99-101250 A
1 _ 6 9,_joJ 15a
CITY OF FEDERAL WAY
PERMIT NO: FjLll99-018
33530 F1r�st Way South
;� ��..•, ::�:: 1...,..�w�,r:::�' H f' 1 f:"' °;;r '•'� t'i..11': .,,, '. ISSUED: n 3/3 /99
BY: FC2
Federal Way, WA 98003 Building Inspection Requests 253-661-4140
253-661-4000 EXPIRES: 09/27/99
ADDRESS:33431 13TH PL S
NO. : 768190-0070
PROJECT DESCRIPTION:TI- change counter and remove wall in medical records area.
NO PLUMBING AND MECHAINCAL
f= OWNER _: - . ---_____,= CONTRACTOR ----- ----_ , LENDER - -
SEATTLE-KC DEPT OF PUB HEALTH OWNER IS CONTRACTOR
33431 13TH PL S
4EDERAL WAY WA
! 06-296-0238 206-680-0201
N/A i
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.6% ***
BLD?:X MEC?: PLM?: FLR--EXIST PROF - DWELLING UNITS: 0 COMP PLAN •/ ° FEES:
} TYPE OF WORK:TEN USE:COM 1ST.: 0: O:sf STORIES 0 REQUIRED PARKING..: 0 SPRINKLERS' ./ PLAN CHECK FEE $ 117.81
CENSUS CATEGORY •437 2ND.: 0: 0:sf HEIGHT • 3.00 ft HAZARD CLASS...,? ED PLAN CK-COMM ONLY $ 27.19
OCCUPANCY GROUP 3RD,: 0: 0:sf VALUATION , REQUIRED SETBACKS FIRE '`:OW 3 qcn ' BUILDING PERMIT....* $ 181.25
:B :? :? :? : OTHR: 0: 0:sf EXIST..$. 0 FRONT,. • 0.00 ft SBCC SURCHARGE * $ 4.50
TYPE OF CONSTRUCTION BSMT: 0: O:sf PROP...$: 10000 SIDE • 0.00 ft WATER SERVICE..:?
:5N :? :? :? DECK: 0: 0:sf REAR • 0.00:ft SEWER SERVICE..:?
OCCUPANT LOAD GAR.: 0: O:sf RECEIVED.:03/31/99
: 0: 0: 0: 0: TOTL: 0: 0:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
ill( TYPES.:? ? FANS • 0 BOILERS/COMPRESSORS $ WATER CLOSETS • 0 URINALS • 0 TOTAL FEES $ 330.75
a PIPING.: 0 ft HOOD • 0 0-3 TON • 0 BATH TUBS • 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK • 0 3-15 TON • 0 SHOWERS • 0 SUMPS • 0
GAS HWT • 0 WOOD STOVES...: 0 15-30 TON...: 0 LAVATORIES • 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100V • 0 30-50 TON...• 0 SINKS • 0 DRAINS • 0
BBQ • 0 MISC • 0 50+ TON • 0 DISH WASHERS 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: 0
GAS LOGS...: 0 10�
00 CFM: 0 UNDERGROUND.: 0 J
-- -= .v=. _ ...__ _ _
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 INFORMATI FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
�_./J �� — 2
OWNER OR AGENT (7131A--------
J-
/ — DATE cam ' 4,
FILE COPY
BUILDING DIVISION
«rvoF G •
• 33530 Fust Way South
Federal Way,WA 98003
uv AY (253)661-4000
ReC �. Fax(253)661-4129
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION # BLJ.Jci, " O I S
Address ✓
vt-
Tenant(if known) �N& <'ru 0�� Lot# Assessor's Tax#
int 1 t KA.O H P tt t ? 7147z\ Ar[ S
Building Owner's Name LA1)lJI( Address .
City 7.(�jDLK2A i 1'�f /l State C VA- Zip (0.3 Phone
Nature of Work
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Nam. ,L)
THA , Pr-0,11 e/cel' T-1464-1147. -
Address
City YE-/ State [ Zip ei1
Contact Person 8y Phone they Phone P 7 Fax (o
�� p„ 0 c Z 'O c,- �`np -07 o i J�1 lv -01
0,06
LICENSE
SS
k .tL NG.C. .NTR�4C7'dR...... BUSINESS
: FEDERAL WAY
Company Name v t 147 J (
Address
50C kNit QM
City , )y State Zip ‘'(2-)i c4
Contact Person Phone Fax
` 'P -QAC-r — Tiso t2-e(p `2-16, •COU'(r 2616,-0 I otx.
