08-105330 Mechanical
City of Federal Way 40 4111Q
Community Development Services Permit #: 08-105330-00-ME
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line:
Ph:(253)835-2607 Fax (253)835-2609 p q (253) 835-3050
Project Name: FOUNDATION HOUSE
Project Address: 32290 1ST AVE S Parcel Number: 172104 9039
Project Description: Demo 1 supply duct, relocate 1 return grille,install 2 new supply air diffusers into offices
and duct distribution from existing vav box,install 1 new exhaust fan and 1 new exhause
grill.
Owner Applicant Contractor
BROOKDALE SENIOR LIVING PUGET SOUND REFRIGERATION HVAC& PUGET SOUND REFRIGERATION HVAC&
6737 W WASHINGTON ST SUITE 2300 MECHANICAL SERVICES(GENERAL) MECHANICAL SERVICES(GENERAL)
MILWAUKEE WI 53214 PO BOX 27073 PSRHVMS924JT(4/30/10)
SEATTLE WA 98125-1473 PO BOX 27073
'SEATTLE WA 98125-1473
,AiZtiet 4Additional Permit Information .4v ' ',
Mechanical Valuation 4000 Is this an Online or O.T.C.application Yes
s• • ,,, ',m'', - sz i J f ' 4 • s �y ' dam: ,,
Ducting 4 Fans I
CONDITIONS:
Subject to field inspection with plans.
PERMIT EXPIRES Wednesday, May 6, 2009
Permit Issued on Friday, November 7, 2008
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 be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: ,., '� Date: '`r 7 1 e"
.csFIs
-...„...
THIS CARD IS TO MAIN ON-SITE - •
CITY OF -' Community Developm nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 08-105330-00-ME
Owner: BROOKDALE SENIOR LIVING
Address: 32290 1ST AVE S '
FEDERAL WAY, WA 98003
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 Mechanical Rough-in(4165) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date 11�0.,4A By Date By cAIL„, Date\,Z.—Codd$
•
I
•
For inspector reference only _ _
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
CITI OF - / ã5o
rale1 QI
EPERMIT SF MF CO EEL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8m AVENUE SOUTH•PO BOX 9718
RAL 7n
NOV o ^ i 'PLICATION
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wwwcittiofederclwa u.co m
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The following is required infornui&M,IV kincomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS . 2:2- FG -"'; i S
SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# ( 01_( - LOT SIZE(sfl
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal descriptlon)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
resent!, i 5,t/Pr' fi, 2a1 izeive&. 6e44.L& , Ts7-Ail z r:ie:.i SC9$y AZ PiAttd,.Z4c$ "nv e46cec
Ahr.0 VUer 17E9' l,trrkAl -6277n ex/C1-04-9 ✓Rv 13ex r In Sr19I j j Mew ext., i*yr -X,9v, ,¢,,.eC i Aw
O .tAver -ttil l it
C/ o f
PROJECT NAME(Name of Business or Owner Last Name) *M "L^t "(-e zi1ltAw- L tf//✓+
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER 7'.L`Pt`r4AZF. h'A'?tole L-ir/tV7, ( ) -
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
6 73 7 -454 S-r sort 23OV ;ltt,w, vice' .,4 63Liy
CONTRACTOR COMPANY ( .C� 6-err
5�
OFFICE PHONE
MAILING ZIP ADDSS - CITY,STATE, CELL PHONE
y(>4 r„ r331ZP SEA Me _,.w4 ft??zr, ( G.:' ) 33/ -- (.541
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
ea-1 In XL/1-0-(2)-15L- lZ131 /l x (206 ) 3L - S5�
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
t viZtt i�'tS
12-4 or re 6. �/L/7f f s'c"Q� 4/ !zcy a r 141/4-141,75g ;3R tt`43C-.r o•n
APPLICANT COMPANY NAME / APPLICANT NAME OFFICE PHONE
17A-1/L_ 6-0,T7 ( ) ,a6 7 -4-WAD
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(32 1./1✓ t ZD ST Sa4i/ZC Zd6) 3zi - 134g,
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other ( 7:56) cf - gEC
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT f L 6c r ( ) 36'7 - Z DO c-74(4_GdTo a Ff't,i9lc f rn4r
LENDER NAME Per RCW 29.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ a&G
SPRINKLERED BUILDING? P7 YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL TOTAL EXISTING Sr TOTAL PROPOSED Sr TOTAL Sr
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
•
Indicate number of each type offixt 9 e'6-be ins d or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ 4' 7 OPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS I FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commmdal)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bauroom sink.) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS crone)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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: �"`r� DATE //11/47
Property Owner and/or Authorized Agent
❑NEW a ADDITION o ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? ❑YES a NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ❑YES a NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application