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90-100748q o— loo-Iqg CITY OF BUILDING INSPECTION FEDERAL WAY BUILDING PERMIT 941-1555 INSPECTION REQUEST LINE - 946-6794 90-1111 CA RICHARD KOCH• DDS 33801 1 WAY S #201 PERMIT NO. OWNER'S NAME JOB ADDRESS W R HANSON 12510 130 LANE NE Al -4 KIRKLAND 821-6747 CONTRACTOR ADDRESS CONT. PHONE WRHAN**251B1 6/91 646-6065 10500 NE 8 ST #195 BELLEVUE CONT. REG. NO. OWNER'S PHONE OWNER'S ADDRESS TYPE JOB: NEW RESIDENCE ADDITION NEWINDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD NEW PUBLIC PUBLIC ADD. NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN_ GRADING OTHER COMMERCIAL ALTERATION (TENANT IMPROVEMENT) 926504-0130, 0140, 0150, 01qg-,AL LOTS 13-17 WEST CAMPUS OFFICE PARK DIV 5 ACCORDING TAX ACCOUNT NO. DESCRIPTION 0170 TO THE PLAT THERE OF RECORDED IN VOLUME 116 OF PLATS PAGES 63 IN KI NG CO WASH ISSUED BY_ ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION BUILDING INFORMATION ^VE NA OCCUPANCY_ B-2--_--_- - TYPE OF CONSTRUCTION III -1 HR BLDG. SQ. FT. OFFICE=1850 SF T BACKS: FRONT NA SIDE NA _._ REAR__ NA STORIES NA HEIGHT LIMIT NA PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS 1 ELEC. HOT WATER HEATER GAS PIPING _ FT. BOILER RECEIVED BATHTUBS LAUNDRY DRAINS _ COMPRESSOR _ TANKS) SHOWES.S URINALS FORCED AIR FURNACE AIR HANDLING UNIT _ NUMBER _ LAVATORIES DRINKING FOUNTAINS _ GAS HOT WATER HTR. MISC. SINKS ,� 5 MISC. CONVERSION BURNER BASIC FEE _ RETURNED DISHWASHERS _ TOTAL FIXTURES 6 UNIT HEATER _ TOTAL MECHANICAL AMOUNT NONE 18,722.00 VALUATION $ BUILDING DEPT APPROVAL:KEVIN ELLIS ON 7/26/90 PERMIT FEE $ 1 9R _ 00 PLAN CHECK FEE 129-00 _ PLANNING DEPT APPROVAL: NO CHANGE IN USE/OCCUPANCY PLUMBING FEE 30-00 MECHANICAL FEE _ 18-00 - FIRE DEPT APPROVAL: KEVIN ELLIS ON 7/26/90 TAL BLDG. FEES $ 3 7 5_ n n RT P/C FEE COPY TO FIRE DEPT SEPA REVIEW WATER SERVICE WATER MAIN CHG. S.B.C.C. FEE OTHER FEES $4.50 DATE PAID ` I AMOUNT $379.50 RECEIPT / AMOUNT DUE 379.50 ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE -MET: ,N 1 IG��x-✓l OWNER OR AGENT G DATE CITY OF FEDERAL WAY BUILDING PERMIT BUILDI41 NG INSPECTION PERMIT NO. OWNER'S NAME JOB ADDRESS CONTRACTOR ADDRESS CONT. PHONE CONT. REG. NO. OWNER'S PHONE OWNER'S ADDRESS TYPE JOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD. NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER TAX ACCOUNT NO. LEGAL DESCRIPTION ISSUED BY DATE OF ISSUE DATE OF APPLICATION BUILDING INFORMATION OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT. 110NE T BACKS: FRONT SIDE REAR_ STORIES HEIGHT LIMIT PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING FT BOILER BATHTUBS LAUNDRY DRAINS COMPRESSOR _ TANK(S) RECEIVED SHOWERS URINALS FORCED AIR FURNACE _ AIR HANDLING UNIT _ NUMBER LAVATORIES DRINKING FOUNTAINS GAS HOT WATER HTR. MISC _ SINKS MISC. CONVERSION BURNER BASIC FEE RETURNED _ DISHWASHERS r TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL AMOUNT VALUATION "TALDING DEPT A.PPR ?`SAL « REViN ALIS ON 7/26/90 PERMIT FEE a . 00 PLAN CHECK FEE "9.00 ;?IJMIUG D8PT "PROVALs *fit? MANGE IN USE/4=PANCY PLUMBING FEE SO. QO MECHANICAL FEE _ PM DEPT ri. PROVAL: KEVIN MAUS OL 726/9 TAL BLDG. FEES COPY TO FIRE DR" ART P/C FEE SEPA REVIEW WATER SERVICE WATER MAIN CHG./ S.B.C.C. FEE OTHER FEES e f r �a•rra Pda i �_"' * _ ,' 379. SO RrXETPT. AMOUNT DUE _-.` " ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET: OWNER OR AGENT DATE 0 0 SET BACKS AND FOOTINGS DATE____—BY—....- . . . .... OX TO POUR FOUNDATION WALLS DATE __.- —___BY PLUMBING GROUNDWORK DATE BY PLUMBING ROUGH IN DATE _c.-L.......BY zL�` WATER LINE O.K. _...._...—._._— ...... —_...... GAS PIPING O.K.__ .__ ....—.._.. -_._ MECHANICAL INSPECTION DATE __,._—__..