03-104525 � � o `
� C�ly�f Federal Way Building - Commercial Permit #:03 - 104525 -OA -.Co
Community Development Services
33530 lst Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: RAIPTIER MEDICAL ASSOCIATES
�
Project Address: 34709 9TH AVE S UNIT�200 Parcel Number: 926480 OO1S
Project Descriprion: TI-Adding one of�ce,modifying reception area and expanding one exam room. No plumbing or
mechanical.
Owner Applicant Contractor Lender
NONE JOSEPH S SIMMONS CONST INC JOSEPH S SIMMONS CONST INC NONE
PO BOX 27089 JOSEPSS153JD 4/4/OS
SEATTLE WA 98125 PO BOX 27089
NONE SEATTLE WA 98125 NONE
Includes:
Census category: 437-Comm #1 #2 �- #3 J�_ #�
Occupancy Group: � B _ �
Construction Type: � Type V-N
Occupancy Load: � � � �
Floor Area{Sq.Ft.): � 1500 � �� �� �
2nd Floor Proposed Sq,Feet...............................:1500' Census Category............. ......... ..�..�.;:x....49�ommercia]aldadd
Fire Sprinklers ......... :............................ Yes Mechanical........ ......:............................ No
Number of Stories......... .....:...........................2 Permit for Building Shell Only...�........................No
Plumbing....... `.................................. No Will Certificate of Occupancy be Issued?............Yes
Zoning Designation.............................................OP
CONDITIONS:
Reminder: An changes to exterior advertising signage require separate permit submittal,review and approval.
PERNIIT EXPIRES April 14,2004.
Pernut issued on October 17,2003
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 Fedez
Owner or a nt: / ' l ' Date: � ��
, ' . .
• •
City ot�ederal Way ' � � . M �
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'�uilding
construction or use. This certificate is valid ONLY when endorsed b�ty staff.
Tenant Name: RAINIER MEDICAL ASSOCIATES Pernut number: 03 - 104525 -00
Address: 34709 9TH S UNITA200
#1 #2 #3 #4
— -
�Occupancy Group: B �——��
rConstruction Type: Type V-N � �
i Occupancy Load:
� Floor Area(Sq.Ft.): 1500 � � �
Owner NONE
Name:
Address:
NONE
nrK. �N.� , c ac� 1
3 -� /- o�G<-��
Building Official Date
The prioriry focus in ihe review and inspection made by the City prior to issuance oJthis Certificate was on those mctters which experience has shown most severely
afject fh.e health and safety of the general pub[ic. A[though the City has made as complete a review and inspectio�r,as�s reasorably possible(within budgeta'ry time
nnd personnel limitations),the City neither guarantees nor warrants to the owner/occupant or to any other pe�son tnat this Certificate evidences strict compliance
with each and every ordinance or regularion of the City or the State of Washingtore aJf'ecting the construclion or use ojsnic structure ar the land upon which it is
siheated. Such compliance is the responsibi(ity ojthe owner and/a•occupant of the prEmr.ses.
