16-104835 ,. I
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City y Development
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Permit #:16-104835-00-ME
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: HALLMARK MANOR
Project Address: 32300 1ST AVE S Parcel Number: 172104 9073
Project Description: Replace existing failed roof top make-up air fan serving kitchen
Owner Applicant Contractor
HALLMARK CARE CENTER JESSICA BRUCEAIR SYSTEMS AIR SYSTEMS ENGINEERING INC
3001 KEITH ST NW ENGINEERING (GENERAL)
CLEVELAND,TN 37312 3602 S PINE ST AIRSYE*229KN(2/1/16)
TACOMA WA 98409 3602 S PINE ST
TACOMA WA 98409
•
Additional Permit Information
Mechanical Work Valuation? 6614 Is this an Online or O.T.C.application? No
Fans 1
PERMIT EXPIRES Sunday,23 April,2017 •
Permit Issued on Tuesday,October 25,2016
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
j� P(P
Washington and the City of Federal Way.
Owner or agent: EJ 1/ A c
Date.: 18-g-5-g-5
__lit
f I
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 104835 00 Address: 32300 1ST AVE S
Project: HALLMARK CARE CENTER FEDERAL WAY WA 98003-5762
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) 0 Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By C'..�1/V.e-- Date 1 a�N„-,
El Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
A
iseivED
A. SEP 2 7 ZoosPERMIT
CITY OF fPPLIcATIoN
Federal Way CITY OF FEDERAL WAY PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcente*cityoffederalway.corn
CDS
PERMIT NUMBER I ( 1 0 1 - g 35 _ iikit 1 O/ 47/cp
TARGET DATE
SITE ADDRESS SUITE/UNIT#
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1� JJo, P-m.I i -7 g- 16 Lf - (j l 3
TYPE OF PERMIT 0 BUILDING 0 PLUMBING YC.VIECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT H-6J I r cur)1 6 ti ..
1% I jh .m r) u 'P�
PROJECT DESCRIPTION [ / -P&J rU a-c--k Coe niz I .r X91 1 — W ail
Detailed description of work to {l Ki` L
be included on this permit only
PROPERTY OWNER E-MAIL
Fe-td ' IdOOloq iSIATII 249 (,..)b ,-. .7
CONTRACTOR
rim ' P tl n e �. p�yr /J
CITY-T I I 3, TA 2IP/�J F/ _ . ✓ lJ �gt9 u
ITI p';'IC�I't 4# �X-1 RA1I.I-ON/ �Ir4 FEDERAL:7.5.0g
WAY BUSINESS LICENSE#
T7 r 6 i(4115 <3 �n Un 7711 1
APPLICANT N () t n ,f _
' CI �/jfl1\,/ . C071 Dl ] iV 61 ✓ _ i -.- to�i
NAME t�J SJ ✓
PROJECT CONTACT �1 ✓ tict 77 -C. 4
respond
individual r receive and �fi I ,J 61 e C� UUU .
respond to all correspondence V T" C� //;v,
036
concerning this application) CITY-T q a _ WE z P�4)4 /,., FAX
NAME n WEA
s..11
PROJECT FINANCING • '/ 0 OWNER-FINANCED
' When value is$5,000 or more MAILING w�DRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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.
� ASIGNATURE: i terut-19-:(11Q), r p 'i
�,.�tJ/"�'�� C/�t ®®/� DATE M L
PRINT NAME:�J t✓S J V& I L
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
• I
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ (9L1-1 L.
Indicate how many of each type offuture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS t FANSGAS PIPE OUTLETS OTHER(Describe)
-
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
-
BOILERS FURNACES HOT WATER TANKS(Gaal
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTINGGAS PIPING WOODSTOVES
-
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type o f fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or'mb/Shower Combo) LAYS(Hand Sinks( TOILETS -
WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINSSHOWERS 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(Ia Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
,/�m ' ,r y�,� -54;
C"�', y ❑Yes❑ No a Yes a No
1 1Viic (11 ho la, ✓ U1 Jbt
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
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COVERED ENTRY
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GARAGE ❑ CARPORT ❑
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EXISTING PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
Area in Construction #of Additional Information
AREA DESCRIPTION Occupancy Group(s) Stories
S.uare Feet
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COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in I
Occupancy P y Grou Pls l Construction #of Additional Information
Square FeetType
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Stones
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Bulletin#100-January 29,2016 Page 2 of 2 k:\Handouts\Permit Application