03-101941City"Ifileacral Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
ph:253.661.4000 Fax:253.661.4129
building - Commercial Pernnt #:03 - 101941 - 00 - CO
Inspection request line: 253.835.3050
Project Name: CHIROPRACTIC WELLNESS & REHAB CLINIC
Project Address: 34211 PACIFIC HWY S Parcel Number: 202104 9053
Project Description: TI - Convert retail space to chiropractic and rehab clinic. Includes plumbing. NO MECHANICAL
UNDER THIS YE'�lf i
Owner
Applicant
Contractor
Lender
CHIROPRACTIC WELLNESS & REI
MICHAEL VELLANI
J T K CUSTOM RENOVATIONS
CHIROPRACTIC WELLNESS & REF
CHIROPRACTIC WELLNESS & REI
14909 SE 44TH PL
JTKCUR*DOOMS (8/20/04)
CHIROPRACTIC WELLNESS & REI
33400 PACIFIC HWY S SUITE 2
BELLEVUE WA 98006
7145 DULLAM LN SE
33400 PACIFIC HWY S SUITE 2
FEDERAL WAY WA 98003
OLALLA WA 98359
FEDERAL WAY WA 98003
Includes:
Census category: 437 - Comm #1 #2 #3 #4 ^ f
Occupancy Group: B
Construction Type: Type V -N
Occupancy Load: 40
Floor Area (Sq. Ft.): 3980
1st Floor Proposed Sq Feet ................................. 3980 Building Pre -con. Meeting Required ................... No
Census Category ................................................. 437 - Commercial alt/add Fire Sprinklers................................................. No
Mechanical................................................. No Number of Stories ................................................ 1
Permit for Building Shell Only ............................ No Permit for Foundation Only ................................. No
Plumbing ................................................. Yes Special Inspection Required ................................ No
Will Certificate of Occupancy be Issued? ............ Yes Zoning Designation...........................................:.BC
Plumbing Fixtures
Description a4uanti t]escri .tion Quantity iescri _tion Quanti.ty
---
Sinks 4 Water Closets 2
CONDITIONS:
1. Prior to certificate of occupancy, a landscape inspection is required. Contact Deb Barker at 253-661-4103 to schedule this
inspection.
2. Curbing shall be installed around all sides of each landscape islands per FWCC
3. Deciduous trees shall be a minimum of 1.5 inch caliper measured at 4.5 feet above the rootball at the time of planting.
4. Evergreen trees shall be a minimum of 6 feet in height at the time of planting.
5. Trees and shrubs shall be added to the interior parking lot landscape islands as noted on the red lined landscape plan.
6. Landscape areas shall contain at least 4 inches of top soil at finish grade per FWCC.
7. Soil in parking lot landscape areas shall be noncompacted to a depth of 18 inches prior to planting any tree, shrub or
groundcover per FWCC.
8. All landscape areas shall be covered with at least 2 inches of mulch per FWCC.
9. All landscape areas shall have ground cover as noted on the redline plans.
10. This decision shall not waive compliance with future City of Federal Way codes, policies, or standards relating to the
subject proposal.
PERMIT EXPIRES January 14, 200�
Permit issued on July 18, 2003
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy anb se will be in accordance with the laws, rules and regulations of the State of Washington and
the City of Federal Way. -
Owner or agent: �� c� Dater b
City of Federal 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 by Qjjy staff.
Tenant Name: CHIROPRACTIC WELLNESS & REF
Address: 34211 PACIFIC S
Permit number: 03 - 101941 - 00
#1
#2
#3
#4
Occupancy Group:
B
Construction Type:
Type V - N
Oteupancy Load:
40
Floor Area (Sq. Ft.):
3980
Owner CHIROPRACTIC WELLNESS & REHAB CLINICS PS
Name: CHIROPRACTIC WELLNESS & REHAB CLI
Address: 33400 PACIFIC HWY S SUITE 2
FEDERAL WAY WA 98003
mx.
