07-104317N, I
fifty of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, V✓A 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Mechanical Permit #: 07- 104317 -00 -ME
Inspection Request Line: (253) 835 -3050
Project Name: PACIFIC MEDICAL CENTERS PRIMARY CARE CENTER
Project Address: 33501 1ST WAY S Parcel Number: 926504 0010
Project Description: Adding (5) VAV boxes with heat, (3) exhaust ns, relocating (1) existing VAV b9x
relocating (1) existing grille and diffuser /grin- ` ductwork.
Owner
Applicant xa
Contractor
VIRGINIA MASON MEDICAL CENTER
MACDONALD MILLER SERVICE IN
CDONALD MILLER SERVICE INC -
1100 9TH AVE
MECH
MECH
SEATTLE WA 98101 -2756
7717 DETROIT AVE SW
MACDOFS980RU 12/31/08
SEATTLE WA 98106
7717 DETROIT AVE SW
SEATTLE WA 98106
Additional Permit Information
Mechanical Valuation ................... .........................19625 Over the Counter Permit? ...................... ............... Yes
Mechanical Fixtures
Ducts.... 5 Fans .............. ............................... 4
CONDITIONS:
PERMIT EXPIRES Monday, August 3, 2009
Permit Issued on Friday, August 3, 2007
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be i accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent -. Date: Ogle 3 /0 2
F04At fm:)
lid'k
r
DATE
` THIS CARD IS TO REMAIN ON -SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 104317 -00 -ME
Owner: VIRGINIA MASON MEDICAL CENTER
Address: 33501 1 ST WAY S
FEDERAL WAY, WA 98003 -6208
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 (4165) ❑ Gas Piping (4125) ❑ Final - Mechanical (4065)
Approved Approved to release test Approved
By
C'J Dat —� By Date B Date /Q— S
(5�c�.07
For inspector reference only
❑ Rough Electrical O FINAL - Electrical
Approved Approved
By Date By Date
r'Q
CITY OF D / — G 1-3z 7—
_ Federal way 3 goo? PERMIT -- ii -----
COMMUNI7YDEVELOPMENTSERVICES SF MF CO(�) EL PL DE EN FP
33325 Ern AVENUE SOUTH • BOX 9718 "L I C ATI O N
FEDERAL WAY, WA 98063 63 -97]8 Y- �
253 - 835 -2607• FAX 253 -835 -2609 0�TY t?� Na
www- cttuoftade,ralwau.com BuJv
The following is re uired i0 formation - an incom lete ai2nlication will not be acce ted. Please erint le ibl (in ink) or type.
PROPERTY • •
SITE ADDRESS 3 50 , (S /! V N— S //++�� / SUITE /UNIT # FL ' r
ASSESSOR'S TAX /PARCEL # �D S C7 � - � V ( 0 LOT SIZE (s) 502 .3 S Qt +
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) C/Ve- Sr (-a&-
(Attach separate page for lengthy legal
N PROJECT INFORMATION
par-1,
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on ft era ' onlid
S'
"i l (
PROJECT NAME (Name of Business or Owner Last Name) l a C V- ry) Ae-Cq er� 0,44
PEOPLE •• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAM, PRIMARY PHONE
V ( r t I A V a lA&,SaA I ( ) N A
MAILING ADDRESS CITY, STATE, I
)1 00 q-h-- ,A, S-e a-
COMPANY NAME
Ac�c� opal( /l/k ( I W
APPLICANT NAME
Ac
APPLICANT NAME
�, Mu6& 20 ni ii�Z
OFFICE PHONE
(ate) -710
- 3)d2-
MAILINGADDRESS
I _I
MAILING ADDRESS
`7 -I 1 -1
CITY, STATE, ZIP
C PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant 40 Agent Other (Describe) F/-,
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
8.NPIRATION DATE
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application)
EXPIRATION
i Z/ 3 i
DATE
/0'
(n ( C- o 0 F �. C)
(L
COMPANY NAME
APPLICANT NAME
Ac
OFFICE PHONE
(aob) -
/ -A
.,Q-, & >z
CITY, STATE, ZIP
MAILING ADDRESS
`7 -I 1 -1
CITY, STA , IP
gg(pti
CELL PHONE
uoe ) -71, i - U). 7 �
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant 40 Agent Other (Describe) F/-,
FAX NUMBER
NAM PRIMARY PHONE E -MAIL ADDRESS
4 mun dl tZ0-yr) 3 $U 2
Per RCW 19.27.095. Lender ',iq ormation is
NAME �/�
required ifproject'value exceeds $5,000
/ -A
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
t ) -
PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
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)
jT Pda,yn��
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
FIRST
o Q
SECOND, T A o� /$ d' -t Y r i n cc" t
T w�
Shy /i'1 6
THIRD
1 h L
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
-� �'c�,r�'�
AMCJ
DECK(COVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
EXISMc
PROPOSM
Tana.
MAL E8 "WOW
TmeLPROPOeIEDOF
TMALW
* *NEW HOMES ONLY ** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type offature to be installed or relocated as part of this project. Do not include existing fixtures to remain.
ofMechanical Work $ i bo 1 q Ws`�_
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATHTUBS (or Tub /Shower Combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
LAVS (Bathroom Sinks)
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS (commerciaD
RANGES
GAS WATER HEATERS
WATER CLOSETS (Toilet)
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
v iae,(e_.)
MISC (Describe)
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 irformation supplied to the city as a part of
this applicatio^
NAN
RELATIONSHIP TO PROJECT ❑ Owner XAgent ❑ Contractor ❑ Architect ❑ Other
% -3 --0'
Bulletin #100 —January 1, 2006 Page 2 of 4 k\Handouts\Permit Application