—__BY O.K. TO ENCLOSE FRAMING DATE .. 1 ._-BY _......f_f-�~ INSULATION DATE .._ ...- —...._BY ...—_..—....--......_ WALL BOARD AND FIRE WALL DATE �.---_..._BY FINAL O.K. TO OC UPY DATE _/ _ BY _�... - .... -- DCD PSD FD ? fro 0 sic(2- rmit # l 11 z C4 CITY OF FEDERAL WAY BUILDING PERMIT APPLICATION —Please Prim A)P TC 5 T ue-A_ BOX 1 TENANT NAME: Richard L. Koch, DDS / -338,91 1�T- wpw 5i7.jl` n I OWNER SITE LOCATION West Campus, Fed ral Way OWNER'S ADDRESS - 7��°+�c;-��r�t0-;oo CITY Bellevue PHONE 646-6065 DESCRIBEJOB Tenant Improvement THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP�X CORPORATION BOX 2 CONTRACTOR'S NAME To be determined by bid CONTRACTOR'S ADDRESS EXPIRATION DATE CITY CONTRACTOR'S REG. # Card MUST be presented PHONE I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION. BOX 3 CONTACT PERSON Bruce Williams, Mi thun Partners PHONE 623-3344 BOX 4 SEWER DISTRICT Federal Way WATER DISTRICT Federal Way BOX 5 ESTIMATED PROJECT COST $95,000 EXISTING BUILDING VALUATION $2,200,000 .(oS�t 13" - -all a9-D-a'ND - D /.0.o v/ 0.07BOX 6 PROPERTY TAX ACCOUNT NUMBER ? tfGAL YE TION Lots 13, 14, 15, '16 & 17 West Campus Office Park Division 5 according i ng to Use p aL l ere o recorded in Volume o pias pages in King oun�y, Washing on. (If necessary, please submit a separate page with the legal description.) K.C. Plat Recording # BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR 17, 200 / 2ND FLOOR 17, 200 / N9S-P 3RD FLOOR 11,20 9BASEMENT / DECK / GARAGE / BOX 8 ( ) SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS = ) ( ) COMMERCIAL/INDUSTRIAL ( ) NEW CONSTRUCTION ( X ) EXISTING STRUCTURE TOTAL AREA OF PROPERTY 222,043 SQ FT BOX 9 PLUMBI(G FIXTURES (including rough -ins) �II MECHANICAL APPLIANCES — BASIC FEE $ N0. WATERCLOSETS GAS PIPING, FEET $ BATHTUBS N0. FURNACE, ELEC. GAS $ SHOWERS GAS HOT WATER HEATER $ LAVATORIES CONVERSION BURNER $ 5 SINKS BOILER, SIZE BTU $ DISHWASHERS AIR HANDLING UNITS $ ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $ LAUNDRY WASHER OUTLET UNIT HEATERS $ URINALS AIR COOLING UNITS, SIZE $ DRINKING FOUNTAINS SUMPS, SPRINKLER VACUUM BREAKERS COMMERCIAL HOOD OTHER LTl1y,,S t S $ $ DRAINS:'; �f SSC $ OTHER $ 6 TOTAL FIXTURES $ 4 . TOTAL MECHANICAL FEE $ ('g' C`G 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 PERMIT APPLICATION IS MADE. I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM (INCLUDING COSTS, EXPENSES, AND ATTORNEYS' FEES INCURRED IN 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 EMP BEES, LWON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION. OWNER/AGENT: DATE: 7- S - cl'ct) - ANP -008 3/90 OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW THIS LINE) ZONE SETBACKS: FRONT_ PLANNING DEPARTMENT APPROVAL REMARKS: _ . J/. SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL REMARKS: SIDE P REAR HEIGHT LIMIT c% �S e-- 6(/- C(7 C c t y,,,, G &,L C DATE %' �6 ` Y D PUBLIC WORKS DEPARTMENT APPROVAL 4246 DATE REMARKS: TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT NEW COMMERCIAL_ COMM. ADD/ALT NEW MULTIFAMILY (UNITS ) MULTIFAMILY ADD/ALT TENANT IMP. ' OTHER OCCUPANCY TYPE OFCONSTRU_CTION STORES r?�(C E' BUILDING SQ. FT. 1�: % �'-`' @ ;�� 6 fJ = 3 6 1 BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ BUILDING SQ. FT. @ _ TOTAL SQ. FT. TOTAL VALUATION BUILDING DEPARTMENT REMARKS: RECEIVED ASSIGNED ADDRESS: Amount PARTIAL PLAN CHECK FEE RECEIVED Date Receipt # BUILDING DEPARTMENT APPROVAL BY t_— DAT ACCEPTED FOR FILING Q' PERMIT FEE PLAN CHECK FEE PLUMBING FEE U- o MECHANICAL FEE •0C> TOTAL BLDG. FEES 17F, 00 PART P/C FEE O SEPA REVIEW b S.B.C.C. FEE OTHER FEES G AMOUNT DUE O Receipt # BUILDING DEPARTMENT APPROVAL BY t_— DAT ACCEPTED FOR FILING