18-101911RECEIVED
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CITY OF
Federal Way
PERMIT NUMBER (
MAY 0 3 2018 PERMIT APPLICATION
CITY OF FEDERAL WAY PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
COMMUNITY DEVELOPMENT 253-835-2607 + FAX 253-835-2609 +nermitrcntelk.Eilyoffederalway.eom
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TARGET DATE 0 17— I�
SITE ADDRESS SUITE/UNIT M
34515 9th Ave S, Federal Way, WA 98003
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL N
$ 111, 000.00
OP
7 0 4 5 1- 0 0 2 0
TYPE OF PERMIT
[BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
St Francis Hospital Patient Lift Installation
Installation of Patient Lifts in 27 patient rooms.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
St Francis Hospital
PRIMARY PHONE
253.944.4111
PROPERTY OWNER
MAILING ADDRESS
34515 Ninth Avenue South
..E-MAILmcanon@catholichealth.net
CITY Federal Way
STATE ZIP 98003 I
NAME ^
PHONE -4- S I
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
Q G
STATE
ZIP
q 7oyS
FAX
o�
WA STATE RACTOR'B L NSE N
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
NAME Buffalo Design
PRIMARY
206 467 6306
APPLICANT
MAILING ADDRESS
1520 4th Ave. Suite 400
E-MAIL
chris@buffalodesign.com
CITY Seattle
STATE
WA
ZIP
98101
FAX
NAME Chris Carlson
PRIMARY 206.467 6306
PROJECT CONTACT
MAILING ADDRESS
1520 4th Ave., Suite 400
E-MAIL
chris@buffalodesign.com
(The individual to receive and
respond to all correspondence
CITY Seattle
STATE
ZIP
98101
FAX
concerning this application)
WA
PROJECT FINANCING
NAME
OWNER -FINANCED
When value is $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW ] 9.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I cert(ry that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I cert(jy that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
Issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and flied against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to 0e- ity as a art a this application.
SIGNATURE. DATE �g
PRINT NAME: Chris Carlson, AIA architect Buffalo Design
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
MECHANICAL PERMIT
Indicate haw MEW of each type o
wture to be installed or rel
AIR HANDLING UNITS
FANS
AIR CONDITIONER
FIREPLACE INSERTS
BOILERS
FURNACES
COMPRESSORS
GAS LOG SETS
DUCTING
GAS PIPING
as
PLUMBING PERMIT
Indicate how mcxng of each type a
be installed or relocated as
BATHTUBS -(or Tub/Shower combo)
LAVS (Bend Sinks) —
DISHWASHERS
RAINWATER SYSTEMS _
DRAINS
SHOWERS —
DRINKING FOUN S
SINKS (Kitchen/Utility) —
HOSE BlB
_ SUMPS —
GENERAL INFORMATION
'd VALUE OF MECHANICAL WORK
--$ 0.00
not include e,,dStjytqfWures to rem
GAS OWTLETS
D.ai (commercial(
HOT WATER TANKS (Gas)
REFRIGERATION SYST
WOODSTOVES
OTHER (Describe)
VALUE OF PLUMBING WORK
0.00
Do not include exisfinffA LctHres to rem
TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS (Electric)
WASHING MACHINES
WATER PIPING
OTHER (Describe)
TOTAL FIXTURES
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
no
N/A
$
EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Patient Rooms (nochange) yes ❑ No
❑ Yes gY 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)
OUSTINGPROP09ED TOTAL
Area Totals
**NEW iF�S ONLY —
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Groups) Construction
Type
# of Additional Information
Stories
Square Feet
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) Construction
Tvve
# of Additional Information
Stories
Square Feet
TOTAL BUILDING 220,608 1-2 1A
3
TENANT AREA ONLY
PROJECT AREA ONLY 6,075 1-2 1 A
NA -
Bulletin #100 — January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application