17-100687 44k16.
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PERMIT APPLICATION
CITY OF FEB 10. 2017
Federal Way PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcenten3ritvoffederahvay.corn
CITY OF FEDERAL WAY
C �/
DS
PERMIT NUMBER] / 0 0 (0 p _ F TARGET DATEAi A-
SITE ADDRESS LLL SUITE/UNIT#
33501 1st Way S 1st Floor Center/FACP R-n
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 4460.00 9 2 6 5 0 4 - 0 0 1 0
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING I&FIRE PREVENTION
NAME OF PROJECT Virginia Mason Tamper and Float Switch Monitor
PROJECT DESCRIPTION Provide (2) IAMS to monitor Tamper Switches and a water tank float.
Detailed description of work to Joint venture between SimplexGrinnell&Sasco Electric.
be included on this permit only
NAME PHONE
Virginia Mason Clinic PRIMARY 53874-1652
PROPERTY OWNER MAILING ADDRESS E-MAIL
33501 1st Way S.
OITY Federal Way g003
NAME Sasco Electric PHONE 425-806-8400
MAILING ADDRESS E-MAIL
CONTRACTOR 16650 Woodinville-Redmond Road
CITY Woodinville WAS ZIP 98072 FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
SASCOE"051 R6 12/ 26 17 601677475
NAME PRIMARY PHONE
SimplexGrinnell 206-291-1400
APPLICANT MAILING ADDRESS E-MAIL
9520 10th Ave S. Suite 100 jastebbins@simplexgrinnell.com
CITY STATE ZIP FAX
Se attle WA 98108 206-291-1500
PROJECT CONTACT NAME Janet Stebbins/SimplexGrinnell 25rg1Hne8 / -VS--
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 9520 10th Ave S. Suite 100 jastebbins@simplexgrinnell.com
concerning this application) CmSeattle TR ZIP F
WA 98108 FAX
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 79.27.095)
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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 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,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application
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t
SIGNATU � dite
DATE 2/7/2017
PRINT N Janet Stebbins/ implexGrinnell
Bulletin#100—January 29,2016 Page 1 of 2 lc:\Handouts\Permit Application
• •
VALUE OF MECHANICAL WORK
MECHANICAL 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.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS- FURNACES 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 rub/Shower combo) LAVS(Rend sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR(or Mobile Home)
COVERED ENTRY
GARAGE 0 CARPORT 0
Area Totals EXISTING PROPOSED TOTAL
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Occupancy Group(s) storks Additional Information
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Occupancy Group(s) #°f Additional Information
(� Stories
•¢'r,,..lu ° (t �) ", r� ;:.;"1 $, ;. ;,wi s
•
TENANT AREA .1111,1111.111
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Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application