07-100780City of Federal Way 0
Community Development Services Mechanical- Perm##: 07-100780-0'O'-M,E
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: AUBURN REGIONAL MEDICAL CENTE
Parcel Number: 185295 0090
Project Address: 1413 S 348TH ST Suite L104
Project Description: Provide & install ductwork, grilles & diffusers, (3) WT boxes & (7) vent/exhaust fans for
tenant space. Existing RTU's by others.
Owner
Applican
Contractor
AUBURN REGIONAL MEDICAL CENTER
K & D MECHANICAL INC (GENERAL)
K & D MECHANICAL INC (GENERAL)
INC
1911 CAMPUS DR SW SUITE 321
KDMECI*008CJ (2/21/08)
202 N DIVISION
FEDERAL WAY WA 98023
1911 CAMPUS DR SW SUITE 321
AUBURN WA 98003
FEDERAL WAY WA 98023
Additional Permit Information
Mechanical Valuation ............................................ 16991 Over the Counter Permit? ...................................... No
Mechanical Fixtures
Du .. ...........
..........
f ...................................... 7
I hereby cefflfy'thWathb',
the occupancy and. the
Owner or agent:
with the laws, rules and
43'ity-of,Federal Way.
09
Date:
THIS CARD IS TO MAIN ON-SITE
CITY OF tommunity Develop'mfnt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07-100780-00-ME
Owner: AUBURN REGIONAL MEDICAL CENTER INC
Address: 1413 S 348TH ST Suite Ll 04
FEDERAL WAY, WA 98003
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence On-going inspections
are logged on the back of this card.
Mechanical Rough-in (416j5) Gas Piping (4125) Final - Mechanical (4065)
Approved Approved to release test Approved
By C�.. Cj Date S - 2 Z. By Date By.C::::'_ Date a. ')o
Federal Way
ECEi� 'PERMIT
conrn(uNmnEVatoPnlENrsER 1c s $F MF C E LPL DE EN FP
33325 Fu AVENUE SOUTH • PO BOX 9718
S3 °1� WAY, X^253s� 260 2APPLI CATI O N °
�e 1 - ..
www.ci1v9 ffedemiwn1 .rnm
WA
�.
The following is t>> - an incomplete application will not be accepted. Please print legibly (in ink) or. type.
SITE ADDRESS SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # _� 5 -2 - V U ( O LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach aeparetepaaefa lengthy legal dwmphwo
PROJECT • •
TYPE OF PERMIT ❑ BUILDING O PLUMBING
)(
MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this Permit only)
CONTRACTOR
N(® y 9(0)
F_�- I »gah e1pllntba
APPLICANT
PROJECT
CONTACT
LENDER
NAME
APPLICANT NAME
t4--k-f- C_ s fz�
j) lz C-nr AG-
MAILING ADDRESS
9�C 04> /=
Tc? P CL A.' AV 7-5 )PAC-12- P
l=l^-IV� 7—/5'
''
71
V 470
E -MAIL ADDRESS
CONTRACTORS REGISTRATION NUMBER
Kb W fz C 0--cv C j
EXPIRAT ON DATE
2 a0
PROJECT NAME (Name of Business or Owner Last Name)
'�
145,049 C ff..ZM C
PEOPLE
•• •
PROPERTY
OWNER
CONTRACTOR
N(® y 9(0)
F_�- I »gah e1pllntba
APPLICANT
PROJECT
CONTACT
LENDER
NAME
APPLICANT NAME
t4--k-f- C_ s fz�
OFFICE PHONE
(L s�1 Y' f' (f Lo �t
MAILING ADDRESS
PRIMARY PHONE
MAlL1NG ADDRESS
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
/
EXPIRATION DATE
CITY, STATE, ZIP
V 470
E -MAIL ADDRESS
CONTRACTORS REGISTRATION NUMBER
Kb W fz C 0--cv C j
EXPIRAT ON DATE
2 a0
E -MAIL ADDRESS
'�
COMPANY NAME
APPLICANT NAME
t4--k-f- C_ s fz�
OFFICE PHONE
(L s�1 Y' f' (f Lo �t
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
/
EXPIRATION DATE
FAX NUMBER
_
CONTRACTORS REGISTRATION NUMBER
Kb W fz C 0--cv C j
EXPIRAT ON DATE
2 a0
E -MAIL ADDRESS
'�
145,049 C ff..ZM C
COMPANY NAME
5 ojod>P�.
APPLICANT NAME
OFFICE PHONE
)
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
_
N ME PRIMARY PHONE EMAIL ADDRESS
'W1)'MQ
r" ' v f- '-+T 1-- Gr N N - I Per RCW 19,57.095: _
Lender information is required if project value exceeds $5,000
MAILING ADDRESS CITY, STATE, ZIP I PHONE 1
EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ _ VALUE OF PROPOSED WORK
SPRINKLERED BUILDING? O YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE o TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
vvej
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 $ 6 �� �'�. -(A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS
WOODSTOVES
BBQS
_
FANS
GAS WATER HEATERS
MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (commerdaq
COMPRESSORS
FURNACES
RANGES
o NO
DLj.CB is
GAS LOG SETS
REFRIG. SYSTEMS
UP /SEPA /SU?
G
o NO
PLATTED LOT?
o YES o NO
BATHTUBS (or`rub /shower combo)
LAVS (Beu,roomsink.)
URINALS
MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS g.ikq
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
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 flied against the City of Federal Way, but only where such claim
arises out of the reliance of the city, in di its officers and employees, upon the accuracy of the information supplied to the city as apart of
this application.
NAME TITLE DATE
/ (Signatu e) (Title)
RELATIONSHIP TO PROJECT ❑ Owner o Agent ❑ Contractor ❑ Architect ❑ Other
a NEW o ADDITION
o ALTERATION
o REPAIR ❑ TENANT IMPROVEMENT.
BUILDING SHELL ONLY?
❑ YES o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED?
o YES o NO
UP /SEPA /SU?
o YES
o NO
PLATTED LOT?
o YES o NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 —January 1, 2007 Page 2 of 4 MilandoutsTermit Application