12-104864Building - Corn-
mercial
City of FedeCommunity & Econ. Way s vices Permit #: 12 -104864 -00 -CO
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253 83
Ph: (253) 835-2807 Fax: (253) 835-2809 p q � � 5-3050
Project Name: STERLING DENTAL CARE
Project Address: 30640 PACIFIC HWY S Unit A
Parcel Number: 092104 9102
Project Description: TI - Interior modifications for new tenant including removal of existing partition walls,
adding partition walls, replacement of single pane windows & adding (5) hand lays. No
mechanical. **2/2U13 Add electric hot water tank**
Owner
ARRIIcant
Contractor
Lender
ROBERT 7 VERZANI
MILAN HEGER
L7 REMODELING
OWNER IS LENDER
30640 PACIFIC HWY S
HEGER ARCHITECTS
L7REMR*911P9 (5/9/14)
FEDERAL WAY WA 980034889
234 DEXTER AVE N
2348 N 145TH ST
SEATTLE WA 98109
SHORELINE WA 98133
Census Category: 437 = Commercial alt / add / conversion
Includes:
#1 #2 #3 #4
Occupancy Class:
B
Construction Type:
Type V - B
Occupancy Load
Floor Areas . ft.
1,626 0 0 0
Additional Permit Information
Building Pre -con. Meeting Required?...................No Existing Sprinkler System in Building? ................. No
Mechanical to be Included?...................................No Number of Stories ................................................. 1
Permit for Building Shell Only?............................No Plumbing to be Included? ....................................... Yes
Special Inspection(s) Required? .............................No New / Additional Sq. Feet - Total.......................... 0
Occupancy #1 - Use ............................................... Professional Zoning Designation................................................BC
Services/Offices
Plumbing Fixtures
Lavatories ....................................... 5 Water Heaters................................. 1
PERMIT EXPIRES Monday, April 29, 2013
Permit Issued on Wednesday, October 31, 2012
I hereby certify that the above information is correct and that the construction on the above described properly and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
an the City of Federal Way.
Owner or agent: Date: ;X /3
City of Federal 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 Chy staff.
Tenant Name: STERLING DENTAL CARE
Address: 30640 PACIFIC HWY S UnitA
Permit #: 12 -104864 -00 -CO
Includes:
#1 #2 #3 #4
Occupancy Class.
B
Construction Type:
Type V - B
Occupancy Load
Floor Area (sq. ft.) 1
1,626 0 1 0 0
Owner Name: ROBERT J VERZANI
ROBERT J VERZANI
Owner Name:
Owner Address: 30640 PACIFIC HWY S
FEDERAL WAY WA 980034889
144e-1
Buildir
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 sevedy 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 itis situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
City of Federal Way
Community & Econ. Dev. Services rnm
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2807 Fax: (253) 835-2809 I L
Project Name: STERLING DENTAL CARE
Project Address: 30640 PACIFIC HWY S Unit A
Building - IColumercial
Permit #: 12 -104864 -00 -CO
Inspection Request Line: (253) 835-3050
Parcel Number: 092104 9102
Project Description: TI - Interior modifications for new tenant including removal of existing partition walls,
adding partition walls, replacement of single pane windows & adding (5) hand lays. No
mechanical.
Owner
AR lig cant
Contractor
Lender
ROBERT J VERZANI
MILAN HEGER
L7 REMODELING
OWNER IS LENDER
30640 PACIFIC HWY S
HEGER ARCHITECTS
L7REMR*911P9 (5/9/14)
FEDERAL WAY WA 98003-4889
234 DEXTER AVE N
2348 N 145TH ST
SEATTLE WA 98109
SHORELINE WA 98133
Census Category: 437 - Commercial alt / add / conversion
Includes:
#1 #2 #3 #4
Occu ancy Class:
B
Construction Type:
Type V - B
Occupancy Load-
oadFloor
FloorAreas . ft.
1,626 1 0 1 0 0
Additional Permit Information
Building Pre -con. Meeting Required?...................No Existing Sprinkler System in Building? ................. No
Mechanical to be Included?...................................No Number of Stories. ................................................. 1
Permit for Building Shell Only? .............................No Plumbing to be Included? ....................................... Yes
Special Inspection(s) Required? .............................No New / Additional Sq. Feet - Total.......................... 0
Occupancy # 1 -Use ............................................... Professional Zoning Designation...............................................BC
Services/Offices
Plumbing Fixtures
Lavatories ....................................... 5
PERMIT EXPIRES Monday, April 29, 2013
Permit Issued on Wednesday, October 31, 2012
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
nd the City of Federal Way.
00 l Z
Owner or agent: Date: �p �3 —
City of Federal 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 bye staff,
Tenant Name: STERLING DENTAL CARE
Address: 30640 PACIFIC HWY S UnitA
Permit #: 12 -104864 -00 -CO
Includes:
#1 #2 #3 #4
Occupancy Class:
B
Construction Type:
Type V - B
Occupancy Load
Floor Area (sq. ft.)
1,626 0 0 0
Owner Name: ROBERT J VERZANI
ROBERT J VERZANI
Owner Name:
Owner Address: 30640 PACIFIC HWY S
FEDERAL WAY WA 98003-4889
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 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 land upon
which itis situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
CITY OF
Federal Way
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 12 -104864 -00 -CO Address: 30640 PACIFIC HWY S Unit A
Project: ROBERT J VERZANI FEDERAL WAY, WA 98003
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.
