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07-101838
t • Community'ty of Federal Deveopme1ntServices Bay uffing - Commercial Perm#: 07-101838-0U-00 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: GERIATRIC DENTAL GROUP r E,r _� Project Address: 728 S 320TH ST Suite A Parcel Number: 082104 9050 Project Description: TI-Interior improvements for dental office in previous chiropractic office space. Includes plumbing and mechanical for exhaust venting. Owner Applicant Contractor Lender CAPITAL SQUARE ASSOCIATES MCBEE&CO INC MCBEE&CO INC FUNDED BY GRANTS 31919 1ST AVE S P.O.BOX 70124 MCBEECI066LZ(6/14/08) FEDERAL WAY WA 98003 BELLEVUE WA 98005 P.O.BOX 70124 BELLEVUE WA 98005 Census Category: 437 - Commercial alt/add/conversion Includes: #1 #2 #3 #4 Occupancy Class: B Construction Type: Type V-B Occupancy Load: Floor Area(sq. ft.) 2,150 0 0 0 Additional Permit Information Existing Sprinkler System in Building? No Mechanical to be Included9 Yes Number of Stories 1 Permit for Building Shell Only? No Plumbing to be Included? Yes New/Additional Sq.Feet-Total 0 Occupancy#1 -Use Professional Zoning Designation OP Services/Offices Mechanical Fixtures Fans 4 Plumbing Fixtures Laundry Washer Outlets 1 Sinks 3 Water Closets 2 PERMIT EXPIRES Monday, April 6, 2009 Permit Issued on Friday, April 6, 2007 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 gent: ,�4,.L"" jii/k Ii--� -C Date: C `'" ' DC7 / C{qty. 01. Fzderal Way • • ' Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 110.2 of the International 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: GERIATRIC DENTAL GROUP Permit#: 07-101838-00-CO Address: 728 S 320TH ST SuiteA Includes: #1 #2 #3 #4 Occupancy Class: B Construction Type: Type V- B Occupancy Load: Floor Area(sq. ft.) 2,150 0 0 0 Owner Name: CAPITAL SQUARE ASSOCIATES Owner Address: 31919 1ST AVE S FEDERAL WAY WA 98003 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 Beverly 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. Cit of Faderal Way Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 110.2 of the International 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: GERIATRIC DENTAL GROUP Permit#: 07-101838-00-CO Address: 728 S 320TH ST SuiteA Includes: #1 #2 #3 #4 Occupancy Class: B — Construction Type: Type V-B Occupancy Load: Floor Area(sq. ft.) 2,150 0 0 0 Owner Name: CAPITAL SQUARE ASSOCIATES Owner Address: 31919 1ST AVE S / FEDERAL WAY WA 98003 Z /oP/6 7 Buildin fficial 9 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 severly 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 lana upon , which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises. `_ • City of Federal Way Busing - Commercial Perm#: 07-101838-00-C O Community Development Services 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: GERIATRIC DENTAL GROUP Project Address: 728 S 320TH ST Suite A Parcel Number: 082104 9050 Project Description: TI-Interior improvements for dental office'in previous chiropractic office space. Includes plumbing and mechanical for exhaust venting. INCLUDES-Air supply and vacuum as per drawings. Owner Applicant Contractor Lender CAPITAL SQUARE ASSOCIATES MCBEE&CO INC MCBEE&CO INC FUNDED BY GRANTS 31919 1ST AVE S P.O.BOX 70124 MCBEECI066LZ(6/14/08) FEDERAL WAY WA 98003 BELLEVUE WA 98005 P.O.BOX 70124 BELLEVUE WA 98005 Census Category: 437 - Commercial alt/add/conversion Includes: #1 #2 #3 #4 Occupancy Class: B Construction Type: Type V-B Occupancy Load: • Floor Area(sq. ft.) 2,150 0 0 0 Additional Permit Information Existing Sprinkler System in Building? No Mechanical to be Included9 Yes Number of Stories 1 Permit for Building Shell Only? No Plumbing to be Included? Yes New/Additional Sq.Feet-Total 0 Occupancy#1 -Use Professional Zoning Designation OP Services/Offices Mechanical Fixtures Fans 4 Plumbing Fixtures Laundry Washer Outlets 1 Sinks 3 Water Closets 2 PERMIT EXPIRES Monday, April 6, 2009 Permit Issued on Friday, April 6, 2007 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: Date: THIS CARD IS TO MAIN ON-SITE • r -.� �ommuni Develo m t Inspection Record Cllr,►o� � A tii I ty p p Federal Way IVR INSPECTION REQUEST PHONE # (253) 835®3050 PERMIT#: 07-101838-00-CO Owner: CAPITAL SQUARE ASSOCIATES Address: 728 S 320TH ST Suite A FEDERAL WAY, WA 98003 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. O Footings/Setback(4110) ❑ Re-steel(4215) 0 Plumbing Groundwork(4190) Approved to place concrete Approved to place concrete or grout Approved to cover By Date By Date By Date ❑ Slab/Concrete Floor(4255) #❑ Underfloor Framing (4285) 1_, Floor Sheathing(4105) Approved to place concrete Approved to sheath floor Approved to install flooring By Date By Date By Date C,,,!1 te t�n-v�' ❑ Rough Plumbing(4230) '/ ❑ Mechanical Rough-in (4165) • ❑ Gas Piping(4125) Approved h i,;I s,;;''j Approved Approved to release test 11 By C W Date 4-. 