17-102952 �,r t�. FPERMI194iP ICATION
Federal Way JUN 2 0 2017
Note: Permit#17-102069-00PL has been issued CITY OF FEDERAL
PERMIT NUMBER I — 1 6 A 5
-
E COMMUNITY DEVEL ME
TARGET DATE
SITE ADDRESS SUITE/UNIT S
33820 Weyerhaeuser Way S
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL it
$ -31426-66 2 1 5 4 6 6 - 0 0 4 0
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING IK FIRE PREVENTION
NAME OF PROJECT Federal Way East/Northwest Kidney Center
Installation of oxygen medical gas system(2,696 cubic feet)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER NW Kidney Center
MAILING ADDRESS E-MAIL
700 Broadway
OITYSeattle STATE ZIP
98122
NAME PHONE
Stirrett Johnsen Inc. 360-308-2080
MAILING ADDRESS E-MAIL
CONTRACTOR 5555 Westgate Road NW diane(aisjimech.com
CITY I STATE zip FAX
Silverdale I WA 98383 360-698-1832
WA STATE CONTRACTOR'S LICENSE S EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
STIRRJ*281B6 5 / 1 / 18 20-04-100200-00-BL
NAME PRIMARY PHONE
Stirrett Johnsen Inc. (Diane Almojuela) 360-692-6128
APPLICANT MAILING ADDRESS E-MAIL
5555 Westgate Road NW diane@sjimech.com_v
CITY'
YSilverdale FATE ZIP FAX
60 -698-1832
WA 98383
NAME PRIMARY PHONE
PROJECT CONTACT Diane Almojuela 360-308-2080
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 5555 Westgate Road NW diane@sjimech.com
concerning this application) T STATE ZIP F
`Silverdale WA 98383 `60-698-1832
NAME
PROJECT FINANCING 0 OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCIV 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 thishiapplication.
SIGNATURE: //` 4.0 ' 4' DATE 7 / 7
PRINT NAME: /A-A.) , �� e -
Bulletin#100—January 1,2013. Page 1 of 3 k:\Tiandouts\Permit Application
r VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ 34,500
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 /q GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commer i4
BOILERS FURNACES HOT WATER TANKS(Ga.)
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) LAVS(Hand Sinka) TOILETS. WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Xitchen(Utiuty) 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 0 No ❑Yes 0 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 D
OTHER(describe),
EXISTING PROPOSED TOTAL _._ ....._�.
Area Totals
:*NEW HOMES ONLY*".",x
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
NEW BWLDIN[4 k
ADDITION
COMMERCIAL--REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
TENANT AREA ONLY •
PROJECT AREA ONLX. F
Bulletin#100-January I,2013 Page 2 of 3 k:\FIandouts\Permit Application