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20-104246-CO Permit Application 10-30-2020CITY OF PERMIT APPLICATION PERMIT CENTER + 33325 Bch Avenue South + Federal Way, WA 98003-6325 Federal Inlay 253-835-2607 + FAX 253-835-2609 +permitcenterfnriryof[ederalway.rom PERMIT NUMBER _ _ TAR[3ET HATS SITE ADDRESS SUITEIUNiT 4 34503 9th Avenue South 220 PROJECT VALUATION ZONSNG ASSESSOR'S TAXIPARCEL s $ 500,000 OP 7 5 0 4 5 1 _ 0 0 5 0 TYPE OF PERMIT N BUILDING ❑ PLUMBING ❑ MECHANICAL © DEMOLMON ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT St. Francis Medical Pavilion Suite 220 Center for Weight Management Tenant improvement of existingspace including, but not limited to new walls, finishes, PROJECT DESCRIPTION Detailed description of uAork to casework, lighting, plumbing lumbin and furniture. Plumbing' mechanical and electrical work to be under separate permit. be included on this permit only SAME PHrMARY PHONE Clise Properties (206) 623-7500 PROPERTY OWNER AKAILI tG ADDRESS 1700 Seventh Avenue, Suite 1800 F-HAII djones@clisepropetes.com CITY STATE ZSP Seattle WA 98101 NAME PHONE Rush Commercial 253 549-5163 YAILnr6 ADDRESS 6622 Wollochet Drive N-W. P-NAIL bgriffin@rushcommercial.com CONTRACTOR CITY SrATE Gig Harbor WA ZtP 98335-8325 FAX WA STATE CONTRACTOR'S LICENSE n'lrarRATION DATE USl I RUSHC' 913JG 04 / 07 / 2021 602 256 278 NAME Buffalo Design PRDLALRY PHONE (206) 467-6306 rnl1520LWO oustREW 1520 Fourth Avenue Suite 400 MML dale buffalodesi n.com @ g APPLICANT CITY Seattle STATE WA ZIP 98101 FAX PROJECT CONTACT NAME Dale Carlson PRIMARY PHONE (253) 848-1311 MA ANO ADDRESS 1520 Fourth Avenue Suite 400 r1hWL dale@buffalodesign.com )The individual to receive and respond to all correspondence CITY Seattle STATE WA 7 zip 98101 FAX concerning this application] PROJECT FINANCING NAME® OWNER -FINANCED When Value is $5.000 Or more MAILING ADDRESS, CITY, STATE, ZIP PRONE (RCW 19.27.095) I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I certify that to the beat 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 rrrnove the owner's responsibility for compliance with local, state, or federal taws regulating construction or environmental laws. I further agrta 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 cony person, including the undersigned, and flied 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. f 10/27/2020 SIGNATURE: _ . DATE PRINT NAME: Dale R. Carlson Bulletin # l00 - February 19, 2020 Page l of 2 k:lHandoutslPerrnit Application MECHANICAL PERMIT Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existiggfixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial) BOILERS FURNACES HOT WATER TANKS (Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING PERMIT Indicate how many of each type offixture 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 EXISTING/PREVIOUS USE LOT SIZE (In Square Feet( EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑ Yes ❑ No ❑ Yes ❑ No 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 EXISTING PROPOSED TOTAL **NEW HOMES ONLY** ESTIMATED SELLING PRICE $ # OF BEDROOMS COMMERCIAL - NEW/ADDITION AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction Type # of Stories Additional Information NEW BUILDING ADDITION COMMERCIAL - REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction Type # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application