13
SWM Precon Site Mtg (4400)Initial
Erosion Control (4365)
Final Electrical
Approved
Footings/Setback (4110)
1:1Approved
Approved
By
To be done prior to breaking ground
Approved to place concrete
By
Date
By
Date
By
Date
13
Re -steel (4215)
Plumbing Groundwork (4190)
Final Electrical
Approved
Slab/Concrete Floor (4255)
1:1Approved
Approved to place concrete or grout
By
Approved to cover
Approved to place concrete
By
Date
By
Date
By
Date
Underfloor Framing (4285)
Floor Sheathing (4105)
Rough Plumbing (4230)
Approved to sheath floor
Approved to install flooring
Approved
By
Date
By
Date
By
Date
Fire/Draft Stops (4095)
Interim Erosion Control (4370)
prior to schedulingEaFraming inspection;
Approved
Approved
Electrical, Plumbing &hanical Rough -in anByZ-CS
Date I I _ z�_ 2
By
Date
Fire/Draft Stop inspectiust be signed off anapproved109.3.4
Gypsum Wallboard Nailing (4130)
❑
Framing (4120)
Insulation (4150)
Approved to insulate
Approved to install wallboard
Approved to install mud & tape
By� S Date I _ _ (
By
�C Date //.-;?7_1Z
By
VK- Date IZ-%f' 12
Suspended Ceiling Grid (4265)
Final - Fire Department (4060)
❑
Final - Planning
Approved to drop tile
Approved
Approved
By
Date
By Cl Date Z — 2/-
By
Date
11
Final Erosion Control (4375)
Final - Plumbing (4075)
Final - Building (4050)
Approved
Approved
Approved
By
Date
By
Date Z _ 2dr -1 3
By
Dates -
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
Federal Way
Building 4ivision
33325 Eighth Avenue Sovih
Federal Way, WA 98003-6325
Phone 253-835-2607 Fax 253-835-2609
CORRECTION NOTICE
ADDRESS:. w � �� �, r 'W <� PERMIT#:
of p r` X--
/'141 ,d�,t/ ;72)
S
IF YOU HAVE QUESTIONS CALL/ (253) 835- 2-
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 R RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
2 : 7, C) 113
DAT
�?f
INSPECTOR
DO NOT REMOVE THIS NOTICE
Page 4off%
CITY OF D
Federal NaceIVE 0 PERMIT
COMMUNITY DEVELOPMET SERVICES ti APPLICATION
253-835-2 4 2p2
unuur. ritRoj�dera!uuz1. ren+
MF ICO) ME PL DE EN FP
7//
SITE ADDRESS
�jo6�p n pari c HWT S' f&de*-iG( Wn , W'4 ct?003
SUITE/UNIT #
PROJECT VALUATION
ZONINd
ASSESSOR'S TAX/PARCEL #
$40 00D
Co
0 f- 2 _/ 0
TYPE OF PERMIT
5LBUILDING ❑ PLUMBING ❑ MECHANICAL
91 DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
-5 fe r kvu Delo Cam
J
Rewc O a non - s -1r yc&W rod r
PROJECT DESCRIPTION
Detailed description of work to
n st-o fig non— 4N '!Li' l
14 Pb la r e WO /J 1 t
lri
be included on this permit only
r r 'z
GL(t 431a Cl e.
PROPERTY OWNER
NAME &I PRIMARY PRONE
MIA& Nogkqe4n, d Zac 777 _ 771F
MAILING ADDRESS V W. E-MAIL
e
&C
0 4 q 0
CITY" - _ v"AA
STATE(
ZIP j O D
a.
'
NAME I aU-to / /cZ
PHONE Ur -O ;1'r���
p NADDRESS
� � � J � E-MAIL
CONTRACTOR
CITY � I f / _ STATE(
W' /
ZIP /arFAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE #
NAME /PHONE�a via wf k8�
MAILING ADD s V
la
APPLICANT
CITY / � /
Y"'L/I &
'S/T�AT ZIP F
v Y IF102
PROJECT CONTACT
NAME PHONE
(The individual to receive and
,(�, /� l EMAIL
MAILING ADD:n I " '
Z3 i
respond to all correspondence
concerning this application)
I / v
CITY
STATE
ZIP n �/O FAX
ALTERNATE CONTACT NAME:
PHONE? E-MAIL
em -_01692
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $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 T
PRINT NAME: !• /i �^ e
Bulletin #100 —January 1, 2011 61 Page 1 of 3 k:Wandouts\Permit Application
0a -
4P
VALUE OF MECHANICAL WORK $ (a copy or estimate must be provided)
Indicate how many of each type of fixture to be installed or relo as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREP INSERTS HOODS (Commercial)
BOILERS NACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate how many of each typc
BATHTUBS (or Tub/shower combo)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
to be installed or relocated as
LAYS (Hand Sinks) _
RAINWATER SYSTEMS _
SHOWERS _
SINKS (Kitchen/utility) _
SUMPS
f this project. Do not include
TOILETS _
URINALS _
VACUUM BREAKERS
WATER HEATERS (Electric)
WASHING MACHINES
Bulletin #100 —January 1, 2011 Page 2 of 3 k:\Handouts\Permit Application