Building Official
3m" C.9
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 severely
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 ofsaid structure or the land upon which it is
situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
POS"' THIS CARD ON THE FRONT OF BUILDING
CITY 6F
Federal Way
PERMIT #: 03-101941-00-CO
BUILDING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE #: 253-835-3050
OWNER'S NAME: LUMBERMENS OF WASHINGTON
OW
SITE ADDRESS: 34211 PACIFICAS
( ) FOOTINGS/SETBACKS
( ) DRAINAGE: Line
( ) FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL: THE ABOVE IS APPROVED
( ) Connection
DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
[ } UNDERF LOOK 5�u S ""
() ROUCH PLUMBING: DWV l� "" C� G Water piping g —
( ) ROUGH MECHAN:CAL
( ) SHEATHING
Gas piping
Roof Floor
` S:H. IAR WALLS
O rCTRICAL ROUGH -DI Ditch Cover
'c E /DRAF'I'STOPS� C
ALL THE ABOVE MUSTBE APPr "±�'E7� 'I`.ZC R TO FRA UN INSPECT!':r:
(1-RAMING/FIRE`. s' PPNG
TH-E ABO" MUST BE, APPROVED PRIOR TO I`,,3ULtt.TING OR SHEETRi. CVJNC:
O INSULATION: Flocrs Walls19 — 0 ttic
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEETROCK
() 1VALLBOARD NAILING ST �P�-r�3� ( ) SUSPENDED CEILING � ����
THE ABOVE MUST BE. APPROVED PRIOR TO TAPI�IG OR INSTALLING CEILINGTLLE
O ELECTRICAL FINAL O " C>
() PLANNING FINAL
O PUBLIC WORKS FINAL
() FIRE FINAL 4; 0
TIME ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL
() BUILDING FINAL aj 3m'' + S G— -
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
INSPECTION LOG
DATE INSPECTOR OK CORR/REJ AREA AND TYPE OF INSPECTION
S
gtmlll
FAX NO. :4258226566 p. 29 2003 12:22PM P2
29 September, 2003
CITY 017 FEDERAL WAY
Dept, of Community i. mlopment Services
P, Q. Box 9718
Federal Way, WA 98063-9718
Ann Chief Greg Bronk
Fire Departnnent
Re: Wellness Chiropractic & Rehabilitation Clinic
File No, 03-101880-00-UP
Subj_ Fire Protection Alarm System
Chief Bruck:
The Owner of the above referenced project has decided not to install a Fire Protection system in this
building project. The building has been improved at this time to provide facilities for the Owner's
chiropractic business on a temporary basis until a new facility is built in the near future. The Ownerwishes
to construct a larger and more elaborato medical facility on this property as part of its overall development.
The building now being improved will be removed to accommodate the new medical building.
Due to the temporary life expectancy of the project, it has been decided to forego an elaborate fire al;lnn
and monitoring system.
If there are any questions pertaining to this decision, please feel fret to contact the Owner's project
representative Mr_ Michael Veilani at telephone nurribcr (425)351-5711.
Thank you for your cooperation in this matter,
Sincerely, .�
David Bordewick AIA
Architect
David Bordewick A.I.A. Architect 10858-1 N.E. 37th plane, aellevue, WA 98004 tel: (425) 822-8546
n CONSTRUCTION PERMIT APPLICATION
Itllly
CITY OF -sg MA� '1 4 M3 PPUCATION NUMBER:
Federal Way - - -
IiY 0 LD NG pEP'WAY APPLICATION NUMBER:
B APPLICATION NUMBER:
**The following is required information —Please print (in ink) or type** J
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: 34211 Pa ific Hwy S.f Federal Way, WA 980D3 ASSESSOR'S TAX/PARCEL *: 2021049053
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): As Attached
TYPE OF PROJECT (This application): X BUILDING X PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): TO Convert a retail space building to a chir-ol2ractic and
Rehabilitation Clinic.
