16-102365 e■ 4
``r� Mechanical
City Federal D way #: 1 -102365-00-M E
Community&Econ.Ave v.Services Permit #. 6
33325 8th v S FINALED
Federal Way,WA 9e003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 q
Project Name: SEA-MAR CLINIC
Project Address: 31405 18TH AVE S Parcel Number: 092104 9233
Project Description: Install gas piping for(14)HVAC rooftop units. ,
,
Owner Applicant Contractor
SEA-MAR COMM HEALTH CENTER M C PIPEMASTERS LLC M C PIPEMASTERS LLC
1040 S HENDERSON ST 12312 135TH STREET CT KPN MCPIPPL881M3(8/6/16)
SEATTLE WA 98108 GIG HARBOR WA 98329 12312 135TH STREET CT KPN
GIG HARBOR WA 98329
. •
Additional Permit information
Mechanical Work Valuation 10000 Is this an Online or O.T.C.application No
Mechanical Fixtures
Gas Piping 14
PERMIT EXPIRES Saturday, December 10, 2016
Permit Issued on Monday, June 13, 2016
I hereby certify that th- above,i irmati.• is correct and that the construction on the above described property and
the occupancy and t ,. use il,- in - ordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. I
Date: 1/ 20/6
Owner or agent: . . ._ �1.
Y
OFD
THIS CARD IS TO ON-SITE '�
Cr"a Construction In ction Record^
Federal Way INSPECTION REQ TS:(253)835-3050
PERMIT#: 16-102365-00-ME Address: 31405 18TH AVE S
Project: SEA-MAR COMM HEALTH CENTEF FEDERAL WAY, WA 98003-5404
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.
0 Mechanical Rough-in(4165) - - Gas Piping(4125) -❑ -Final-Mechanical(4065)
Approved Approved to release test Approved
By Date s, Date •7_(`16 c. Dater (e 1 SCJ ,
1
1
1
El Rough Electrical Final Electrical
g rical Right of Way
Approved Approved Approved
1 By Date By Date By Date
1
,,,„,„ ,A, et").�,i7YOF PERMI'TIPPLICAZ'ION
r
federal Way MAY 1 � Zoos
`,» CITY OF FEDERAL WAY
PERMIT NUMBER L
l
— - TARGET DATE C'/71 "
SITE ADDRESS J SUITE/UNIT#
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ & - 1 ( 0 / - r Z 3 3
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING !.,MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT 1 _�4 ./.�
PROJECT DESCRIPTION �" 0`n t• ►y i/ 1 �1 °S
Detailed description of work to
be included on this permit only
NAME Se-4_, � PRIMARY PHONE
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAM. PHONE
G zs ' 377 v11.-1
MAILING ADDRESS /' L E- L f ,
CONTRACTOR 1- 31,?.. 1-55 'cv r, GI-• J�u^- Gd�b�j/if bt../'C>s�
CI'fTL l, l L- -- I ZIP
J�'� /FAX
WA STAlE CONTRACTOR'S LICENSE# I EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
V ( 1 <6 , 1 1AN3 / /
NAME ----_----... PRIMARY PHONE - --
j 6-.rin e. G S W r-` A.-C4v✓
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT 20Y1 CoL6 2s-5 3 ?7 07/ 7
(The individual to receive and MAILING ADDRESS j' E-MAIL / / y
respond to all correspondence 1 2-3 (2- (3S S( v 4 lG e,/ a4,0a0 fizoki•C,
concerning this application) CITY, / / I STAT; ZIP
=1, ' l/,/� �Kic� III/,
qf 327
PROJECT FINANCING NAME ❑ OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.0951
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.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 remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmie the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense,f h claim), w 'eh may be made by any person,including the undersigned,and filed against the city,
but only where such claim A se o t of t liance of the city, including its officers and employees, upon the accuracy of the 1
information suppliLd o the c ,t • fart of application.
I SIGNATURE: igih.. ,L: AIL r DATE
PRINT NAME: I _ '
Bulletin#100—February 22,2016 Page 1 of 2 k:\Handouts\Permit Application
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VALUE OF MECHANICAL WORK H I
MECHANICAL PERMIT $ x
Indicate how many of each type of fudure to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) .1 1
AIR CONDITIONER FIREPLACE INSERTS HOODS(commerc(a1)
BOILERS URNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Tub/shower combo) LAVS(Hood sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Eiecu q
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AR O PR PERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING I PROVEMENTS
I k U
EXISTING/PR VIOU USE LOT SIZE(In Square Feet) EXISTING FIRE SP ER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
- es ❑ No es ❑ Noy
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)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES O1NLX**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION
Area m Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
Area in Construction #of
AREA DESCRIPTION Square Feet Occupancy Group(s) Type Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—February 22,2016 Page 2 of 2 k:\Handouts\Permit Application