, POS' �'3IS CARD ON THE FRONT OF BUILDI-�" � ,, �
� CITY OF
:. Federal Wa BUIL�ING DIVISIaN �
� INSPECTION RECC:'I:D
INSPECTION REQUEST PHONE#: 253-8.':5-3050
PERMIT #: 03-104525-00-CO
OWNER'S NAME: NONE g
SITE ADDRESS: 34709 9TII S UNIT�200
( ) FOOTINGS/SETBACKS ( ) FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
( ) DRAINAGE: Line ( ) Connection
DO N(1T POUR SLAB UNTIL THE ABOVE IS APPROVED
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV Water piping
( ) ROUGH MECHANICAL Gas piping
( ) SiIE�THRJG �oof Floor
( ) SHE�R WALLS
( ) ELE'.�?'R:CAL ROUGH-IN Ditch Cover
( ) FIRE/DT:AFTSTOPS
Ai,L THE ABOVE MUST BE APPROVED PRIOR TO FRAMING INSPECTIOi�
( j FRA1�?ING/FIRESTOPPING l/— -�j"` — c7 3 C��
TFIE ABOVE biUST BEAPPROVED PRIOR TO INSULATING OR SHFETRO�KING
( ) INSULATION: Floors Walls_ Attic
THE ABOVE MUS'F BE APPROVED PRIOR TO APPLYING SHEETROCK
( j \'VALLBOARD NAILING I ( ����?J" �" (/� ( ) SUSPENDED CEILING
' THE ABOVE MUST BE APPRC�VED�RIOR TO TAPING OR INSTALLING CEILING TILE
O ELECTRICAL FINAL�2" L�I� O 3 'T�
( ) PLANNING FINAL
( ) PUBLIC WORKS FINAL
O FIRE FINAL 2 � Z O ' � T �
THE ABOVE MUST BE APPROVED PRIOR`T BUILDING;DEPARTMENT FINAL '
( ) BLTILDING FINAL ^ " !� �,.,
DO NOT OCCUPY THIS BUILDING UNTIL BiTILDING FINAL IS APPROVED
� �"``������� CONSTRUCTION PERMIT APPLICATION
CITY OF � � � � � — _ �
PPLiCATION NUMBER: -
Federal Way �CT O � 1�03 ppLICATION NUMBER: - -
�=�r1`JF F�D�FiAL WAY Pp��nON NUMBER: _ - - _- - - - - - -
BUILDING QEPT
`�The following is requtred ihformation—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. ��`2�
• • • � • .
SITE ADDRESS: {�"'i' l � `( ��M �1.� ��vf � � Q
71`� ASSESSOR'S TAX/PARCEL #: '('f�����Q� -r .�_U C�_
LEGAL DESCRIPTION OF SUB]ECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): �JD� � v.J-�S% C-(�/✓�P..�.�
:. l�.�S t�+= �-�-���,..:t.• �j i�r�-' �r�s�l� 2�r ck�l.vr� fi� �to1.. �i`1 �,�= (a�..,�r P 7�;-�<<j'L l..�c_.,.� �...,
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vn�l� %� , L-f}�/� £�clL7a,J G� C.Li 1� (,� ►L�I1rC� G_-s+ /�/Z.j � �70 �C'�l �
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. � . • .
TYPE OF PROJECT(This application): �BUILDING o PL�UMBIfdG ❑ MECHANICAI ❑ DEMOLITION
! o ELECTRICAL O ENGINEERING ❑ FIRE PREVENTION SYSTEM
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PPROJECT DESCRIPTION(Provide detailed description): t��� 1 ✓✓� P�� L�L,'Y���'j�' �5�
t'h��Q�L/{t,. ��t C-�' . A-J(a t^cv`t �f�c=�G� , mc0 �i—;' ,2tr L��7a� /9yv'�
E�'-f't�� �•'� € C7�0� !2-C�,.� �
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PROJECT NAME: f���� n�`CA� 7`�SL�C IG-��S
• • • • •
PitOPERTY OWNER: N^ME: ; DAY?IME PHONE
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MAIUNG ADDRESS(STREET ADDRE55;CITY,STATE,ZIP):
. ;_� fc0 t 5 f�6�'� �K �� 7 L �3 Sc�-. �� ��l G t �
CONTRACTOR: NAME: � � pAYf1ME PHONE: �
'��v��►.? S . 5;,�..,�.� 5 �����c;��.,.�� t�v� ; (zc6) 3,��_- 7ZL� ;
. i MAILING ADDRESS(S7REET ADDRESS;CITY,STA7E.ZIP): . EVENING PHONE �
�_�L' ��3�'� -�._�� �� S''�! S ��- . L�� � , � �� ! c��� ) �t 2.� - �o S� ;
I CI'fY OF FEDERAL WAY BUSINFSS LICENSE NUMBER: FAX NUMBER I
- - I ( ) - I
CONTRACTOR'S REGISTRATION NUMBER:
T � D(PIRATION DATE:
Ecopy-�card required) L/ ,1 Ti S � � `5 5 ( S � � jj � � � �' � '�"- �
APPLICANT: NAME�� DAYTIME GHONE:
