16-100452 f} - • I Mechanical
City of Federal Way Permit #: 16-100452-00-M E
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: HALLMARK MANOR
Project Address: 32300 1ST AVE S Parcel Number: 172104 9073
Project Description: Replace existing hot water storage tank in boiler room 141.
Owner Applicant Contractor
HALLMARK CARE CENTER JESSICA BRUCE AIR SYSTEMS ENGINEERING INC
3001 KEITH ST NW AIR SYSTEMS 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? 7727 Is this an Online or O.T.C.application? Yes
No Fixtures Associated with This Permit!!
PERMIT EXPIRES Monday, July 25, 2016 .
Permit Issued on Wednesday, January 27, 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 Washington
.
4zilcIrth?Mgi,ederal Way. sOwner or agent: ' Date: 6 '1
THIS CARD IS TO MAIN ON-SITE , . : _...
CITY Construction In ection Record '
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 16-100452-00-ME 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) ❑ Gas Piping(4125) ❑ Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By `�;4Q Date �j j
Rough Electrical Final Electrical 111Right of Way
ElApproved ❑ Approved Approved
By Date By Date By Date
a �4
•CEIVED
anroF A PERMIT APPLICATION
Federal Way JAN 2 7 2016
cm OF FEDERAL WAY
PERMIT NUMBER I
cQ_ _
� M L0 I TARGET DATE
SITE ADDRESS
e SUITE/UNIT#
�� 1 e
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1)7 .-7 Rai I 8(3 1 -7 .2. 1 b y- - ci 1 g 5
TYPE OF PERMIT ❑BUILDING 0 PLUMBING OE MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT I4&Jt� e i i f !,& ,nom zr 5A4.!& _i/, n K. ,
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it 6(-41
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PROJECT DESCRIPTION e _'1_ �f �Q�i
Detailed description of work to R LI') C)I. I a('Yl 141 .
/
be included on this permit only
( I`1 I SSM C '4CY PRIMARY PHONE
PROPERTY OWNER D $ E-MAIL
TA/N
ad._ ST:TAl ZIq V®Q _
Mr
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CONTRACTOR ✓"` �� ��J I��(LYI �J-�I+wJ
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_ - ( tzs 7 I C./",,..iLi/1 I CPIRAf jO DATE
E FEDERAL WAY BUSINESS LICENSE#
N��� G, .//fir l .- / J
/ r G + t I1 L ea t rtQ _ -- PRIMARY PHONE
�/ CAPPLICANT MAILING ADD S J E-MAIL
1 5 82 1 CITY I STATE ZIP FAX
-
NAME J t V/ I C.J.-� ) PRIMARY PHONE
PROJECT CONTACT 1C�/�
(The individual to receive and MAILING ADDRESS
E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING *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► ofofthisyapplication.�pl
SIGNATURE: ` ' Pr �-ACX. a 3( ( 14(f i DATE I ;1 — I L
PRINT NAME: 3J J O L t-ei1- Y 0.1..-C.
Bulletin#100-December 29,2015 Page 1 of 3 k:\Handouts\Permit Application
• • .
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ '172
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include tinq fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS .OT ,R(Da '-! I
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial) ..Ly r*
BOILERS FURNACES HOT WATER TANKS„as) ■` Ar
COMPRESSORS GAS LOG SETS REFRIGERATION SYST . .)
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type offixture 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(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
-
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
N'o L ul) l- Gi D $ 0
EXISTING PREVIOUS USE LOT SIZE(In Square Feet( EXISTINFI SPRINKLER SYSTEM? PROPOSED FIRE SUPPR ION SYSTEM?
hV 6G
� L9.0® Yes❑ No ❑Yes CI o
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
f
FIRST FLOOR(or Mobile Home)
....................................................................................................................................................................................
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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 inOccu Construction #of Additional Information
AREA DESCRIPTION Square Feet Group(s) Type Stories
4
,:',.:,..P!,1001,71.1#4,114!"*". ,4 . ,.. ..�.,Fs,
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
Area inOccu as Group(s) Construction #of Additional Information
AREA DESCRIPTION Square Feet P Pl l Type Stories
a .. .4,-/.,:,.-,-";:•.'_.., ..BUILDING : _ ... c; /......�//N..J r,�A„ .r. �„u.,�v�,�l'��f,�✓F,.,F� 1/' �h,,.i, .:Ei f,.i ...
TENANT AREA ONLY
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Bulletin#100—December 29,2015 Page 2 of 3 k:\Handouts\Permit Application