PROJECT NAME: Chiropractic wellness and rehabilitation Clinic
PROJECT•- •
PROPERTY OWNER: NAME: Chiropractic Wellness and Rehabilitation Clinics, PS DAYTIME PHONE:
Le� _ 253 661-6101
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, zip):
33400 Pacific Hwy S., Suite 2, Federal Way, WA 98003
CONTRACTOR: I NAME: JTK Design and Renovations
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, zip): 7145 Dullam Lane SE, 01alla, WA 98359
BUSINESS LICENSE NUMBER:
(copy of card required)
APPLICANT: I NAME: Michael Vellani
JTKCUR*OOOM5
DAYTIME PHONE:
206 817-6284
EVENING PHONE:
253 853 6079
FAX NUMBER:
EXPIRATION DATE:
08 — 20 - 2004
DAYTIME PHONE:
425 351-5711
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): 14909 SE 44" Place, Bellevue, WA' 98006 EVENING PHONE:
, i 425 351 5711
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT _X OTHER ( DESCRIBE): Project Coordinator 425 988 0125
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER X APPLICANT ❑ CONTRACTOR MVellani@aol.com
PROJECT•- •
EXISTING USE: Lumber retail EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ 155,000.00
PROPOSED USE: C €ro r ctic and Reahab Cent r PROPOSED VALUATION FOR IMPROVEMENTS: $ 53 435.00
SPRINKLERED BUILDING? ❑ YES X NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES X NO
"NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: NIA
ESTIMATED SELLING PRICE: $ N/A
PROJECT FLOOR AREAS
FLOOR
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
BASEMENT
FIRST
3980
3980
3980
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
3980
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC. {. ]
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: X ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
4 SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
2 WATER CLOSET(S)
]ISCLAIMER/SIGNATURE BLC
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
_ MISC. ( )
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 the permit application is made. 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 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 n.
NAME/TITLE: Michael Vellani I Projgct Cdrdingtnr `�`-� --DATE: 05 — 08 - 2004
❑ PROPERTY OWNER X APPLICANT ❑ Cd6TRACTOR
FOR OFFICE USE ONLY:
❑ NEW a ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION :
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES d NO
PLATTED LOT? ❑ YES 0 NO
CHANGE OF USE? ❑ YES ❑ NO
Construction Permit Fee Calculation Sheet
*******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT.
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building, mechanical, and fire prevention system fees are based on the following schedule.
TABLE A
TOTAL VALUATION
FEE FACTOR
(1) $1.00 to $500.00
(1) $30.00
(2) $501.00 to $2,000.00
(2) $30.00 for the first $500.00 plus $4.00 for each a(lditlanal.SI00.0Aor fraction thereof, to and including
$2,000.00
(3) $2,001.00 to $25,000.00
(3) $90.00 for the first $2,000.00 plus gU8.00 for early addltlona131.OG10.tltl
or fraction thereof, to and
including $25,000.00
(4) $25,001.00 to $50,000.00
(4) $504.00 for the first $25,000.00 plus 313.Q7 far each addl,�ly,(+a131.000A0 or fraction thereof, to and
including $50,000.00
(5) $50,001.00 to $100,000.00
(5) $829.00 for the first $50,000.00 plus ,£a farcach additrana131.D0000or
fraction thereof, to and
including $100,000.00
(6) $100,001.00 to $500,000.00
(6) $1,279.00 for the first $100,000.00 plus 17 0. Ug +
or fraction thereof, to and
including $500,000.00
(7) $500,001.00 to $1,000,000.00
(7) $4,079.00 for the fist $500,000.00 plus 0.00 for each addlria+ra131000,00
or fraction thereof, to and
Including $1,000,000.00
(8) $1,000,001.00 and up
(8) $7,079.00 for the first $1,000,000.00 plus $J.50lW eac(I addftlowl $1,
00, or fraction thereof.
Bold number is the base fee for the specified increment
ftafirhreO, er derlined m er & The fee oar additional spec~ i►rre
PLUS: Add 65 percent of the base building permit fee for plan review fee.
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add 15 percent of the base building permit fee for Fire District #39 surcharge, commercial only.
Add $4.50 for WA State Building Code Council, plus $2.00 per unit for duplex & above.
** Electrical, plumbing, and mechanical fees are calculated separately **
■ BUILDING
PROPOSED VALUATION: 70,349.00
FEE FACTOR FROM TABLE A: Number: 5 (a) Base Fee: 829.00
(b) Additional Increment Fee: 180.00
Estimated Permit Fee: (1) 1009,00
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERCIAL ONLY)
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee: (4)_
Estimated Plan Review Fee: (5)
■ FIRE PREVENTION SYSTEM
PROPOSED VALUATION: 825.00
FEE FACTOR FROM TABLE A: Number: 2 (a) Base Fee: 30.00
(b) Additional Increment Fee: 12.00
Estimated Permit Fee: (6) 42.00
Estimated Plan Review Fee: (7)_
Base Fee Number of Fwtures
$26.00 + { 6 X $9.00/fixture} _ 80.00 (8) Estimated Permit Fee
Estimated Permit Fee
X .65 =
Miscellaneous Fixture Charge: (10) _
(9) Estimated Plan Review Fee
Sub Total (Pane One): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11) 1131.00
TABLE B
NEW RESIDENTIAL SERVICES
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
Single Family
Service or feeder only ...........................
