08-101509 ECEIVE
pp
CITY OF
Federal WayV,�� PERMIT
COMMUNITY DEVELOPMENT SERV!®9 AR 2 7 2008 SF MF CO ME EL PL DE EN FP
33325 8mAVENUE SOUTH•PO BOX 9718 APPLICATION TD
FEDERAL 98063-9718
253-835- 07• A 2 3 F FEDERAL
www.otyo a er way. rC WAY —�
The following is requiredGfaSition-an incomplete application will not be accepted. Please print legibly(in ink)or type.
PROPERTY INFORMATION
SITE ADDRESS 33801 1ST WAY S.,#101,FEDERAL WAY,WA 98003 SUITE/UNIT# 0 c
ASSESSOR'S TAX/PARCEL# 9265040160 LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) WASHINGTON PARK PROPERTIES
(Attach separate page for lengthy legal description)
PROJECT INFORMATION
TYPE OF PERMIT BUILDING PLUMBING MECHANICAL --- - —._—
DEMOLITION ( ENGINEERING - X FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
THE SCOPE OF THID PROJECT IS TO ADD INITIATING DEVICES AND RELOCATE NOTIFICATION&INITIATING DEVICES FOR THE PURPOSE OF TENANT IMPROVEMENT.
PROJECT NAME(Name of Business or Owner Last Name) CD!RADIOLOGY Civ ' 1---re--- Til .l c/s
PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER WASHINGTON PARK PROPERTIES
MAILING ADDRESS DIY,STAT E,ZIP E-MAIL ADDRESS
PO BOX 1310 VANCOUVER,WA 98666
CONTRACTOR COMPANY NAME APPLICAN I NAME OFFICE PHONE
SMITH FIRE SYSTEMS MANAGEMENT,LLC. SCOTT JERKE (253)248-2004
MAILING ADDRESS CI I Y,S I A I E,ZIP CELL PHONE
1106 54TH AVE E. TACOMA,WA 98424
CIJY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIHAI ION DA I E FAX NUMBER
200610470900BL 12/31/07 (253)926-0726
CONI RAC I UR'S REGIS I HA I IDN NUMBER - EXPIHAI ION DAZE E-MAIL ADDRESS
SMITHFS946L0 6/20/08 SJERKE@SMITHFIRE.COM
APPLICANT COMPANY NAME APPLICAN NAME OFFICE PHONE
SMITH FIRE SYSTEMS MANAGEMENT,LLC. SCOTT JERKE (253)248-2004
MAILING ADDRESS CI I Y,STA I E,LIP CELL PHONE
1106 54TH AVE.E. TACOMA,WA 98424
RELATIONSHIP 10 PROJEL I FAX NUMBER
Architect Tenant Agent XOther CONTRACTOR (253)926-0726
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT SCOTT JERKE (253)248-2004 SJERKE@SMITHFIRE.COM
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS LI I Y,SIA I E,ZIP PHONE
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK$ 3512
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)
Y
It
• •
• PROJECT FLOOR AREAS
AREA-DESCRIPTION EXISIINC, PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMEN I
FIRST 1307
SECOND
THIRD
ADDITIONAL FLOORS(DES
DECK(COVERED OR UNCOVERED?)
GARAGECARPORT
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTALEXISTINGSF 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.
MECHANICAL
Value of Mechanical Work$ (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 (Commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS (or Tub/Shower Combo) LAYS (Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS (Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
' SIGNATURE
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 harmless the City of Federal Way as to an claim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by a 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 accuracy oft information su plied to the city as a part of this application.
SIGNATURE: I DATE 3 -7`C?
Pr erty Owner and/o Authorized Agent [[[
FORJ9F.FIA S ® �n rr
„uri i,� ..
NEW ADDITION ALTERATION REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY? YES NO BASIC PLAN? YES NO
ZONING DESIGNATION CHANGE OF USE? YES NO
NEW ADDRESS REQUIRED? YES NO UP/SEPA/SU? YES NO
, - , - ..
PLATTED LOT? YES NO DEMO PER ..m�.,.
MIT REQUIRED? YES NO
Bulletin#100-August 16,2007 Page 2 of 4 k\\Handouts\\Permit
Application