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes 0 No
............................................................................................
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nt ,� ,,.�,,,,,1
Name {„���a� 1- 406' ) 171P-C,3 E/� FbA,N � i
Address 1
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
ill'
isti9 n Use 7 P
ro osed Use -
1
Permit includes: q Building ❑ Plumbing ❑ Mechanical ' Other F.,.E/77• 7,',,4,
Type of Work: D Residential ❑ New '';k:Remodel ❑ Number of Units 0 Deck
D Commercial ❑ Addition ❑ Garage ❑ Shed 0 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 // ssq ft
Water Availability ❑ Sewer Availability LI On-Site Septic System Availability 1:1I6 Project Valuation $ (72'Z)
Zoning I Lot Size Existing Bldg Valuation $
LENDER >< »>>_ >> >> ` '. €`>` ?f»> » r<»»<»>? ',
:...........................................................................................
Name Iry i'v / Address
City State Zip
MECf7AtMICALC. .1+I...FiK
Contractor Name Address
uly
ni,
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
' ContractorName Address
k-/NC ' 6 Zi
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains TotaI:bitUre`Obunt
ONLY $
EVALUATION
1111E+�FTA�IICAt SIN T.GOU�IT.
MECHANICAL
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping 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' :ZG1^ ��—./ Date: /
l
•
RUILUInG.Ary
Rev Seo 8126197
! 99. /04,150
CITY OF FEDERAL WAY PERMIT NU: i3L1)iv-U1E34
33530 first Way South DU I L Di t.4 e P Eft 14 I T ISSUED: 03/31/99
Fede Way, WA 98003 Building ,Crv3pect:ion Requests 253-661 -4140 BY: FC2
253-661-4000 EXPIRES: 09/27/99
ADDRESS:33491 13TH PL, S
NU. : 76£3190-0O/0
PROJECT DESCRIPTIOW TI- change counter and raove ua11 in Medical records area.
NO PLUMBING AND MECNALNCAL
r4 oNNER .mR ;,..y.m..s,. .-x........�. :. .:. .:.zn a"a CONTRACTOR nccm=::- =,ccnr 41cm conoaccccauccmcam4mc.:ammum.c LENDER *.CLcco ma:4.c===cc,..cmcccaccucccoccaccumcconmi
SEATTLE-KC DEPT OF PUB HEALTH OWNER IS CONTRACTOR
33431 13TH PL S
FEDERAL WAY WA
206-796-0238 206-60-0?01
N/A (c es
fJt S: T:tax]f2tT,-�C..^.25."^.r`%'.CmAAS'CY YL;:t'li a.-:.n%k6:A.'t3YffiML't a`.1.ti¢4a.7 m.F::ro$ttu':I
,•••.j3a'.+'r.; R}C�SGR:CL:II�.:m¢'1902..Ut3%C>:tS to �r:YLi't rte'9:9]::.55::14 .�Ik:S4':ala Yka— atntY'"':..."A:'J:.:C....:.G....ffi^'-S"' A.::w]I:rS 2';a..NSiP:TX➢taa tang
Ott CONERACIORS, RIME USE MIEN Olt L131 NNER RENOIR SALES TAX FOR PROJECTS VITEN ERE CITY OF FEIUAI MAY. TAX RATE : 8.6% sss
tc[sRcaxccmcc3'C,.ccmcmS:r:..cASmaccmM:s...tR.Yk.^-'lE40W1. aYMtz.w.aan fsilsLRetittt.a. 6 ...OSX:.i'. ^6164591,9*Cwa.a >xAtmS7 CC5CttSS*m.6%ASD+t+5tiCY.C-ztt=IMTU:rtt9=10WA=:Sf4G.-`021=5 zfvtl%.24.,G4==411t7LlaFFC 4+.24Ma.z=t*.===.t
1 RID?:X NEC?: PLM?: FLR--LXI` , !P--- D EtETN UNTTS. II CORP PLAN •� FEES:
TYPE OF WORK:TEN USE:CON 1ST.: �0: 4:,t TOp3LS ....: 0 REWIRED PAR/1 ..f ,tothot PLAN CHECK FEE $ 117.81
CENSUS CAT€GORY.....:437 2Hn_: rt: 0:s4 'LICN1 . 0.40 tt z i41• _ i ,"° � . - - FD PLAN CK-CORN ONLY $ 27.19
I OCCUPANCY GROUP--_._----- ?FO.: . : .t !AtUt1IOW- tIVIRED SLIBAUS -- FIRE FLOC, �x gp. BUILDING_ PERMIT * $ 181.25
I :8 :? :? :? . OOTIIR: f: ^. f f l!'.1..$, 1 fMONT . ... .. O,10 ft - StCt SURCHARGE x $ 4.50