17_ 1,7 By Date By Date ` O Fire/Draft Stops (4095) NOTE: Prior to scheduling a Framing(4120) ❑ Framing (4120) Approved inspection;Electrical,Plumbing&Mechanical Approved to insulate Rough-in and Fire/Draft Stop inspections must be By Date signed-off and approved. IBC 109.3.4/UBC 108.5.4 By Date ❑ Insulation (4150) ❑Gypsum Wallboard Nailing(4130) ❑ Suspended Ceiling Grid(4265) Approved to install wallboard Approved to install mud&tape Approved to drop tile By Date By � Date z�� By Date ❑ Final-Fire Department(4060) ❑ Final-Planning (4070) ❑ Final-Mechanical(4065) Approved Approved Approved By G L Date (o/S�L' By Date By Date • ❑ Final-Plumbing(4075) ❑ Final-Building(4050) Approved / Approved By J Date tt�/S/d 7 By 1-f Date c-.7/,&/(3) L/ U (X �' N 6- 6v Re5.7 00 *,� & �. . — sib ( G //7 Ule��l GEIVb© r APR 00/007 �% 1,9-- - / (///) J LITY OF �. y Federal Way CITYO` )rEDERAL�' RMIT COMMUNITY DEVELOPMENT SERVICES p A1t' DE EN FP 3332F D AVENUE WAY.WPIR•PO 6390X97184g� {.��rLICATION O(III3iII / FEDERAL WAY.WA 98063-9718 253-835-2607•FAX 253-835-2609 www.ci(uollede,olu:ulj WUI The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. • PROPERTY INFORMATION sITEADDRESS 728 South 320th, Federal Way. Wa. 98003 SUITE/UNIT# # A 0 ASSESSOR'S TAX/PARCEL# 8 2 1 0 4 _ 9 2 6 5 LOT SIZE(sJ) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) See Attachment (Attach separate pagefar lengthy/ego/description) • PROJECT INFORMATION TYPE OF PERMIT {i7 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detnilvd description of work included on this permit oniti) Adapt existing space from previous use as Chiropractic office to Dental office (NO MEDICAL GAS TO BE USED) Adjust bathrooms to be ADA compliant. Add cabinetry, new floor covering . paint. Add Compressed air lines anr) vacuum lines to dPrltpl ,14.air locations. Add Dental x-ray. PROJECT NAME(Name of Business or Owner Last Name) Geratric Dental Group • PEOPLE INFORMATION PROPERTYPRIMARY PHONE OWNER NAME Capitol Square LLC % Mary Kaercher (206 ) 725-9.600 MAILING ADDRESS CITY,STATE,ZIP ma vE pitolsquare @ATT.N. P.O. Box 18194 Seattle. WA 98118-0194 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE McBee & Co. , Inc. George McBee (425 ) 702-6367 MAI ING CITY,STATE,ZIP CELL PHONE P.n. Ig0Dr/0124 Bellevue, WA 98005 ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER 20-07-100628-00-BL 12/31/07 (425 ) 867-1960 CONTRACTORS REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS °0t =$? MCBEECI066LZ george@mcbeecoinc.com APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE McBee Co. , Inc. George McBee (425 ) 702-6367 MAILING ADDRESS CITY.STATE,ZIP CELL PHONE P.O. Box 70124 Bellevue, WA 98005 ( ) - RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect ❑Tenant rtAgent ❑ Other Contractor (425 ) 867-1960 NAME 3677 1.E.indeamy@yahoo.com PROJECT PRIMARY PHONE S ( 5n 3 ) 7 72 CONTACT Amy Linder LENDER NAME Per RCW 19.27.095: None - Non Profit Lender information is required lfproject value exceeds$5,000 MAILING ADDRESS CM'.STATE.ZIP PHONE Funded by Grants ( ) • DETAILED BUILDING INFORMATION EXISTINGUSE Physician's Office PROPOSED USE Dental Office EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ -lam` ,0007- 55) PO, SPRINKLERED BUILDING? ❑YES 21 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES a NO WATER SERVICE PROVIDER 51 LAKEHAVEN ❑ HIGHLINE n TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) U PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST Existing - No Additions 2 , 150 SECOND THIRD ADDITIONAL FLOORS(DESCRIBE)-- DECK(❑COVERED-elf E UNCOVERED?) GARAGE t1 CARPORT E EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF NUMBER OF FLOORS **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ • FIXTUJRES Indicate number of each type of fixture to be installed or relocated ps part of this ect. Do not include existing fixtures to remain. MECHANICAL01 S' Value of Mechanical Work$ 600.00 "' (AOPY OF'BID OR ESTIMATE MUST BE INCLUDED WITH APPLICA77OM Mechanical to Remain AS IS AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS `I FANS Exhaust GAS WATER HEATERS 1 MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(Commercial) Dryer Vent COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(orTub/ShowerCombo) LAYS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS 5 vacuum outlets DRINKING FOUNTAINS SHOWERS 2 WATER CLOSETS rrb"e 7 Air outlets ELECTRIC WATER HEATERS 3 SINKS 1 WASHING MACHINES HOSE BIBBS SUMPS SIGNATURE I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I am authorized 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. �yf� AØI/dWi/ NAME/TITLE ✓ s a_., c�.P".>rr4)2n L( " DATE April 4, 2007 (SlgTature) S RELATIONSHIP TO PROJECT ❑ Owner ❑Agent DI Contractor ❑Architect 0 Other FOR OFFICE USE ONLY ❑ NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES ❑NO ZONING DESIGNATION CHANGE OF USE? o YES ❑NO NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ❑YES ❑NO PLATTED LOT? o YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO Bulletin#100—April 2,2007 Page 2 of 4 k\Handouts\Permit Application