10-100240 1 Phil-111 bin g
of Federal Way • W `
u`_
Development Services Permit #: 10-100240-00-PL
P.O.Box 9718
Federal way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph (253)835-2607 Fax (253)835-2609
Project Name: PAIN CENTER OF WESTERN WASHINGTON
Project Address: 350 S 333RD ST Parcel Number: 926500 0210
Project Description: Installation and roughing in(4)water closets, (7) exam room sinks,(3)other sinks,an ice
maker.water heatre,and backflow preventer
Owner Applicant Contractor
MHC PROPERTIES LLC FAWCETT PLUMBING FAWCETT PLUMBING
15109 134TH AVE E 8905 CANYON RD E FAWCEPI023LW(5/27/11)
PUYALLUP WA 98374 PUYALLUP WA 98371 8905 CANYON RD E
PUYALLUP WA 98371
- Plumbing£Fiactures .
Lavatories 4 Other Plumbing Fixtures 2 Sinks 10
Water Closets 4 Water Heaters 1 .
CONDITIONS:
Subject to field inspection without plans.
PERMIT EXPIRES Sunday, July 18, 2010
Permit Issued on Tuesday, January 19, 2010
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
.? aft /d-the City of Federal Way. /
Owner or agent: •----� Date: ` /` (VL
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THIS CARD IS TO REMAIN ON-SITE -
Federal Wayi Construction In ction Record -
INSPECTION RE UESTS: 253 835-3050
Q ( )
PERMIT #: 10-100240-00-PL Address: 350 S 333RD ST
Owner: MHC PROPERTIES LLC FEDERAL WAY, WA 98003-6321
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 Plumbing Groundwork(4190) -❑ Rough Plumbing(4230) El Gas Piping (4125)
Approved to cover Approved Approved to release test
By Date .By C\ y Date `"l —a--4t_i 3. 'By Date
o Final-Plumbing(4075) `
Approved
.By %1-40ate 7
CI Rough Electrical Final ElectricalCl Right of Way
Approved Approved Approved
By Date By Date By Date
y0 11/11'
14
- /(5� _g-°.
'11161
CITY OF C p PERMIT SF MF CO ME E PL DE EN FP
Federal Way
COMMUNITY DEVELOPMENT SERVICES Jq N 1 APPLICATION / /
253-835-2607•F 253-835-2609 "1 (j j
www.cityof( ••• - , 1 9 C i' n
SITE ADDRESS I
3.- -- 33 S, " yl‘, .-0 6-e44 6,4)." y ?;
SUITE/UNIT# 1 ZONING ASSESSOR'S TAX/PARCEL#
NAME OF PROJECT ../Dr p r Fa� i� , � /�
(Tenant or Homeowner Name) L�4i ✓'
, �( 0,‘-0,‘-/� `>tiirsTc e / 1:114- -
I: BUILDING '❑E‹)PLUMBING El MECHANICAL
TYPE OF PERMIT ❑ DEMOLITIONLECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
%/)� "ria el-/w �ii,r/f/wi I G✓ 4-/ W✓/ ✓Y2 �c.49y<T)
PROJECT DESCRIPTION '7 .6-, „ i/�/ 3. o 7-i Si���"�
Detailed description of work to ,Q
be included on this permit only )C4 M't 41 ti,, R4 14)Pr l9"//�. 1K Kari:�' f- e10—'�'> ePs. .,i2, /�
NAME ( PRIMARY PHONE
PROPERTY OWNER iii‘ /;Ya/ )C,� ee a/_ Cic„-r(e,./ kite)- . I ) -
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
OWNER IS ALSO: 0 CONTRACTOR El APPLICANT El PROJECT CONTACT
NAME PRIMARY PHONE
F OUT- PVOA6i wo.
I . � ) 31 -(oOJ
CONTRACTOR MAILING ADDRESS,CITY,STATE.ZIP i FAX
l:�j Ca wy6.t ,arm/ .p.13-- K) w✓P '.yn/1 "CI S3(- i oc) 1
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
P lAibi pi b zuA) S /27/2L,il
NAME PRIMARY PHONE
APPLICANT ( )
MAILING ADDRESS,CITY,STATE,ZIP FAX
( ) -
PROJECT CONTACT NAS ---yy PRIMARY PHONET
(The individual to receive and --L��'N.i tc.� (Z� ) -g3 7
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) g% / ,WYEC �.vj,��rl tisir f t 0 WA- 'In)/P ) ,S 1 - t w I
ALTERNATE CONTACT NAME:: PRIMARY PHONE JE-MAIL
K6- irw s r (Z' ) to0 .--0�r.sy
PROJECT FINANCING NAME
❑ OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
iRCW 19.27.095/ ( )
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to ;,;,....L. as • •• .- app Rca ion.
SIGNATURE: /I ' DATE /---/ • 2.C)l
PRINT NAME: l alk 0/ �"
Bulletin#100-January 1,2010 Page 1 of 4 k:u-Iandouts\Permit Application
0 t r
. MECHA1.
•
NICA1 O 1 Ultnn 4,,j'%/.
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLElb OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
/, PLUMBING FIXTURES %�
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
t�
BATHTUBS(orTUb/Shower Combo) f LAVS(Hand Sinks) TOILEib WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS 1 L'FL r'hIseC.4
DRINKING FOUNTAINS I D SINKS(Kitchen/unity) WATER HEATERS(Electric) Z U.f il O''EW,,g4( t rF/CG'
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ 7 .1 $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
o Yes ❑ No ❑Yes r) No
RES IDENTI
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 OJVLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL- NEW/ADDITION`
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
NEW BUILDING
ADDITION COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 1,2010 Page 2 of 4 k:\Handouts Terinit Application