17-103594 fft
Building - Commercial
City°fFederal Way -� -- -- Permit #:17-103594-00-CO
Community Development Dept.
33325 8th Ave S •
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: LIFE CARE CENTER
Project Address: 1045 S 308TH ST Parcel Number:082104 9042
Project Description: ADD-Construction of a structural slab for the installation of a 1333 gallon,UL-142,Subbase
tank.Installation of UL listed equipment by Electrical Permit.Fire department final required.
Owner Applicant Contractor Lender
FEDERAL WAY CONVALESCENT KEITH JONESD SQUARE ENERGY D SQUARE ENERGY LLC OWNER IS LENDER
CENTER LLC 201 W NORTH BEND WAY
3001 KEITH ST NW 201 W NORTH BEND WAY NORTH BEND WA 98045
CLEVELAND TN 37312 NORTH BEND WA 98045
•
Census Category: 437-Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.)
Additional Permit Information
Mechanical to be Included? No Number of Stories 1
Is this an Online or O.T.C.application No Permit for Building Shell Only? No
Plumbing to be Included? No
Total Valuation:4,898.00
n,�F
PERMIT EXPIRES Sunday,8 April,2018
Permit Issued on Tuesday,October 10,2017
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: 4 Date: /CV io / /7
THIS CARD IS TO REMAIN ON-SITE
40°4
CITY
Wa Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 103594 00 Address: 1045 S 308TH ST
Project: FEDERAL WAY CONVALESCENT 4 FEDERAL WAY WA 98003-4706
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.
❑ Initial Erosion Control(4365) 0 Footings/Setback(4110) El Foundation Wall(4115)
To be done PRIOR to breaking ground Approved to place concrete Approved to place concrete
By Date By Date By Date
„ •
4❑ Drainage/Downspout(4040) � Re-steel(4215) .,
. l Slab/Concrete Floor(4255)
Approved to backfill Approved to place concrete or grout Approved to place concrete
By Date . By 0.,-1,„\,..4 Date t b -- -1-, ..By e us.,,, Date 1 0.2 Cs'\-1, .
•❑ Underfloor Framing(4285) ' ® Floor Sheathing(4105) i El Shear Walls(4245)
Approved to sheath floor I Approved to install flooring I Approved to install siding
By Date By Date ! By Date
I=1 Roof Sheathing(4220) 0 Fire/Draft Stops(4095) 121 Interim Erosion Control(4370)
Approved to install roofmg Approved Approved
By Date By Date By Date
•
Prior to scheduling a Framing inspection; 13 Framing(4120) 14 Insulation(4150)
Electrical,Phimbing&Mechanical Rough-in Approved to insulate Approved
and Fire/Draft Stop inspections must be signed- to install wallboard
off and approved. IBC 1093.4 By Date By Date
El Gypsum Wallboard Nailing(4130) El Suspended Ceiling Grid(4265) El Final-S K F&R(4060)
Approved to install mud&tape Approved to drop tile Approved
By Date By Date By Date
4.• t
El19 Final-Planning Final Erosion Control(4375) El Final-Building(4050) '
Approved Approved Approved
By Date• ��By Date ,:.By 0n9 Date \_3�-..l�
•
ID Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
CRY OF 0641 Ilhl RECEIVED PERMIT APPLICATION Federal Way +fin
JUL 2 2017 PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcenter cityoffederalway.com
I CITY OF FEDERAL WAY G /�
PERMIT NUMBER / !!MMUg/3 0/ /`
7
TARGET DATE
SITE ADDRESS SUITE/UNIT#
` o($ SP 3o ar4 s-F
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
cip
$ 1i gam• Q- 1 -o- - 5_ o
TYPE OF PERMIT lk$UILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT G .tAA-o ,, Rally / r
PROJECT DESCRIPTION fetA�"id? 111,1%
"La) CD,Irp.a4.4.. tan,.tan,. Tbr G•. r
�.
Detailed description of work to 1L(.►. O Iy,$„ X 330
be included on this permit only
NAME PRIMARY PHONE /15
PROPERTY OWNER L1f� Care_ C...4.41444- Rio-Slit”lir-3
ADDRESSMAILING
3 601 .Kl l rlL sr 41n/ S'liN..WIL:+a..e lus..0r►
CIC TY STATE ZIP
.Q.va.lahrl. T'E'L 373/z-3113
NAME.b Stl uar._. f4...�4 LLC_ gitS g 8 it-L88Z.
MAILING ADDRESS-t Q E-MAD.
CONTRACTOR 161 Lai A £..11'. 0.4 4.44, fi d ZO.M don.!,M
CKbI .�aa�. ZIP
Dis_
FAX
$L6- 342.- S577.-
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
N E LLI�IS£ X45- , 8 i tl /1?
NAME ' PRIMARY PHONE
Kos fit xon. .s 204-IGI-issr
APPLICANT MAILING ADDRESS E `
201 14 40441 B•4101 1. 4-y K, 1@ d1.2. t rs1.6•01
AY STATE ZIP FAX
A.A.I.tek WA 12044,5"
NAME PRIMARY PHONE
PROJECT CONTACT Ku
'44 3e ...4 Zvi.'7411-1S3S
(The individual to receive and MAILING ADD s i I E-MAIL .•per
respond to all correspondence ZS I W 4. B WAY Kts �l�.t2lati + Y.CIM.
concerning this application) C 4 k r�E ZIP
rgo ts FAX
NAME iV
PROJECT FINANCING OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP 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.
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 the city as a part of this application.
•
SIGNATURE: DATE g_11- 17
PRINT NAME: K'�..1 a.1546-.0
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many 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)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
$
Indicate how many of each type of fixture to be installed or relocated as part ofT this project.Do not include existing fixtures to remain.
BATHTUBS(ornb/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) fif
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
s4 34r7 .o
EXISTING/PREVIOUS USE LOT SIZE(Ia Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Woes❑ No ❑Yes p/fVo
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
t.s .:..4z
FIRST FLOOR(or Mobile Home)
fix" `rr tt P
3 , 'ed
COVERED ENTRY
oT..`5* . .. r a i.. ♦. .S .a+.. �$ L r ..`'+.'rvw.w y_mt ,. Ym' ,,;3`y4 _.
GARAGE 0 CARPORT 0
1,ME ( k z, >
Area Totals EXISTING PROPOSED TOTAL
44
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
Area in Construction #of
AREA DESCRIPTION Occupancy Group(s)
Stories Additional Information
Square Feet
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
Area in Construction #of
AREA DESCRIPTION Occupancy Groups) Type Stories Additional Information
Square Feet
TOTAL Bynam Y
TENANT AREA ONLY + �■ p t
PROS t,AREA 1
tA.rsis: no+t4t. _ '..
Bulletin#100-January 29,2016 Page 2 of 2 k:\Handouts\Permit Application