07-102572 f
Comm ityity o Fe eras Way
pment Services Bui g
in — Commercial Perm#: 07-102572=00-CO
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: ST FRANCIS HOSPITAL ICU/PCU EXPANSION
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: ADD-FOUNDATION ONLY for 20,000 square foot ICU/PCU wing addition to level 3 of
hospital together with a 3,000 square foot ER addition at level 1.
r
Owner Applicant Contractor Lender
FRANCISCAN HEALTH SYSTEM HAMMES COMPANY SKANSKA USA BUILDING INC. FRANCISCAN HEALTH SYSTEM
1717 S J ST 1325 4TH AVE SUITE 1035 SKANSUB985RT 1/12/09 1717 S J ST
TACOMA WA 98405 SEATTLE WA 98101 1633 LITTLETON RD TACOMA WA 98405
PARSIPPANY NJ 07054
4
Census Category: 437- Commercial alt/add /conversion
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq. ft.) 0 0 0 0
1
A i _ a rmit I0)rOla >ton
Building Pre-co 'Meeting Required?.. No Mechanical to be included? No
Number of Stories '1Permit for Building Shell Only? No
Plumbing to be Included? No Special Inspection(s)Required? Yes t
New/Additional Sq.Feet-Total 0
No Fixtures Associated With This Permit !!
CONDITIONS: 1 )11
This parcel is located within a Wellhead Protection Area ( re o nd must comply with FWCC,
Chapter 22,Article XIV "Critical Areas" and fill out a Hazar terials Inventory Statement,if
applicable.
PERMIT EXPII S ` n• , , ' ay 24, '009
Permit Issu- in T 1 .ay, May 24, i 7
I hereby certify that the above informati. is c*rre -hat the cons, ion o e above described property and
the occupancy an. -- use will be in a• 'rd. - th the laws, rule- = egula ins of the State of Washington
41)
d ' ity of Federal Wii
-
Owner or agent:
.,i- 6eSlAik , Date:
DATE INSPECTOR ` ' AREA AND TYPE OF INSPECTION
5- 2s'-c7• G c-..) J,'vvs!. 7/i i P 4- fey, e. s t - / 977.
illk THIS CARD IS TO MAIN ONoSITE - -
CITY .' community Developm1Flit Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102572-00-CO
Owner: FRANCISCAN HEALTH SYSTEM
Address: 34515 9TH AVE S
FEDERAL WAY, WA 98003-6761
This card is part of your required inspection documents. 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 Footings/Setback(4110) ❑ . Foundation Wall(4115) .
❑ Drainage/Downspout(4040) ,
Approved to place concrete Approved to place concrete Approved to backfill
By Date By Date By Date
J
11 Re-steel (4215) ❑ Slab/Concrete Floor(4255) Underfloor Framing(4285)
Approved to place concrete or grout Approved to place concrete Approved to sheath floor
By Date By Date By Date
e
GI Floor Sheathing(4105) 0 Shear Walls(4245) ❑ Roof Sheathing(4220)
Approved to install flooring Approved to install siding Approved to install roofing
By Date By Date By Date
r® Fire/Draft Stops (409;7—) EFraming4120
NOTE: Prior to scheduling a Framing(4120) 0 ( )
Approved inspection;Electrical,Plumbing&Mechanical Approved to insulate
i Rough-in and Fire/Draft Stop inspections must be
signed-off and approved. IBC 109.3.4/UBC 108.5.4
By Date By Date
❑ Insulation (4150) ❑Gypsum Wallboard Nailing(4130) .
❑ Suspended Ceiling Grid(4265)
Approved to install wallboard Approved to install mud&tape Approved to drop tile
By Date j By Date By Date
❑ Final-Fire Department (4060) ❑ Final-Planning(4070) 0 Final-Public Works(4080)
Approved Approved Approved
By Date By Date By Date
❑ Final-Building(4050)
Approved
By Date
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
1110
RECEIVED #
Federal Wa*AY 1 0 Z007 PERMIT
COMMUNITY DEVELOPMENT SERVICES SF MF CO EEL PL DE EN FP
3332E AVENUE SOUTH•
PO BOX 9718
FEDERALWAY,WA 4 VP& IPPLI CATI ON N253-835-2607.FAX 25 35 J a1.4R r
i- u.ciilJOfrF7 mhcal ri t.tj
IAVI
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
PROPERTY� INFORMATION
SITE ADDRESS ';3` s' eJ W+ AWL �"�'I SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# 1 S O d S t - C7 G ( ® LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION 'ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
l
PROJECT NAME(Name of Business or Owner Last Name) 1. / ' I t
NI PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER tA \k 5 � (:453 )`(;(.e -".I'�Q
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
1'1n = - v �.� tuPC 161,6‹-'1433
CONTRACTO COMPANY NAME t.c.p1'I 5•'lAPPLiCA NT NAME O ICE PHONE
O�
MAILING ADD sS r,v CTATF 71P CELL PHONE 1 AWA e.�n .�,pasF liON D b-c c4 -
CITY OF FEDERAL L WAY BUSINESS LICENSE NUMBER N DATE FAX( NUMB)ER
®3\ 0 \ 1Z-31
COPY of card required �+� CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
with each application �/ S /A Ns LAM'VYS- 'r 1-n - 0
9
APPLICANT COMFANY NAME t `-T/\ PLICANT E ,` OFFICE PHONE
et&5 6a4"lP! � Mme_ )q - Beta ,..
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
i
6a-S". X �� ls�"35 �' �t t b% (Act. ) bk 4 -ga9.D
RELATIONSHIP TO PROJECT 1 FAX NUMBER
0 Architect ❑Tenant rq�Agent 1Other 0 ? (21(51. )464 -q I
PROJECTttkt
dPRIMARY PHONE E-MAIL ADDRESS
CONTACT � �E.— (a )464 -�a.c.® et co 6t N Q.►, ,, ,, G c-ci-•-•
LENDERNAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILIIL ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WO • 3B'z,oOO
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUI• ' ■ YES .:
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
I
4
■ PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
S•.FT. S•.FT. S•.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
■ FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSLlb(Toile()
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way,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.
NAME/TITLE ( DATE lb 0"1
(Signature) / (Title) 5 I
RELATIONSHIP TO PROJECT ❑ Owner V..Agent ❑ Contractor ❑Architect ❑ Other, )C?-e'
FOR OSCE USE.ONLY
❑NEW ❑ADDITION o ALTERATION ❑REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? o YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#100—April 2,2007 Page 2 of 4 k\Handouts\Permit Application