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12-103137 *Building T Cormrcial City of Federal Way Permit #: 12-103137-00-CO Community 8 Econ.Dev.Services 33325 8th Ave S Federal Way,Fax Inspection Request Line:saoo3 (253)835-3050 Ph:(253)835-2607 Fax:(253)835-2609 Project Name: BELLA DENTAL Project Address: 34410 16TH AVE S Unit 109 Parcel Number: 250090 0040 Project Description: TI-INITIAL Interior improvements to create partitions,equipment,finishes and lighting. Mechanical and plumbing on separate permits. Owner Applicant Contractor Lender BELLA DENTAL PAIGE LAUER J C I CONSTRUCTION INC BANK OF AMERICA 34410 16TH AVE S SUITE 109 OFFICE WRAPS JCICOI*990NW(8/16/13) 600 N CLEVELAND AVE UNIT 300 FEDERAL WAY WA 98003 570 KIRKLAND WAY SUITE 201 31073 9TH AVE S WESTERVILLE OH 43082 KIRKLAND WA 98003 FEDERAL WAY WA 98003-4770 Census Category: 437-Commercial alt/add/conversion Includes: #1 #2 #3 #4 Occupancy Class: B Construction Type: Type V-B Occupancy Load Floor Area(sq.ft.) 1,512 0 0 0 Additional Permit Information Existing Sprinkler System in Building? Yes Mechanical to be Included? No Number of Stories. 1 Permit for Building Shell Only9 No Plumbing to be Included? No New/Additional Sq.Feet-Total 0 Occupancy#1-Use Professional Zoning Designation. CE Services/Offices No Fixtures Associated With This Permit!1 PERMIT EXPIRES Saturday, February 9, 2013 Permit Issued on Monday, August 13, 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 and the City of Fede al Way. q Owner or agent: /!� . i. �� 61/ L iG�2k C � d�, r Date: 7/5 /z. r.,t) � � /1411V City ofFederal Way 11111 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 City staff. Tenant Name: BELLA DENTAL Permit#: 12-103137-00-CO Address: 34410 16TH AVE S Unit109 Includes: #1 #2 #3 #4 Occupancy Class: B Construction Type: Type V-B Occupancy Load Floor Area(sq.ft.) 1,512 0 0 0 Owner Name: BELLA DENTAL Owner Address: 34410 16TH AVE S SUITE 109 FEDERAL WAY WA 98003 a-s,pk - ) Buildlfig 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 severiy 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 it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises. # f • THIS CARD IS TO MAIN ON-SITE Constructionlit ' CITY OF In ection Record Federal Way INSPECTION REQ TS: (253)835-3050 PERMIT#: 12-103137-00-CO Address: 34410 16TH AVE S Unit 109 Project: FEDERAL WAY MARKETPLACE IN 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. ❑ SWM Precon Site Mtg(4400) -0 Initial Erosion Control(4365) 0 Footings/Setback(4110) Approved To be done prior to breaking ground Approved to place concrete By Date By Date By Date . ♦ . 0Re-steel(4215) El Slab/Concrete Floor(4255) #❑ Underfloor Framing(4285) Approved to place concrete or grout Approved to place concrete Approved to sheath floor By Date By Date By Date o Floor Sheathing(4105) 0 Fire/Draft Stops(4095) ❑ Interim Erosion Control(4370) Approved to install flooring Approved Approved • By - Date By • Date ' _ • By Date Prior to scheduling a Framing inspection; 0 Framing(4120) ' 0 Insulation(4150) ' Electrical,Plumbing&Mechanical Rough-in and Approved to insulate Approved to install wallboard Fire/Draft Stop inspections must be signed-off and approved. IBC 109.3.4 By n` Date/a-2-(z By Date o Gypsum Wallboard Nailing(4130) '❑ Suspended Ceiling Grid (4265) 0 Final-Fire Department(4060) Approved to install mud&tape Approved to drop tile Approved By \` Date 1 -Cs_LI _ tett 1 Date 1'_ 1- 1 By Date • 0 Final-Planning 0 Final Erosion Control(4375) ❑ Final-Building(4050) Approved Approved Approved By Date By Date Dat /---`,9P j> El Rough Electrical El Final ElectricalEl Right of Way Approved Approved Approved By Date By Date By Date ,, 11 A • - _ x 3 /3 7- CITY OF RMIT SF MF 0 PL DE EN FP