93-103072 .- /0302,
CITY
335300Firstt Way South F FEDERAL WAY BUILDING P PER ISSUED:MIT NO: 112/10/9383
Federal Way, WA 98003 Building Inspection Requests 661-4140 BY.: FC
661-4000 EXPIRES: 06/08/94
ADDRESS: 181 S 333RD ST Unit: BLD A
NO. : 926500-0250
PROJECT DESCRIPTION:TI - FOR INSTALLATION OF MEDICAL GAS SYSTEM (MEDICAL OFFICE)
OWNER -- CONTRACTOR -- LENDER
COLUMBIA DENTAL GROUP MC KINSTRY CO
181 S 333RD ST BLD A 5005 - 3RD AVE S
FEDERAL WAY WA 98003 P 0 BOX 24567
SEATTLE NA 98134
762-3311 X305 762-5900
MCKIN*=372ND
BLD?:X MEC?:X PLM?: FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN .q FEES:
TYPE OF WORK:TEN USE:COM 1ST.: 0: 0:sf STORIES - 0 REQUIRED PARKING..: 0 SPRINKLERS/ 0 MEC PRMT ISSUANCE... $ 20.00
CENSUS CATEGORY •437 2ND.: 0: 0:sf HEIGHT • 0.00 ft HAZARD CLASS 0 MEC APPLIANCE FEES.* $ 11.00
OCCUPANCY GROUP 3RD.: 0: 0:sf VALUATION REQUIRED SETBACKS FIRE FLOW • 0 gps
:? :? :? :? OTHR: 0: 0:sf EXIST..$: 0 FRONT . 0.00 ft
TYPE OF CONSTRUCTION BSMT: 0: 0:sf PROP...$: 1000 SIDE • 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: 0:sf RECEIVED.:12/02/93
0: 0: 0: 0: TOTL: 0: 0:sfIII
IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.:0TH 0TH FANS 0 BOILERS/COMPRESSORS WATER CLOSETS • 0 URINALS 0 TOTAL FEES $ 31.00
GAS PIPING.: 280 ft HOOD 0 0-3 HP • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 HP - 0 SHOWERS • 0 SUMPS • 0
S HNT • 0 WOOD STOVES...: 0 15-30 HP 0 LAVATORIES . 0 VAC BREAKERS...: 0
NV BURNER: 0 FURN>100K • 0 30 50 HP 0 SINKS • 0 DRAINS 0
BBQ . 0 MISC • 1 5+ HP . 0 DISH MASHERS . 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC NTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE . 0 <=10,000 CFN: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
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 INFORMATIONrFURNISED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FERERAL NAY REQUIREMENTS MILL BE MET.
OWNER OR AGENT '�" S:1-*=14/4
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• •
7-SETBACKS & FOOTINGS
Date By
FOUNDATION WALLS
Date Bi
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PLUMBING>GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
71IhSHEAR WALLS
Date By
PLUMBING ROUGH-IN
Date By
GAS PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date By
INSULATION
Date By
•
GWB - 1ST LAYER
Date By
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDING FINAL C'2-t1-1 r `l/Y:f- -- 4,2,7N rn' 7A) r"7G',� r
Date? -%V- Gj `5 By/7-74.; lac-l) j - l(7-3 /Lt�Le
OTHER
Date By
OTHER
Date By
CD0193
•
•
. City of Federal Way
, FCEIVED
N`, �� - 2 3APPLICATION FOR BUILDING PERMIT
DEC 199
CITY OF FEDERAL WAY / n�j
PLEASE PRINT BUILDING DEPT. APPLICATION#: /L/V f ' '.
SITE LOCATION ;`:<:>?;: Address t e f 3 33 ao dt . u • 6 GO
Tenant (if known) Lot# Asse or's Tax#
Cie) ;i* L.,11\}.1 ��e..�� �,, c)U -oasD _
Budding Owner Name Address
.C":5/414 E'
City State Zip Phone
Nature of Work .1 i'.I-'T� ''e?'71c ✓, L`,il 1. 4-tai %'?Z j/ -gfvt -`'}y,Si€7✓I = .
APPLICANT ; :::.:::>.::. ::.... .
Name (F,M,L)
1\1\LV,11 )6k V--\-1 ( )...)E.Si\.;) _','J
Address 1
City J � v., State _ Zip
Contact Person Day Phone Other Phone Fax
Gi
���)77— C62 o-f//0c .-/1-42 . ,
BUMIV GG CONTRACTOR...; .
...:..................:.......................................:............................
Company Name
F \ Z--iCA—
Address •
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified 0 Yes 0 No
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
C00492(Rev 4/931
lUsti use
31 aLopose,0
Use,
Permit includes: CI Plumbing anical
❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement_ _ sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability 0 Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuatio S
Zoning Lot Size Exlstin 'Bld""aXe(uation $
...........................................................................................
Y.LNbER
Name Address
City State Zip
MECIUNICAY.:CON"T' ACTOR,
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified Cl Yes 0 No
.......... .......... ...................................................................
..........................................................................................
PLUMBING CONTRACTORigNM '>::: ::::
.......................................................................................
....... ...................................................................................
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
•
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PLUMBINGITURE aCOUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
..... ......... ... .. ........ .................................
......... .......................................................
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL.;UNIT•COUNT •
Fuel Type (electric/other) 6—P7CTT Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping „jegol Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
.................................................................
..................................................................
BBQ's Wood Stoves 3-15 Tons Total Unit Count
DISCLAIMER: 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 employees,upon the accuracy of the information supplied to the City as a part of this
application. �{
Owner/Agent: Date: , 2' - `