17-102131 • RECEIVED
,116, MAY 092017 PERMIT APPLICATION
CITY OF .:tea
e £ rFCITY OF F DE OPMEN PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
COMMUNITY 253-835-2607+FAX 253-835-2609 +permitcentetYc,c.:itvoffecierahvac.com
PERMIT NUMBER L i _ 1 ci _ F 1.,,[ A
TARGET DATE
SITE ADDRESS SUITE/UNIT#
34515 9th Avenue S First Floor Central Observation Unit
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 20460.00 7 5 0 4 5 1 _ 0 0 2 0
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING II FIRE PREVENTION
NAME OF PROJECT St Francis Observation Unit, First Floor Central
Modify existing fire alarm system at St Francis Hosp Observation Unit, 1st Floor Central.
PROJECT DESCRIPTION Joint venture between SimplexGrinnell and H&M Electric.
Detailed description of work to
be included on this permit only
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 sox
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 PRun g E1400
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 EMAIL
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: DATE 5/2/2017
PRINT NAME: Janet 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)commcrdai)
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) LAYS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Eletric)
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 0 Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
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
OTHER(describe);';
EXISTING PROPOSED TOTAL
Area Totals
**NEW HO. S ONLY"*
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area In Construction # of
Occupancy Group(s) Additional Information
Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application