Federal Way COMMODEVELOPMENT ES RECEIV LI CATI O N g1I ,1/ Z253835-2607•FAX 253-835-2609 J U www.oftuoffederalwau.co n i SITE ADDRESS CITY OF FEDERAL WAY S smTIT E/mo # ''3 44+ t o I to-IA- �+ v E. S i 09 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ yam; 3too � C Z e o o q 0 _ o o c- o TYPE OF PERMIT )(BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT (Tenant Name/Homeowner Last Name) ,1.L.4,..oesc t E.N*IsC L.. PROJECT DESCRIPTION ��1 S--�a LT ,4- --1 R,e__ A' I S 1 L SF- pE --A,�l„_ Detailed description of work to C LC— t't1 C-L—LA D t It e_ I N1"C'E1 _t O 1e PA° se:1-l T1 O4 S i be included on this permit only E G-t,C t eA/t e--{J..r1 ct Ni l S('f-e_-S t Pc-1,3p c n- e • NAME PRIMARY PHONE PROPERTY OWNER - _27V011/4-1 Al Al -rPL E-- Vv Es-r•j LLQ MAILING ADDRESS E-MAIL 171, COX 129 4- -31_o SS 9 A-v1.--.c o. crry STATE ZIP A-itt3J1ZN \j )Ac q e O7 ® NAME PHONE LA7 Ni S-t�t.1't-L N e- 61A i L-c e•-R-S1 1144.-. 1.-.O(o-951-440 C) MAILING ADDRESS 4-$ of L i l L t t4 ca ti 1e., IN A.-•-(( N i;- eros r ►N� N t_ 181ixe.g.s,i..c,ru CONTRACTOR CITY STATE i -Ev F -r- Pair.-lc W Az�Q'I g FAX ISS A 1 C) WA STATE CONTRACTOR'S LICENSE C EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#1`\ L 0N5T6 i q ezjs 4- / zS / I`'1' NAME ? PHONE fit(= t t, L -A t t.Fes.- (©r-Fi.c. vv 12. Ps) q•-Z�-cI S Z--53q 3 APPLICANT MAILING ADDRESS E-MAIL 5-1o Ic_ .-kLL--AJ i7 kik-)ArYI Sc)tI-E._ Zs0l PA-tete.®a-FtGE-wle.atPs.L ot.t CITY STATE ZIP FAX 1 t t.4h'ti a LOA" 'Cl Sd o 3-3 4--z S--g 5 Z--s3 9-1 PROJECT CONTACT NAME _ PHONE (The individual to receive and p (.,1L' L�'�' respond to all correspondence MAILING ADDRESS yo E-MAIL this application) ( 5 A'A/e_ A S iO' ) CITY STATE ZIP FAX ALTERNATE CONTACT NAME: PHONE E-MAIL 1.--O4-1Sok 6.A- Loi2.J®OFPr c e-i vt2�►'PS,Cava PROJECT FINANCING NAME0 OWNER-FINANCED Required value of$5.000 or more 1:* ARZA-rri.r- gt�e- �� � MAILING ADD .CITY.STATE,ZIP PHONE (RCW 19.27.095) ,O0 tai, C.l.--VEL I-►..P A-Ve_.4 3c'o 1 (o(i•1=•--71 4-e 35,7 IJEs tt.A.-e--.. of-t-l.O 30 82— I certify under penalty of perjury that I am the property owner or aut • • 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. -Te SIGNATURE: DATE fci;' 2-SI 12.- PRINT NAME: F:›01/4-1(..a.[i L---k—vi E.--e-- 1 Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application L' 111 0 • VE. -e-12-12-E 7 Sl)(e,.i/t t rr? -L-MECHANICAL FIXTURES VALUE of MECHANICAL WORK $ (a copy of bid or estimate must be provided) Indicate how many of each type of f ixt re to be installed or relocated as part of this project Do not include existing f uctures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(commerew) BOILERS FURNACES HOT WATER TANKS(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES 17E--'42-1 t7 an,t i-t'TPc-t_. PLUMBING FIXTURES 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. BATHTUBS(or Tub/Shower combo) LAVS(Hand Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/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 Ivo w ag Vis-reAe.--r PUE'l..-4.c. $ dkt,A -i- EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ki Tc& N T '2-- I to q (Yes❑ No ❑Yes )(No WA's- RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER(describe) Area Totals a PROPOSED TOTAL - -- --- "*NEW HOMES ONLY" ESTIMATED SELLING PRICE$ #OF BEDROOMS 1-3/.6c COMMERCIAL—NEW/ADDITION AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information in Square Feet Type Stories NEW BUILDING ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION in Sq Feet Occupancy Group(s) Cons ypection Stories Additional Information TOTAL BUILDING -7575 Ari M22) 5 V- lj i TENANT AREA ONLY 15 i 2- VV- 6 1 PROJECT AREA ONLY I S I Z V - 6 Bulletin#100-January 1,2011 Page 2 of 3 k:\Handouts\Permit Application