13-103132 RECEIV• . 3 - 7 0 ( 3
F,rrw PERMIT SF MF CO ME PL DE EN a
Federal Way juL 16 2013
COMMUNITY DEVELOPMENT SERVICES PP LI CAT I O N
253-835-2607•FAX 253-835-26I
I TE OF FEDE-•
cuw;.clittoffe:lerrdu u a.rnC
CDS
SITE ADDRESS SUITE/UNIT#
34515 9th Avenue South Kitchen
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL S
4575.00 7 5 0 4 5 1 0 0 2 0
TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING E FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) St Francis Hosptial - Kitchen
PROJECT DESCRIPTION Modify existing fire alarm system. Joint venture between
Detailed description of work to SimplexGrinnell & Sequoyah Electric.
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Franciscan Health System (253) 874-2227
MADAHG ADDRESS E-MAIL
34515 9th Ave S.
CITY STATE ZIP
Federal Way WA 98003
NAME PHONE
Sequoyah Electric 425-814-6000
MAILING ADDRESS E-MAIL
15135 NE 92nd St.
CONTRACTOR
CITY Redmond STATE
FAX
ZIP 98052 425-814-6005
WA STATE CONTRACTOR'S LICENSE S EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
SEQUOEL977S9 1 / 29 / 15
NAME PHONE
SimplexGrinnell 206-291-1400
AIL
APPLICANT
MAILING ADDRESS 9520 10th Ave S, Suite 100 jastetbin@simplexgrinnell.cpm
CITY Seattle STATE ZIP 9 810 8 FAX206-291-1500
PROJECT CONTACT NAME Janet Stebbins/SimplexGrinnell PHONE 206-291-1468
(The individual to receive and
respond to all correspondence MAILINGADDRESS 9520 10th Ave S, Suite 100 jastebbinnss@simplexgrinnell.com
concerning this application)
CITY _$
Seattle AZE ZIP 98108 FAX 206-291-1500
ALTERNATE CONTACT NAME: W PHONE E-MAIL
Steven Burger 206-291-1452 s3urger@simplexgrinnell com
PROJECT FINANCING NAME
El OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS.CITY.STATE.ZIP PHONE
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 cert(fy 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:/, `3n•�(.r1 �Y ,(1..te ,C�8.1 Pt,if DATE 07/15/2013
PRINT NA, •/Janet Stebbins/SimplexGrinnell
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application
• • •
MECHANICAL FIXTURES
VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
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 OUTLEIS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(cas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES
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'nb/Shower Combo) LAVS(Hand Sinks) TOILL1'D WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(eieebio)
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 AIDPITION .;
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECD-
-gg-1111 ,11
GARAGE ❑ CARPORT ❑
OTHER(describe)'
EXISTING PROPOSED TOTAL
Area Totals
,��ioCliX11
liy0mi,'�1�i�)ftOligS.()15tL".'Yn"'- ..
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMER"'" �N'�o %W DDITION � �
Area Construction #of
AREA DESCRIPTION
in Square Feet Occupancy Group(s)
Type Stories Additional Information
h' h,.
NEW BuILDINNG ip� p,r ` 0
ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
TOTAL Pi
BUILDING ,�, NO,
-,P40ia ��� �k 1 "!u
TENANT AREA ONLY
PROJECT AREA ONLY ",
Bulletin#100-January 1,2011 Page 2 of 3 k:\Handouts\Permit Application