02-105370 � ,
'City ot F:4feral Way � '
CommunityllevelopmentSenices Building - Commercial Permit #:02 - 105370 - QO - CO
33530 Is[1'�'ay S
Federal Way,W.4 98003-6210
Ph:253661.4000 Fax:253.661.4129 Inspection request line: 25?J.g35.3�5�
Project Name: ST FRANCIS MEDICAL OFFICE BUILDING
Project Address: 34509 9TH S Parcel Number: 750451 0010
Project Description: TI-Non-structural interior alterations to portion of lst floor medical office building for a 1,475 sq ft
conference/classroom. No plumbing or mechanical under this permit.
Owner Applicant Contractor L,ender
ST FRANCIS MED CTR ASSOC BOXWOOD*DARRELL TURNER* RUSHFORTH CONST CO INC ST FRANCIS MED CTR ASSOC
1717 S J ST 1218 3RD AVE SUITE 1412 RUSHFC*305R1 3/15/03 1717 S J ST
TACOMA WA 9P405-4933 SEATTLE WA 93101 6021 12TH ST E SUITE 100 TACOMA WA 98405-4933
TACOMA WA 98424
Includes:
Census category: 437-Comm #1 #2 #3 #4
Occupancy Group: A-3
Construction Type: Type II-FR
Occupancy Load: 63
Floor Area(Sq.Ft.): 1475
1 st Floor Proposed Sq.Feet.................................1475 Building Pre-con.Meeting Required...................No
Census Category................................................. 437-Commercial alUadd Fire Sprinklers................................................. Yes
Mechanical................................................. No Number of Stories................................................3
Permit for Buildine Shell Only............................No Permit for Foundation Only.................................No
Plumbing................................................. No Special Inspection Required................................No
Will Certificate of Occupancy be Issued`'............Yes Sensitive Areas?................................................. No
Zonind Designation.............................................OP
CONDITIONS:
All new and refaced signs require a separate sign application and review.(FWCC,Sec.22-335(g)(6))
PERMIT EXPIRES July 26,2003,IF NO WORK IS STARTED.
Permit issued on January 27,2003
I hereby certify that the above information is rorrect 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 Federal Way.
Owner or agent: � Date:
� �����
!
C�cy or'�ederal Way • -
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 109 of the Uniform 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 bv Ci staff.
Tenant Name: ST FRANCIS MEDICAL OFFICE BU Pernut number: 02- 105370-00
Address: 34509 9TH S
#1 #2 #3 #4
Occupancy Group: A-3
Construction Type: Type II-FR
Occupancy L.oad: 63
Floor Area(Sq.Ft.): 1475
Owner ST FRANCIS MED CTR ASSOC
Name: 1717 S J ST
Address: TACOMA WA 98405-4933
Building Official Date
The priority jocus in the review and inspection made by the City prior to issunnce oJthis Certificnle ivns on those mntters whid�experience has sho��n most serere/ti
nJject the henith nnd snfety of the genernl public. Although the City hns made as complete a review and inspection as is reasonably possible(within budgetary time
nnd personnel limitntions),the City neither guarnntees nor warrants�o the owner/occupnnt or ro an}�other person that[his Certificate evidences strict comp(innce
with each and every ordinnnce or regulation of the City or the State ojW�shingron affecting Ihe ronstructiar or�ese of snid structure or the lnnd upon which it is
si7unted. Sudi compliance is the responsibility ojthe owner nnd/or ocrupnnt of the premises.
PO�� �HIS CARD ON THE FRON`�OF BUILD"'^
� ��� �` �UILilING DIVISION - � •
uv FiY INSPECT�ON 1R�COR�D
�� YNSPEC'I'ION REQUEST PI�CENE#: �53-835-3050
PERMIT #: 02-105370-00-CO
OWNER'S NAME: ST FRANCIS MED CTR ASSOC
SITE ADDRESS: 34509 9TH S
( ) FOOTINGS/SETBACKS ( ) FOiJNDATION WALL
.,. � ����w DO NOT POUR CONCRET'E I7NTII1'I�IE ABOVE IS APPROVED `� ;' �:'.- ,�������'_''
a����� _ . -
( ) DRAINAGE: Line ( ) Connection
� e DO NOT POi7R S„L,�AB UNTIL��HE ABOVE°IS APPROVED `�a���, :�' -�'��,��;
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV Water piping
( ) ROUGH MECHANICAL Gas piping
( ,l SHEATHING Roof Floor
( ) SHEAR WALLS
O BLECTRICAL ROUGH-IN Z ' 2' � " 0 3 ��,�Ditch Cover
( ) FIRE/DRAFTSTOPS S�— � ��
"�'"'� ALL THE ABO.VE:1VIUST`�BE�PROVED�PR�O nR T0 FRAMING INSPEG7CIO�T � ��' '�' `�
��� � , . �. . -�;a� :'��.�
( ) FRAMING/FIRESTOPPING `� �fj 'U 3 G.�o�
;=�; �w��r���- : ��� THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR SHEETRO�CKING ;� a.��:��.;
( ) INSULATION: Fluors Walls _Attic
`���" ' � THE ABOVE MUST BE APPROVED RIORCTO APPLYING SHEETROCK "'�� `
.:,�.,.. �.�� �
:�: , - _ = a
O WALLBOARD NAILING — /— a O SUSPENDED CEILING S — �S� b � r e
�'�� ��t' THE.ABOVE MUST.B�°��P�2U'�',E,.D�,,RYQ<R. *��zall�G�4RINSTALLTNG(;`EIT�ING"TII`:E��� ' �'�
(�) ELECTRICAL FINAL
( ) PLANNING FINAL
( ) PUBLIC WORKS FINAL
(t) PIRE FINAL
�`�� ��.� �.TAE�A�OYE'�l3i�S�E,_ U�D� O v IJII.�ING DEPARTIV�IE1�'T�F�`AL._ _.��.�� � �'
�.� .��r._ �.,,w,�n. . _ ._
... �.