-.�� � � j Y�.'1 1�.� ��� � � V-��. � ��j2 - �Z-2�
MAILING ADDRESS(STREET ADDRESS;CifY,STATE,ZIP):
� ��'' r7 G' ('� �-� � O 1 �.�?� ��.� � � EVENINGP�ONE�
� RELATIONSHIP TO PR07ECT: ���� � �Z� � � ������ I � �
� FAX NUMB£R: '
l O ARCHITECT p TENANT O OTHER( DESCRIBE): L"'tT? C)� . + �ZL�;1 �6 Z- -C.� I �S j
j E-MAIL ADDRESS: I
� v Sl.wr.o•ii1.C�r"�-
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER lU APPLICANT �CONTRACTOR �b�,i/(rp�C. ��
/`
� r : � • • •
EXISTING USE: �� - f�►G�-C Gt EXISTING BUILDING ASSESSED/APPRAISED VALUATION �
� �.�.:
PROPOSED USE: fY1�-. ��(� � PROPOSED VALUATION FOR IMPROVEMENTS: § �� , �C��
SPRINKLERED BUILDING? �Q YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: LAKEHAVEN ❑ NIGHLINE o TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: LAKEHAVEN ❑ HIGHLINE Ci PRIVATE(SEPTIC)
**NEW RESIDEN7IAL CONSTRUCTION C **
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: �
• • • � -
FLOOR EXISTING S .FT. PROPOSED S .FT. TOTAL
BASEMENT
�Rsr � � (:? �� '— - �I"'�C� ' � ��� �:
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS? �
TOTAL:
+
Indicate number of each type of fixture �
MECHANICAL Valu of Mechanical Work: $ �
AIR HANDIING UNIT(S) EVAPORATNE COOLER(S) GAS lOG(S) REFRIG.SYSTEM(S) 1
BBQ(S) FAN(S) HOOD(5) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET HEAT SOURCE: ❑ ELECTRIC ❑GAS
PLUNiBYfdG
BATHTUB(S) ORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) N WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINiQNG FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSEf(S) MISC.( ) �
INTERCEPTOR(S) SUMP(S)
. • �,
I certify under penalty of perjury that the information fumished by me ts true and correct to the best of my knowtedge,and �
further,that I am autho�ized by tfie owner of the above premises to perform the work for which the permit application is made. I
furtf�er agree to hold harmless tfie City of Federel Way as to a�y ciaim(induding costs,expenses,and attorneys'fees incucced in the
tnvestigation and defense of such claim),which may be made by any person,tnduding the undersigned,and filed agains_t-�he Ci�y Qf
Federal Way,but only where such claim aris��'o�tt of the reliance of the aty,including its officers and employees,upon t�e accurecy
of the information supplied to the city as a part of this appiication.
/'�� �
NAME/TITIE:-J'� C� �/ "N�lr�-Lz.3S i��� (/�t:n'1 DATE: L� � � �
❑ PROPERTY OWNER ❑ APPLICANT �CONTRACTOR
_,FOR.OFFICE.USE';ONLY.;�' �Z!�
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�;,NEW�-��"p AD � �<[3 AL-TERATION-��`'-��n,REPAIR ���:� , ENANT.IMPROVEMENT��-=,,.,M�.. '
:CENSUS:CODE�:� -
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' ,, „ .�, �,�:.-�-==���� s�'��.�"!' srLOT.SIZE:r, _. � .. ,��-�„$`>--«'�;.°x,'�_., i,f �,�
ZONING DESIGNATION,, �� �'w����',��;��, �BUILDING.SHELL'�ONLY7a D�YES�;:�`�= O :"
�COMP PLAN DESIGNATION, .- ' ,�� :6/15IC�PLAN?;�,�=D YES W ; NO;r.
,'SECTION.���,-��TOW:_' N P_ ' NGE ��'� , NEW ADDRESS RE UIREO �'�;.:"o YES = O�;� x
"'PL'ATTEU`:LOT? .�i"❑Y •����`:�:` -� •'CHANGE OF USE?. �k,, .-�"'❑YES�:'- NO - -
COMMUNffY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTFi•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253�61�000�FAX:253�61-4129
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