09-102248 '
City of Federal Way Mechanical
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Community Development Services Permit #: 09-102248-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: HEALTHPOINT-FEDERAL WAY DENTAL CLINIC
Project Address: 33431 13TH PL S Parcel Number: 768190 0070
Project Description: Installation of(1)ductless split system,relocate(6)grilles and associated ductwork.
Owner Applicant Contractor
KING COUNTY HERMANSON COMPANY LLP(GENERAL) HERMANSON COMPANY LLP(GENERAL)
500 4TH AVE 1221 2ND AVE N HERMACLO05BJ(8/25/10)
SEATTLE WA KENT WA 98032 1221 2ND AVE N
98104-2337 KENT WA 98032
i4-,,' y f Additional Per itInformation
Mechanical Valuation 3500 Is this an Online or O.T.C.application9 No
, Mechanical d
Compressors/Heat Pumps 1 Ducting...: 1
PERMIT EXPIRES Sunday, December 20, 2009
Permit Issued on Tuesday,June 23, 2009
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 a iter». ce with the laws, rules and regulations of the State of Washington
an. the Cit , edgral Way.
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Owner or agent _ 1(c.( .I + Date: i
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DATE INSPECTOR AREA AND TYPE OF IiNSPECTION
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• THIS CARD IS TOMAIN ON-SITE •
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-102248-00-ME
Owner: KING COUNTY
Address: 33431 13TH PL S
FEDERAL WAY, WA 98003-6357
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 Mechanical Rough-in(4165) 0 Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By 0, 1 Date By Date By '111 1-a'Date /Z/141
For inspector reference only
❑ Rough Electrical ❑ FINAL-Electrical
Approved Approved •
By Date By Date
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....A JUN 1 6 2009 PERMIT SF CO EL PL DE EN FP
Federal
'��Way
COMMUNITY DEI S1 fSFEDE ICATION / .> /
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253-835-2607•FAX 253- 35- 0
www.cituolfedera(wau.corn CDS
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SITE ADDRESS
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ZONING `ASSN%ES`OOR'S TAX/PARCEL# y I
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NAME or PROJECT ,` : `i)� _ al, !, kCCS
(Tenant or Homeowner Name) '�`'�Cj��`-
❑ BUILDING ❑ PLUMBING MECHANICAL
TYPE OF PERMIT ❑ DEMOLITION ❑ ELECTRICAL ❑iNGINEERING ❑ FIRE PREVENTION
PROJECT DESCRIPTIONRAki,...,m. .,N
•}Detailed description of work to be included on this permit only -
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NAME PRIMARY PHONE
PROPERTY OWNER \LA l op A 0( � ( Af �� L ie5-1 C
MAILING ADD S.CITY,STATE,ZIP E-MAIL
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OWNER IS ALSO: 0 kierr-CONTRACTORON/�, 0 APPLICANT 0 PROJECT CONTACT
NAME PRIMARY P
MAILING ADD' RESS,CITY, o D - Q105-6- iW
CONTRACTOR() ,7 7 A 2n ,r\ ` ` - V tc*- Ck<
WA STATE CONTRACTOR' • E i� XPIRATION DATE FEDERAL WA SINESS LICENSE# r'
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PRIMARY PHWIE
APPLICANT " •1L4, (�``)� 5 �U
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MAILING ADDRESS,CITY,STE, + — FAX
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PROJECT CONTACT NAME ��� • i. •, PRIMARY PHONE
(The individual to receive and S ( )
respond i all sraesponden) d ( Tlt5
s, . ^ ,6concerning this application) L. 1�.Jif ( ) _
eASERNATE CO ,-CT N...... PRIMARY PHONE E-MAIL
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PROJECT FINANCING NAME
0 OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS.CITY,STATE, PRIMARY PHONE
IRCW 19.27.095) ( ) _
I certify under penalty of perjry til hat am the property owner or authorized agent of the property owner.I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless-The Citj of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred
in the investigation and defense of such claimh\which may be made by any person, including the undersigned, and filed against the
city, but o where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information ppl ed to the city as a part oj`th'-application.
SIGNATURE: t C��t/ mik.11 --- aviip DATE [t • \tb• (
PRINT NAME: ,_- w, L:/1) A
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Bulletin#100-4/21/2009 Page 1 of 4 k:\Handouts\Permit Application
• •
MECHANICAL FIXTURES
3
Value of Mechanical Work$ ..,)``(_..) (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 OUTLETS OTHER(Describe)
XAIR 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 of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/shower combo) LAVS(Hand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
RESIDENTIAL
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 ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—4/21/2009 Page 2 of 4 k:\Handouts\Permit Application