19-102454 o y
Building - Commercial
City of Federal way Permit #:19-102454-00-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: EVERGREEN PROSTHETICS&ORTHOTICS
Project Address: 922 S 348TH ST Parcel Number: 114040 0020
Project Description: TI-Interior remodel for new tenant including minor demolition,construction of walls and
upgrading finishes. No plumbing or mechanical.
Owner Applicant Contractor Lender
EVERGREEN PROSTHETICS& BLOX CONSTRUCTION BLOX CONSTRUCTION OWNER IS LENDER
ORTHOTICS PO BOX 626 PO BOX 626
34709 9TH AVE S EVERETT WA 98206 EVERETT WA 98206
FEDERAL WAY WA 98003
Census Category: 437-Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 0.00
Additional Permit Information
Mechanical to be Included" No Plumbing Work Valuation? 0
Mechanical Work Valuation" 0 Number of Stories 1
Is this an Online or 0.T.C.application? Yes Permit for Building Shell Only" No
Plumbing to be Included" No Occupancy#1-Use Professional
Services/Offices
Comprehensive Plan Designation Office Park Zoning Designation OP
Total Valuation:90,000.00
stv;c... ? a r _ a`^' "yam.
PERMIT EXPIRES Sunday, 17 November,2019
Permit Issued on Tuesday,May 21,2019
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
ashington and the City of Federal Way.
Owner or agent: `v Date: 11 Z 1 \ l
THIS CARD IS TO REMAIN ON-SITE "'
CITY OP Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 19 102454 00 Address: 922 S 348TH ST Bldg B
Project: EVERGREEN PROSTHETICS& OR FEDERAL WAY WA 98003-7051
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) ! ® Footings/Setback(4110) 0 Re-steel(4215)
To be done PRIOR to breaking ground
s Approved to place concrete Approved to place concrete or grout
By Date By Date By Date
4❑ Slab/Concrete Floor(4255) s❑ Underfloor Framing(4285) ® Floor Sheathing(4105)
Approved to place concrete Approved to sheath floor Approved to install flooring
i
•By Date By Date By Date
El Fire/Draft Stops(4095) ® Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in
and Fire/Draft Stop inspections must be sigaed-
By Date By Date off and approved. IBC 109.3.4
® Framing(4120) 1 ® Insulation(4150) In Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date By Date By Date
,
El Suspended Ceiling Grid(4265) El Final-S K F&R(4060) 74 Final-Planning
Approved to drop tile Approved Approved
1
By G.I . Date AO/? f / �'�By Date 1 By Date
O Final Erosion Control(4375) El Final-Building(4050)
Approved Approved
*By Date ��BY 414 Date til I`'( 19 •
1
Li
Rough Electrical Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
A
CITY OF MAY 21 2019 PERMIT APPLICATION
Federal Way On OF FEDEFW.WAY PERMIT CENTER+33325 8°'Avenue South+Federal Way,WA 98003-6325
COMMUNITY DEVELOPMENT 253-835-2607+FAX 253-835-2609+per nitcenteisicitvoffederalway.com
PERMIT NUMBER J / - / . _a 5 4_ - __C-1) TARGET DATE 'D7 .1 i io• 3
SITE ADDRESS SL ���SS�rrr IT SUITE/UN #
C/$69) (9.41 S.%. 3 Yet- soli-
..„
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PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT UILDING 0 PLUMBING ❑ MECHANICAL ❑ DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
A
NAME OF PROJECT E Jz"..e_�n ?{d✓j P^ I ( S ori -S
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PROJECT DESCRIPTION
Detailed description of work to 1 ( — r\f -:-J 4 .) ,' ( 0) ` ..`-‘\- de ,--‘c-.., d�c.,"
be included on this permit only 5 f Aet- .) ,cs ( f
NAME __I ._
" . _ PRIMARY PHONE -...
r.
L cJerjree- p()S T`tCT.'r5 f Of i �ZS
PROPERTY OWNER MAILING ADDRESS/ ' E-MAIL
'34-0‘-)CA `ice ti ,�,�V
CITy,....-_, .`r-., \ t,/ STATE ZIP
4/4- �f c U 3
...... NAME !- q PHONE
10�c ecY*1 SI("V(..i-? - = 339 - 09*E 3
MAILING ADDRESS MAIL
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CONTRACTORCAY }�- ,A) / / ✓� /+ ---(.0 .,'?",---? C.u..�.,
e t e_("a 1 7 W Ta ZI'�i Z�. t✓ G z-i CJ�� —`l
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
1UAcXCC_l_cl c3lDCK. iQ ( C) /..;)C-1, SC-- tri— tvZ S-Z--uu- 3`.
_ NAME �pr PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME M PRIMARY PHONE
PROJECT CONTACT 3f Jt. •
_ ' [G��'41 .ct (14 J w'42-1 -6L E'?
(TheMAIL DRESS E-MAIL
individual to receive and 0� �% r e <v�tc),�c�,�1.r-,4.V VA-of,,�-;,-L
respond to all correspondence l �' C�
concerning this application) CITY STAT ZIP , FAX
L vzr-e� kA - tt V 'c,6
NAME , --O
PROJECT FINANCING WNER-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 ODII 1/
G�
PRINT NAME: - r():c 6 ` ^' •
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(commer ie))
BOILERS FURNACES / HOT WATER TANKS(Gee)
COMPRESSORS GAS LOG SETS 'rREFRIGERATION SYST
DUCTING GAS7Y1 WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
:
r.
Indicate how many of each type o ixture to be installed or relocated as part of this pro'ebt.Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower combo LAYS(Hand Sinks) TOIL ' WATER PIPING
DISHWASHERS z RAINWATER SYSTEMS U' NALS OTHER(Describe)
DRAINS SHOWERS / VACUUM BREAKERS
DRINKING FOUNT S SINKS(Otchen/Utility) ,✓ WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
I/ ft Lit A
S
EXISTING/ VIO S USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPP ION SYSTEM?
D -- ce, /\1
A_ ❑Yes ❑ No 0 Yes 0 No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASgMENT: ',....'Ll'619 F
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
, m .
COVERED ENTRY
� z
GARAGE ❑ CARPORT El
OTHER(describe)? -, .{
EXISTING I PROPOSED •TAL
Area Totals
*• , HOMES ONLY
ESTIMATED SELLING PRICE '. #OF : DROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
NEW BUILDIN(
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
TOTAL BUILDING , 6"1 "'; !. 4
TENANT AREA ONLY 61 Z + t
PROJECT AREA ONLY" '� }
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application