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CITY OF PERMIT SF MF CO ME PL DE EN FP
Federal Way
COMMUNI7YDEVELOPMENT SERVICES APPLICATION RECEIVED
253-835-2607•FAX 253-835-2609
?not,,irytjkedernhuuatL eum
MAR 11 2014
SITE ADDRESS CITY OF FEDERAL WAY ITE/UNIT#
34515 9th Avenue South ' CDS Pharmacy
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 7000.00 7 5 0 4 5 1 _ 0 0 2 0
TYPE OF PERMIT BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING X] FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) St Francis Hosptial - Pharmacy TI
PROJECT DESCRIPTION Modify existing fire alarm system. Joint venture between
Detailed description of work to SimplexGrinnell & Thompson Electrical Contractors.
be included on this permit only
NAME PRIMARY PHONE _.
PROPERTY OWNER Franciscan Health System (253) 874-2227
MAILING ADDRESS E-MAIL
34515 9th Ave S.
CITY STATE ZIP
Federal Way WA 98003
NAME PHONE
Thompson Electrical Contractors 253-539-0999
MAILING ADDRESS E-MAIL
PO Box 45260
CONTRACTOR
CITY STATE ZIP FAX
Tacoma WA 98444
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
THOMPSECOO8CW 2 16 X16 200110296100BL
NAME SimplexGrinnellG'�'E206-291-1400
APPLICANT
MAILING ADDRESS 9520 10th Ave S, Suite 100 jaste binnss@simplexgrinnell.cDm
CITY Seattle STATE ZIP 98108 FAX 206-291-1500
PROJECT CONTACT NAMEJanet Stebbins/SimplexGrinnell PHOS 206-291-1468
(The individual to receive and
respond toall correspondence MAILING ADDRESS
9520 10th Ave S, Suite 100 jaste biMns�@simplexgrinnell.com
concerning this application)
CITY Seattle STATE ZIP 98108 FAX 206-291-1500
ALTERNATE CONTACT NAME: PHONE E-MAIL
Steven Burger 206-291-1452 s urger@simplexgrinnell co
PROJECT FINANCING NAME
0 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 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: - Y' 7" ,flv,s,�, 1,/Nf1 it-Y-0 7-7.4 I,// DATE 03/11/2013
PRINT NAME: Janet Stebbins/SimplexGrinnell
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application
• 4110
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 futures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS)commercia))
BOILERS FURNACES HOT WATER TANKS(Gas)
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 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 il
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT .
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT 0
Ti3ER(describe) r
a+?I III'I',
EXISTING PROPOSED TOTAL
Area Totals
**NEW-HOMES any**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
Dips VNN p x71 r
iaggi-"I � a�� I ��COMMER L-NE%)V !DITIONI N 0�. 1
AREA DESCRIPTION
AreaConstructionGroup(s) Construction #of Additional Information
in Square Feet Type Stories
'I iii J� d
VIEW UILDINO ° dG
ADDITION Ta'
y� 8�;'t '� iii ii- i/r '�.. e- .. ._,- i i _., d IO.Ai-. -
I1�IP�2�a1 ;1: 1' TS �' I 'jl ti : '.
AREA DESCRIPTION
Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
Iqh illli pig �Hhi s ii •
BUII1 D NO ,040"0,40-00' NII
TENANT AREA ONLY
PROJECT"AREA ONLY Ni i is i q ti�
Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Pennit Application