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08-104865 Mechanical City of Federal Way 1 • • �..{� Q Community Development S rvices Permit #: 08-104865-100-M E P.O.Box 9718 Federal Way,WA 98063-9716 Ph (253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050 : Project Name: VIRGINIA MASON CLINIC Project Address: 33501 1ST WAY S Parcel Number: 926504 0010 Project Description: Install(5)new firesmoke dampers into existing ductwork. Owner Applicant Contractor VIRGINIA MASON CLINIC JOHANSEN MECHANICAL JOHANSEN MECHANICAL 1100 9TH AVE 20109 144TH AVE NE JOHANMI173PK(02/02/09) SEATTLE WA 98101-2756 WOODINVILLE WA 98072 20109 144TH AVE NE WOODINVILLE WA 98072 �. 6a.!' fY Mechanical Valuation 14500 Is this an Online or O.T.C.application? Yes • �., ..zr� ��< .. ,. ,r ,__ �� ...� ., �.. 1,yY`,�, �a';-.,. �� ... I W.. MAS Ducting 5 PERMIT EXPIRES Sunday, April 12, 2009 Permit Issued on Tuesday, October 14, 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: .L)/t. Date: i CY/L//(-'r DATE INSPECTOR AREA AND TYPE OF INSPECTION /MY/ Xs /44e.s T,'") fI QST — ,4.L 0d� • THIS CARD IS TO•MAIN ON-SITE NM CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 08-104865-00-ME Owner: VIRGINIA MASON CLINIC Address: 33501 1ST WAY S FEDERAL WAY, WA 98003-6208 This card is part of your required inspection documents. Scheduled inspections may be failed if thiscard 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. Ongoing 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 /p , .x.aDate By Date By L CeJ Date/0 30 • • For inspector reference only 0 Rough Electrical 0 FINAL-Electrical Approved Approved By Date By Date ...k CITY OF R C 91� • 1.L `' - lo_Y, �1.��N///' Federal Way PE RM IT coMnlumTYDEVELorMErrrSERVICES OCT SF MF CO E EL PL DE EN FP 3332F8THAVENUE LWA .WA •PO BOX 9718 PLICATION FEDERAL WAY.WA 8 TD 253-835-2607•FAX 2=819 9//�'''t�,{"` www.cittloffederalwat Or PEDERAL VYPI{ / The following is required inc tion-an incomplete application will not be accepted. Please print legibly(in ink)or type. + • PROPERTY INFORMATION SITE ADDRESS_-33S0 1 ` t'�"� SC v L-. a SUITE/UNIT# ASSESSOR'S TAX/PARCEL# -1 Z LO S U `'1 L1 G'I I LOOT SIZE(sf LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) W *�` L a✓�etA S O —j C _ c-cC--- i 0 S (Attach separate page for leng y legal description) • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu) j�nS3-a 11 (5 ) r•1Q tel) In re. .lg► . - .,.„ . . s P (2 � • . . i ,r 111 PROJECT NAME(Name of Business or Owner Last Name) �/N c'-) , /‘� �O'ISO r1 P-e�(_� I we,. '�I • PEOPLE INFORMATION PROPERTY NAME119 PRIMARY PHONE OWNER O J i r,_,, ,;a1 c€ . , �-e4 co, 1 r ( ) - MAILING DRESS CITY,STATE,ZIP E-MAIL ADDRESS CONTRACTOR COMPANY NAME � �w I ff APPLICANT N E p OFFICE PHONE -JO�e1✓'\rQ✓\ 1\stit.keitliOci1 1V)1 (1(2S) Li CO - ,Z� 6 MAILING ADDRESS CITY,STA ZIP C�GMs2CELL PHONE 2vic l 1 yy.+"- Ave- G- WoOck in J,1 l� , 0441- ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER I SI -`'tom ^ 1 u 7 (o co 7 -0� � L 12.I 3 1 ) © (�'7s )1-1�s"(o - to 5 S3 CONTRACTOR'S REGISTRATION NUMBER EXPIRATIO114 DAT E-MAIL ADDRESS APPLICANT OMPAINY_NAME APP CANT N` OFFICE PHONE ©�ln - QGk�ll1G'�'t J"t VG� ✓�`� ( Ll?.S) 527 - l�� MAILING ADDRESS CITY,STATt,ZIP CELL PHONE '7._n bG1 1`-P441-- Ave I -) , 1 ivoc!:nv,}4 w1.!4 9X72 ( ) - RELATIONSHIP TD PROJECT �+ (} FAX NUMBER 9 ❑ Architect 0 Tenant o Agent "KOther CCAA- CGICX e3 C__- (L ZS) W&10 -1,833 PROJECT NAME 1 ,, ` . ,, PRIMARY PHONE E-MAIL ADDRESS CONTACT t VILe,V a � C� ( �0-S) 521 - l 2(v iv,„(c 'x114,,stri fr e c7.,_e 0.-- LENDER NAME 1 Per RCW 19.27.095: Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - /DP_A-12ei• DETAILED BUILDING INFORMATIONpEXISTING USE i C O ` CJ`` PROPOSED USE /-`�-- EXISTING ASSESSED/APPRAISED VALUE$_ _VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 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 ❑ CARPORT 0 EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF NUMBER OF FLOORS **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ • FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work$ )L 5 CAV (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 _ S MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(Commercial) �1( e._5/tel C) lt n_ COMPRESSORS FURNACES RANGES ,g ` DUCTS GAS LOG SETS REFRIG.SYSTEMS 6CA S PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS Bathroom sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet) 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 relianc of th city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of th' .pplication. q SIGNATURE: �� — DATE I 0/ 10 6 Property Owner and/or Authorized Agent / FOR OFFICE USE ONLY ❑ NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? a YES ❑NO ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? a YES ❑NO PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO Bulletin#100-January 1,2008 Page 2 of 4 k\Handouts\Permit Application