17-101368 RECEIVED_
/ILMAR 2 7 2017
ilnO CITY OF � ��� PERMIT APPLICATION
,F, L.WAY PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
COMMU ;'iY I �G . PMENT
Federal Way 253-835-2607+FAX 253-835-2609+oermitcenteKilcitvoffederalwav.com
PERMIT NUMBERfff - 3
- TARGET DATE
SITE ADDRESS SUITE/UNIT#
34515 9th Avenue S Cath Lab-Garden Lev and 1st Fl
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 25920.00 7 5 0 4 5 1 _ 0 0 2 0
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING CYJ FIRE PREVENTION
NAME OF PROJECT St Francis Cath Lab-Garden Level, Level 1
Remove existing FACP in Cath Lab area and 15 devices. Relocate 5,Add 43 New
PROJECT DESCRIPTION Devices to existingfire alarm system. Joint venture between SimplexGrinnell and
Detailed description of work to y p
be included on this permit only H&M Electric.
NAME PRIMARY PHONE
St Francis Hospital (253)835-8100
PROPERTY OWNER MAILING ADDRESS E-MAIL
34515 9th Ave S
CITY STATE- ZIP
Federal Way WA 98003
_.
NAME _ . PHONE
H&M Electric 360-386-1554
MAILING ADDRESS E-MAIL
CONTRACTOR 918 Cedar/PO Box 799
CITYMarysville sfe ZIP 98270 FAx
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
HMELEI*077KR 5 19 17 19-93-103797-00-BL
NAME SimplexGrinnell PRIITE-1400
APPLICANT MAILING ADDRESS E-MAIL
9520 10th Ave S. Suite 100 jastebbins@simplexgrinnell.com
CITY STATE ZIP FAX
Seattle WA 98108 206-291-1500
NAME PRIMARY PHONE
PROJECT CONTACT SimplexGrinnell/Janet Stebbins 206-291-1400
(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) CITY STATE ZIP FAX
Seattle WA 98108 206-291-1500
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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 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.
SIGNATURE: i / S/141� �/'(yl� DATE 3/10/2017
PRINT N -net Stebbins for SimplexGrinnell
Bulletin#100—January 29,2016 Page 1 of 2 k:\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 Tub/Shower Combo) LAVS(Hand 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
4ipASEMEN
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
•
COVERED ENTRY
PPPIP ---
DEI
GARAGE 0 CARPORT ❑
:OTHER iG1SG• w\ . \ b , �
EXISTING PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
S.uare Feet •e Stories
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
Area in Construction #of
AREA DESCRIPTION Occupancy Group(s) Additional Information
Square Feet a Stories
q BIIIIAI9Ik1C� \\ .F- `� ` \ -#a \ w. �� - it �\,, � �,y `\\\: irk• `�ii,u�•••
TENANT AREA ONLY
iii `�"
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Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application