09-102507r
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CITY OF A R oq--to 4 5
Federal Way pr PERMIT
COMMUNitY DEVELOPMENTSERVICES JUL 0 2 1 SF MF CO ME EL PL DE EN FP
3331581 AVENUESOUTH•PO BOX 9718 ATI O N
FEDERAL WAY,WA98063 -9718 � -IDI
253-!35-_2. 607•FAXeraj8 - Y O `,J
wcityaHederah .c
The following is required information Zn incomplete application will not be accepted. Please print legibly (in ink) or type.
PROPERTY •' •
SITE ADDRESS 301 S. 320TH ST. SUITE/UNIT#
ASSESSOR'S TAX /PARCEL # 1721049105 LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) 6ROUPHEAI.1rH
(Attach separate page forlengthylegaldescription)
PROJECT "•' •
TYPE OF PERMIT BUILDING PLUMBING MECHANICAL
DEMOLITION ELECTRICAL ENGINEERING X FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
THE SCOPE OF THIS PROJECT IS TO ADD FIRE SIGNAL EXPANDERS & NOTIFICATION DEVICES FOR THE PURPOSE OF TENANT IMPROVEMENT.
PROJECT NAME (Name ofBusiness or Owner Last Name) GRO PHE T TH FEDERAL WAY
PEOPLE INFORMATION
PROPERTY NAME E
OWNER
GROUPHEALTH COOP C/0 TRAMMELL CROW CO.
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
COMPANY NAME
SMITH FIRE SYSTEMS MANAGEMENT,LLC.
APPLICANI NAME
SCOTT JERKE
12501 E MARGINAL WAY S. #ASB -1
TUKWILA, WA 98168
TACOMA, WA 98424
COMPANY NAME
SMITH FIRE SYSTEMS MANAGEMENT,LLC.
APPLICANI NAME
SCOTT JERKE
OFFILtPHONE
(253) 248 -2004
1106 54TH AVE E.
TACOMA, WA 98424
200610470900BL 12/31/09
(253) 926 -0726
SMITHFS946LO 6/20/10
SJERKE @SMITHFIRE.COM
COMPANY NAME
SMITH FIRE SYSTEMS MANAGEMENT, LLC.
SCOTT JERKE
UFFILt PHONE
(253) 248 -2004
1106 54TH AVE. E.
TACOMA, WA 98424
Architect Tenant Agent XOther CONTRACTOR
(253) 926 -0726
NAME
SCOTT JERKE
PIIIMARYPHUNI
(253) 248 -2004
E-MAIL AUDHI,55
SJERKE @SMITHFIRE.COM
NAME-
er
Lender information is required if project value exceeds $5,000
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUES VALUE OF PROPOSED WORKS 64,142.00
SPRINKLERED BUILDING? YES NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? YES NO
WATER SERVICE PROVIDER LAKEHAVEN HIGHLINE TACOMA PRIVATE (WELL)
SEWER SERVICE PROVIDER LAKEHAVEN HIGHLINE PRIVATE (SEPTIC)
0
PROJECT FLOOR AREAS
DESCRIPTION AREA
I I
SQ. FT.
SQ. FT.
L
SQ. FT.
BASEMENT
FIRST
51,618
SECOND
THIRD
ADDITIONAL FLOORS (DESCRIBE)
DECK( COVERED OR UNCOVERED ?)
GARAGE CARPORT
NUMBER OF FLOORS
EXISTING
PROPOSED
TOTAL
TOTAL EXISTING SF
TOTAL PROPOSED SF
TOTAL SF
* *NEW HOMES ONLY ** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (orT.b /Showercombo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
(A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAVS (Bathroom Sias)
RAINWATER SYST
SHOWERS
SINKS
SUMPS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (Commercial)
RANGES
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS (Toilet)
WASHING MACHINES
WOODSTOVES
MISC (Describe)
MISC (Describe)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my
knowledge, the information submitted in support of this permit application is true and correct. l certify that I will comply with all applicable City of Federal Way regulations pertaining to the work
authorized by the issuance ofa 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 environmen tal 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 ode by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city,
including its officers and employees, upon the accuracyhe informatiory�i pplied to the city as apart of this application.
SIGNATURE:
NEW ADDITION
BUILDING SHELL ONLY?
ZONING DESIGNATION
NEW ADDRESS REQUIRED?
PLATTED LOT?
/
DATE 2 /
ALTERATION REPAIR TENANT IMPROVEMENT
YES NO BASIC PLAN? YES NO
CHANGE OF USE? YES NO
YES NO UP /SEPA/SU? YES NO
YES NO DEMO PERMIT REQUIRED? YES NO
Bulletin #100 - August 16, 2007 Page 2 of 4 k\ \Handouts\ \Permit
Application