(`) BUILDING FINAL !/' � � �� �
�`.�'`�€ ., „� ..; �.h�-:,��.��,*� �v _ . �
���,DO NOT OCCUPY THIS BUrLDING UNT��L�BUILDING'FINAL IS`�APPRO'VED'�;'
�
� � �„
INSPECTION LOG
DATE INSPECTOR OK CORR/REJ AREA AND TYPE OF INSPECTION
/ '
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. 4
♦
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� ���� NOV 2 �'� Z�U� CONSTRUCTION PERMIT APPLICATION
V� � PPLICATION NUMBER: � �-- � � �� 1 O - 0 0 Gd
�,kTsO�� �G ��F� ':'� PPLICATION NUMBER: - - - - - - - - - -
PPLICATION NUMBER: - -
**The following is required information—Please print(in ink)or type** �� � �
Piease note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. ��
. � . , . �
SITE ADDRESS: ��/�___�1�����`l/• ..�/. ASSESSOR'S TAX/PARCEL#: �S Q �s1 ' aQ��
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ���%J-,rpy_J
� • • • �
TYPE OF PRO]ECT(This application): �UILDING ❑ PLUMBING o MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING n FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIO (Provide de ' d description): /��/ �
/ � S CO G! drJ Q�✓'
O / , H�.
PROJECT NAME: S "" N�� G D
• • • • •
PROPERTYOWNER: N,artE: . DAYTIMEPHONE:
��l'-s�'A�, c�.��� -�35
MA[ING ADDRE55(STREET ADDRE55;CI'fY,ST ,ZIP:
��� �H v ��.�� s
CONTRACTOR: NAME: �i �} „1 � r . �AYT[ME PHONE: _
I �
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MAILING AD RES (STREET ADDRE55;CITY,STATE,ZIP): EVENING PHONE:
� �
CIT'OF FEDERAL WAY BUSINESS LICENSE NUMBER: -,�,"'J FAX NUMBER:
`�l/� ' � � . -
CONTRACTOR'S REGIS7RATION NUMBER: EXPIRATION DATE:
� �
APPLICANT: NAME: DAYTIME PHONE:
vr�/I h�i�� D oA' P� >3�f3 oZ
MAI�I G AD%RESS(STREET ADDR"t55;C ,STATE,ZIP��/� - /O/ �JG P�oNE:3 _023
/�
RELA�TI NSHIP TO PROJECT: • fAX UMBER:
�ARCHITECT ❑TENANT ❑OTHER(DESCRIBE): � � -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PRO]ECT: ❑ PROPERTY OWNER �APPLICANT ❑ CONTRACTOR V✓�j�� � O L�
��
. . � • • •
EXISTING USE: IG� EXISTI G BUILDING ASSESSED/APPRAISED VALUATION $�DD�.OD�• DD
PROPOSED USE: ��//� / � PROPOSED VALUATION FOR IMPROVEMENTS: $ �� , DDD O�
SPRINKLERED BUILDING? pif'tS ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:fYY�S o NO
��� ,
WATER SERVICE PROVIDER: �5'LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: B'LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: ¢
• • • • �
FLOOR EXISTING .FT. PROPOSED S .hT. TOTAL
BASEMENT
FIRST � /�_�.�
�,L
SECOND
THIRD
� FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) PAN(5) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑GAS
PLUMBING
BATHTUB(5) LAVATORY(S) URINAL(S) WATER HEATER(5)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
� •
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 perto�m the work for which the permit appiication is made. I
further agree to hold harmless the City of Federel 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 of
Federal Way,but only where such claim arises out of the reliance of the city,inciuding its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: ��G��� ` �`yI� DATE: II 2 r ��-
O PROPERTY OWNER PPLICANT ❑ CONTRACTOR
�� �Z'U/"..