$57.00
# of Thermostats (First-$43.00; add'n-$13.00ca)
(First 1300 ft2-$85.50; Each add'n 500 ftZ-$27.50)
Service and feeder .................................
$93.00
# of [.ow voltage fire or burglar alarm
Square Feet:
_
First 2500 8'•$50.00.; Each add'n 2500 W-$13.00
Each outbuilding or garage ... ..........................
$35.50
MOBILE HOME/RV PARK
Square Feet:
(Inspected with service)
# of service or feeders
* Per WAC 296-46-910(5)(bxi & ii)
_ Each outbuilding or garage.............................$57.00
(First service/feeder-$57.00; Add'n
service/
# of Signs (First sign-$43.00; add'n sign
(Inspected separately)
feeder-$37 each)
$20.00 each)
_ Swimming pool, hot tub, spa................$85.50
Yard Pole meter loops ........................... $57.00
NEW MULTI -FAMILY
COMMERCIAL/INDUSTRIAL
COMMERCIAL/INDUSTRIAL
(Includes three units or more)
Altered Service or Feeders
Service
Feeder
Amps Service or
Add'n
_ 0 to 200................................................. $ 93.00
_ Up to 200 amp ............... $ 93,00 ..................
$ 27.50
Feeder
_ 201-600 ...... „::.:...................................216.50
201 - 400 amp..................115.50......................57.00
_ 0 to 100 ........................... $ 93.00........
$ 57.00
- 601 - 1000...... -....................................... 326.50
_
401 - 600 amp..................158.50......................78.50
_ 101- 200 ......................... 115.50............
72.50
over 1000............................................... 363.00
601 - 800 amp...... ............ 202.50 ....................
108.50
201 - 400 ......................... 216.50............
85.50
` # of circuits
Over 800 amp..................289.50....................216.50
_
^ 401 - 600......................... 252.50 ..........
101.00
(1-5 circuits-$72.50; Add=n circuits, $6 ea)
ALTERED SINGLE/MULTI FAMILY
^ 601 - 800..........._............ 326.50 ..........
138.00
(When inspected separately from the services.)
801 - 1000....................... 399.00 ..........
166.50
TEMPORARY SERVICE
Service or Feeder
_ Over 1000....................:... 434.50..........
232.00
Residential/Multi-Family/CommerciaUIndustrial
0 to 200 amp ... ......... ...... » ............................ ..$ 71.50
_ Over 600 volts surcharge ........................
72.50
0-100................................................... $ 57.00
_
_ 201 - 600 amp:.:.:.:» ...::...... ..............................
115.50
_ Mast or meter repair ........ __....................
78.50
101 - 200........................... 72.50
^_
_ over 600 amp ................. ................... ».... »».....
174.00
201- 400................................................... 85.50
_ Mast or meter repair ..........................................
43.00
! 401 - 600.................................................115.50
# of circuits
over 600.........................................125.00
_
(1-4 circuits-$57.00; Add'n circuits $6 ea)
It a new or altered eonunercral service is 2UU amps or greater, or a new or atterea resiaenuat service is greater man wuu amps, a plan review is ruquneu. rr ,s j� io V1
permit fee +$72.50. Add-1 plan review for other submissions is $85.50/hr.
FIXTURE DESCRIPTION A
FIXTURE FEE FROM TABLE B JqL
NUMBER OF Ui+ rrS C
TOTAL D
TOTAL COLUMN: D :
Estimated Permit Fee: (I )
Estimated Plan Review Fee: $72.50 +
Estimated Permit Fee: (1
Bond Amount: (15) .
Estimated Permit Fee: (16)
Bond Amount: (17)
Mitigation Fee: (18)
SBCC Surcharge: (19)
Total Column (D)
Estimated Permit Fee from line 12
X .35) = (13)
■ DEMOLITION
■ OTHER FEES
(20) (22)
(21) - - (23)
TOtal (Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24) 1131.00
Bulletin #100 - December 23, 2002