15-100783 D - a
• Mechanical
City of Federal Way Permit #: 15-100783-00-M E
Community&Ecom.Dev.Services FILip
33325 8th Ave S
Federal way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835 2607 Fax (253)835 2609 pec
Project Name: ST FRANCIS HOSPITAL
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Rework existing HVAC system to accomodate additional heat load of new CT equipment
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM OLYMPIA SHEET METAL INC OLYMPIA SHEET METAL INC
1717 S"J"ST 2839 MARVIN RD NE OLYMPSM044JE (4/5/16)
TACOMA WA 98405-4933 OLYMPIA WA 98516-3170 2839 MARVIN RD NE
OLYMPIA WA 98516-3170
Additional Permit Information
Is this an Online or O.T.C.application? No
Mechanical Fixtures
Air Handling Units 1
PERMIT EXPIRES Tuesday, September 8, 2015
Permit Issued on Thursday, March 12, 2015
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will in accor nce with the laws, rules and regulations of the State of Washington
And th City of Federal Way.
Owner or agent: P.>'/w+ Date: 3`SZ.- l
+. • f y
10 THIS CARD IS TOOON-SITE
CITY OF 14kA Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-100783-00-ME Address: 34515 9TH AVE S
Project: FRANCISCAN HEALTH SYSTEM FEDERAL WAY, WA 98003-6761
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) E Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By ' VADate t I,a l By Date By �j� Date t(_1 7—IS
El Rough Electrical Final Electrical
ElRight of Way
Approved Approved Approved
By Date By Date By Date
• 0
�m� PERM PPLICATION
Federal Way REC` IV
ED
_ Q M FEB 18 2015 3
PERMIT NUMBER l -D _ 1 0 0 7- V 3_ J 't �,C /��' /(�/I s
H1R raremorL CDS
SITE ADDRESS SUITE/UNIT#
3i/5/ 9 i/I1rr 5, / 1L /,A.��9Y &'l 95V.
PROJECT VALUATION ZONING ASSESSOR'S TA%/PARC # j O O z_ O
TYPE OF PERMIT 0 BUILDING 0 PLUMBING X MECHANICAL 0 DEMOLITION 0 ENGINEERING/ , 0 FIRErPREVENTIONIVE
NAME OF PROJECT 57' F>NC 13 /10373/T'L CT /Ctpb ke//1.4 T
PROJECT DESCRIPTION Agko®iel� t /ST/lei - Mae C y�5��5T&'7 7P ALGaisq/VIOM7
Detailed description of work to f7 Ph/ / /d/�'�- /7&9T ie74b d F A' ) c T
be included on this permit only CO 11/,>/V
opm
PROPERTY OWNER Nom(..- /1 /�fCc/ 4A) /1 L^T'r/ (TMARYy
/S 760 /
MAILING SS
p o_ Sox 2i97 1'i�/i',LE@ F// N&4LT//.O2G-
�O�A CITY STATE ZIP Yr,
OLYMP/✓1 64 7 NET/9Z /141 -MAILING ADDRESS
_E 0NE) y9/-//Z3
CONTRACTOR z83,7 r "r 9/eAi /�o OYe OFFICE-( s/7���-�
���/t'JP/�9 �t�/�3 �983/k ( ,o) q9/-//f 3
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PHONE
NAME , j /A1 ,// 5/ 8 I 0 z3 -5-61-/f
APPLICANT g3! M4,641 CP �LC Wii//046aV5///lierit.G'
C o� 'i�pi� ST 9�'�®� ( AX ) yq/- 03
N PHONE
PROJECT CONTACT 5`J/"/E , J ,4801E
(The individual to receive and elAu uvG ADDRESS EMAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
PROJECT FINANCING NAME Pt OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.09
5
1
I certi(j under penalty of perjury that I am the property owner or authorised agsnt 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 - --- •ut of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city • a part of` application. Q
SIGNATURE: ` A ' �rAger DATE res /U/ 2(/5.
PRINT NAME: O/� A&,VB
Bulletin#100-January 1,2013 Page 1 of 3 kaHandouts\Permit Application
• • •
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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 X OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial) 1411/ B0X
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
x DUCTING GAS PIPING ___ WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $ .
Indicate how many of each type of fixture to bev o rted as part. project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Ha ) TOILETS WATER PIPING
DISHWASHERS RAINWAIIE: MS URINALS OTHER(Describe)
DRAINS --" RS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(eieetrio)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
N° L° LUQ $
EXISTING/PREVIOUS USE LOT SIZE IIn Square Feet) EXISTING FIRE ER SYSTEM? PROPOSED FIRE UPPRESSI SYSTEM?
I�i5cY 1' / es ❑ No ❑Yes pfNo
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
.:. 2 d - „ i ; tee. : ;(` x
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—._..—.._—__..._._._..
FIRST FLOOR(or Mobile Home)
COVERED ENTRY
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O
GARAGE ❑ CARPORT ❑ /
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®STING PROPOSED TOTAL
Area Totals
tWH x,
ESTIMATED SELLING PRICE$ #OFOBEDROOMS --
t
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupan r- up(s) Construction #of Additional Information
is$quare Feet Tie Stories
Fes`? A t c t y
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°z n sr- .U�ADDITION
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z }COMMERCIAL—REMODE
EMODE , ' ENANT IMPROVEMENTS
Area
Construction #of
AREA DESCRIPTION Occupancy Groups)
Additional Information ion
Square Feet TY?! Stories
b d w t ilY gi T' '' I � 1 Y
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B � ^ L 4r £- „ A y i
,._ « °ef x > 4# r $ <1 1 0 ,Wit'Mt.g N. . . is
TEN ONLY
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Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application