09-101808 V'
City of Fde6 • PYuinding
rcornrne: =es Permit #: 09-101808-00-PL
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: HEALTHPOINT-FEDERAL DENTAL CLINIC
Project Address: 33431 13TH PL S Parcel Number: 768190 0070
Project Description: Installation of(3)clinic sinks and dental air&vacuum outlets.
Owner Applicant Contractor `
KING COUNTY NORTH COAST PLUMBING INC NORTH COAST PLUMBING INC
500 4TH AVE 9909 RAINIER AVE S NORTHCP930KA(5/30/11)
SEATTLE WA SEATTLE WA 98118 9909 RAINIER AVE S
98104-2337 SEATTLE WA 98118
� ,s �r � �iy y+ it �:, �+ �'s'''� '.,,.,,'',,..,w,, ���Asx Y� i --e-----`4e1;54,
��.\",4 � , ��E�,.,.,,,F
.. ,. ,.;,. ,��„ , r_ �. €P; a t-tires ,:,•,`..,,,, VSs , `.
Lavatories 3 Other Plumbing Fixtures 12
PERMIT EXPIRES Saturday, November 14, 2009
Permit Issued on Monday, May 18, 2009
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
,�, r and the City of Federal Way.
Owner or agent: elf yC' Date: 11 C `
t
•
DATE INSPECTOR AREA AND TYPE OF INSPECTION
• 2 0-cat S ittIts 0.4 "03--- .63fie"ep
THIS CARD IS TO MAIN ON-SITE
CITY OF Community DevelopnWnt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 -
PERMIT#: 09-101808-00-PL
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.
.El Plumbing Groundwork(4190) E Rough Plumbing(4230) Q Gas Piping(4125)
Approved to cover Approved Approved to release test
By • - „ ,41' By Date By Date
.
- 0 Final-Plumbing(4075)
/Approved
By , L/Date q/2i
0l'
••
For inspector reference only
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
... 1--..ci
A REk. x6,- \i/iD AL - t o ( 6 'R.
• Federal Way PERMIT SF MF CO ME EL • �'9E EN FP
• MAY 1 8 2009
COMMUNITY DEVELOPMENT 8 SERVICESijkr,
CATION .�
253-835-2607•FAX 253-835-2609
tvunv cihioffeder Ory '. rt,.
L 1, t� 1
Cr
,. .. CL) I • 7 ,,
,, r .x a
�F Y
3 ., a , „ hnaG.,,,c .5'..,
SITE ADDRESS
33 31 \3 VL 5
SUITE/UNIT# ZONING ASSESSOR'S TAX/PARCEL#
`.7 8 \ 9 b - 0 7
NAME OF PROJECT
_e
(Tenant or Homeowner Name) ���� `.- e)\‘,,.. '� �eGCr' �c1 LLL,y
Ve.. ...-t7c,\ C`1v\iC
0 BUILDING X PLUMBING ❑ MECHANICAL
TYPE OF PERMIT
0 DEMOLITION ❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION
PROJECT DESCRIPTION I \-5;r-,.\\ 3 �. • CAW\,C S ��k J
Detailed description of work to �\` �v� `-\ , ��` ���'`� � �"'
be included on this permit only \ ea _ �>,npp � A``{ e&- C C)9 or ) k e.. .
k.....r.. „;„a. �..,. .o..,Y..w _,. e [.... .... 4,r, ,.., :;„ . v r.0 jCt .. ..,. .. ,.# .3+. r .. Sa d'... eL,.... kW �y
NAME PRIMARY PHONE
PROPERTY OWNER V; eN ( ) -
MAILING AD ,CITY,STATE,Z E-MAIL
Scx� ( A z Sec,4c.2A /No/
OWNER IS ALSO: 0 CONTRACTOR 0 APPLicArrr 0 PROJECT CONTACT
PRIMARYNAME
NIo 4 0 E04 pkOWADt►-� C ( ) 0 - (1600
CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP 1y��Y�+n�, '-` Q 1�j4 / �j FAX [��/'�
Ct6\0A ?O‘%,‘ e.1' S 5�N."C. TI gal/8 FEDERAL BUSINESS60/SE#
WA STATE CONTRACTOR'S LICENSE# DATE
NOR7li eQ a3o KA S 3v,05,
NAME
-�/ /� �,c�/� PRIMARY PHONE
APPLICANT I'i Com"- li YL)-CC .X k (GC.)6)TY/ - 6/7/
MAILING ADDRESS,CITY,STATE,ZIP FAX
Afire .2.;e, At,e.S5 $U'jC Jp4 ��/A (ZO ' ) � -V6
PROJECT CONTACT ►* PRIMARY PHONE
(The individual to receive and Vi'``e c.-%. al-,' ( )
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) ( ) -
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
( ) -
PROJECT FINANCING NAME
/ 0 OWNER-FINANCED
Required for projects with "Y
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
Ifurther agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred
in the investigation and defense of such claim),which may be made by any person, including the undersigned,and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as/a part of this application.
SIGNATURE: At'1� 'l DATE C.. 86/0
PRINT NAME: PO-AL C �..('C'Z.-yle
Bulletin#100-4/21/2009 Page 1 of 4 k:\Handouts\Permit Application
111,
MECHANICAL FIXTURES
Vnh e of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate,number of each type offix ure 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)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commeretat)
BOILERS FURNACES HOT WATER TANKS(cas)
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(ormb/Shower Combo) LAVS(Hand Sinks) TOILE IS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS gj AL,
DRINKING FOUNTAINS S SINKS(IUtchen/utility) WATER HEATERS(rlectne) 1 fr/4 C-
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 D
OTHER(describe)
EXISTING PROPOSED
Area Totals TOTAL
"NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) ape 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
I.
(
Bulletin#100-4/21/2009 Page 2 of 4 k:\Handouts\Permit Application