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13-101167' Wchahicai My & Federal way Permit #. 13 101161=00ME Community & Eoon. Dev. Services • 33325 8th Ave S [ Federal Way, WA 98003 + 6 Ph: (253) 835-2607 Fa)c (253) 835-2609 h4>- Inspection Request Line: (253y835-3050 Project Name: MARC -ANTHONY CHIROPRACTIC CLINIC Project Address: 32812 PACIFIC HWY S Parcel Number. 797880 0020 Project Description: Add (2) fans to existing rooms for associated tenant improvement Owner MARC -ANTHONY CHIROPRACTIC CLINIC Aoolicant MARC -ANTHONY CHIROPRACTIC CLINIC Contractor OWNER IS CONTRACTOR 12811 8TH AVE W SUITE B103 12811 8TH AVE W SUITE B103 EVERETT WA 98204 EVERETT WA 98204 Is this an Online or O.T.C. application? ................. es Fans................................................ 2 PERMIT EXPIRES Monday, Permit Issued on Wednes . , I hereby certify that the above information is correct 9QPat the the occupancy and the use will be in accord w e laws, ,*- ancIdWitv of Feder Owner or agent: ber 9, 2013 J3,2013 on the above described property and ulations of the State of Washington Date: ,3 /3 —%? ` HIS CARD IS TO REMAIN ON-SITE cmr of TMS Construction Inspection Record Federal Way INSPECTION REQUESTS: (253) 835-3050 PERMIT #: 13 -101167 -00 -ME Address: 32812 PACIFIC HWY S Project: MARC -ANTHONY CHIROPRACTIC FEDERAL WAY, WA 98003-6408 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 0 Mechanical Rough -in (4165) 0 Gas Piping (4125) Final - Mechanical (4065) Approved 1:1Approved Approved to release test rBy Approved By ` Date By Date Date Date Rough Electrical Approved Final Electrical Approved 1:1Approved Right of Way By Date By Date By Date f Cn„OFA PERMIT tPPLICATION Federal Way RECEIVED PERMIT NUMBER �p _ a MAR 13'2013 TARGET DATE r,m r)F FFnr-om ttiAv SITE ADDRESS •3D_S 1 D— �ac� c. �� S , T- aoa` WN00 a�oo SUITE/Ung f � 'PROJECT VALUATION ZONING ASSESSOR'S TAR/PARC � � O Q © 4:�­o TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION 11ENGINEERING El FIRE PREVENTION NAME OF PROJECT Ma — A 1��N y C441 rc PK-'Aq1 C cwN 1C, PROJECT DESCRIPTION Detailed description of work to `n Q Y ` 1 �� W� a� �- �5 be included on this permit only PROPERTY OWNER NANA S 0%1 Qe/'a PRIMARY PHONE zO6 6v4t-- D MAILING ADDRESS -7/� �irsf � S •.�%� , Iveh cedes/ � "ATE Z9 �DO3 NAME PHONE NAILING ADDRESS E -MAD. CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # NAME PRI MARY PHONE APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX NAME PRIMARY PHONE PROJECT CONTACT MAILING ADDRESS E -MAH, (The individual to receive and respond to all correspondence CITY 8TATE ZIP FAX concerning this application) PROJECT FINANCING NAME ❑ OWNER -FINANCED Required value of $5,000 or more (RCW ]9.27.095) MAILING ADDRESS, CITY, STATE, ZIP PHONE 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 ci art of t is^a application. � 2 SIGNATURE: DATE 412 �3 � 3 PRINT NAME: j1�6 EUC�1 #lfioacof'/ Bulletin #100 —January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application