Olympus Construction, Inc. Robert Osmond 425.277.5444
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
PO Box 50082 Bellevue,WA 98015 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
2 0 - 0 3 - 104702 - 00 B L 12/31/2004 425.430.5412
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
OLYNPI136QS 11/04/2004
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Olympus Construction,Inc. Robert Osmond 425.277.5444
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
PO Box 50082 Bellevue,WA 98059 ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect 0 Tenant 0 Agent x Other(Describe):General Contractor 425.460.5412
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
Robert Osmond 425.277.5444 OlympusInc@aol.com
LENS_, Arc iRCW 19.274395cLomitainformation is NAME ]�
rodulred ViProl�value arca lids$6,000 !Ji. . vQ v
MAILING ADDRESS /'� OF,STATE,ZIP
32" /sf L/V! So . foo
,/1rdb#t W /4 PO 03
• DETAILED BUILDING INFORMATION
EXISTING USE: Medical Office PROPOSED USE: Dental Office
EXISTING ASSESSED/APPRAISED VALUE $1.2 million VALUE OF PROPOSED WORK $ 91,000.00
SPRINKLERED BUILDING? 0 YES x NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES x NO
WATERT SERVICE PROVIDER x L�VEN 0 HIOHLINE ❑TACOMA 0 PRIVATE(WELL)
•
R SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPT!
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
BASEMENT SQ.FT. SQ.FT. SQ.FT.
FIRST ei ) Z I m`
SECOND (P
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS =64D16 anorroecn TOTAL TOTAL sam
113761111O al TOTAL PROPOS=f TOTALIS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $1-
AIR HANDLING UNITS EVAPORATIVE•r i ERS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPL: : ' ERTS RANGES MISC(Describe)
COMPRESSORS .- ACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
t.
BATHTUBS(or Tub/Shower Combo SHOWERS Air vacuum piping for a
WATER CLOSETS(Toilet) dental office MISC
f IP (Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS Relocating one lavatory for ADA
compliance,
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS isathmomaka.) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the beat of my knowledge,and further,that I
am authorised 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 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 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 supplied to the city as a part of
this application.
NAME/TITLEl DATE / .'C' a Cf
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent 0 Contractor 0 Architect x Other:General Contractor
FOR OFFICE USE ONLY
a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—August 19,2004 Page 2 of 4 k\Handouts\Permit Application