1 TYPE OF CONSTRUCTION----- BSMT: 0: 0:sf PROF ..t: 10000 1GIDE • 0.00 ft WATER SERVICE..:?
:5N :? :? :? DECK: 0 0:sf , REAR........., 0.00:ft SEWER SERVICE,.:?
OCCUPANT LOAD -- GAR.: 0: 0:sf REC€TVED.:03/31/9"
. 0: 0: 0: 0: TOTE: U: O:st IMPERV SURFACE: 0 Sf SENSITIVE AREAS?.:?
+zt KII+G:wAnAA&:90:tmMl+nfCSlmam.C'a:BCmmm¢uRe3u:aC.4+:�'_^.G'zt�r.uY_s:zY-^;:.::nm9ax.N.-.:✓...tisA..r.:.:mma..-.:c:xM_...a.....R.....:cr¢ �tz"';s&::tl«mCzeSmr:xss:mxc9szacn:: ,:JR5-..::tu s.:xe:ss::a:.9sS`.:9iS:rxc:cmx.xs,..
FUEL TYPES.:? ? FANS • 0 8OTTERS/CONPRES5ORS WATER CLOSETS • 0 URINALS,....,..: 0 TOTAL FEES 330,75
GAS PIPING.: 0 ft HOOD 0 0.3 ION •• 0 BATH TUBS..........: 0 DRINKING FOUNT.: 0
FURN<10OK..: 0 DUCT WORM 0 3.15 TON • O SHOWERS • 0 SUMPS • 0
GAS NWT • 0 WOOD STOVES...: 0 15-30 TON...: 0 LAVATORIES • 0 VAC BREAKERS...: 0
COMP BURNER: 0 FURN>100K • 0 30-50 TON...: 0 SINKS • 0 DRAINS • 0
BBV........: 0 RISC • 0 50+ TON.....: 0 DISH WASHERS • 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS--------- €LEC RIR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE • 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLIS...: 0
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
k:.a;,.4::7♦'CT.Ytl::C:i.'S::�L.:GiiACTi.SmSC':RA19 :i'Tsw�:::A»:91:.:>;S4G59::ttG'k.Y:imX±e Gn.'+.GCS;::'Y'.':Ctl tiaSC:Y.:::S�tPa s:ma aztf5_..:...:oY...GC,._l-......:.9_:T...,....:.:t.'....Alt%IRRID. talaaa ta.:.n ecsmk:S.lC,r.«>::y .y$......St:.F:1A:n L'K,L:<'GK.`-^]r1%:SwL::9 ;y.7.'S.IYS.,.9i:J.9....1.._'..ti S:-Y C..,::.
PERMITS EXPIRE LBO DAYS AFTER ISSUANCE IF 80 WORK IS STARTED. RESIDEHIIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER BATE Of ISSUANCE.
I CERTIIY TWAT THE INFORMAIT FMRKISNLD WY Mt IS TRUE AND CORRECT TO INE BEST Of MY INONLEDGE AND IDE APPLICABLE CITY. OF FEDERAL MAY REQUIREMENTS MILL RE NET.
OWNER OR AGENT 0. +./ /,f!, ii ' ;v DATE L'.'5
FIELD COPY J7V 5 53693