14-100483 R2CEIV
cmoF E4 PERMIT • MF CO ME PL DE EN FP
Federal Way
COMMUNITY DEVELOPMENT SERVICS A N 3 0 2 OAP P L IV ATION
253-835-2607•FAX 253-835-2609
/ '1(4�C 1 i/)
www `rt E„merty OF FEDERAL WAY
CDS
SITE ADDRESS SUITE/UNIT#
33501 1st Way South GIM Remodel
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 9055.00 9 2 6 5 0 4 _ 0 0 1 0
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) Virginia Mason GIM (General Internal Medicine)
PROJECT DESCRIPTION Modify existing fire alarm system in GIM Remodel. Will tie in
Detailed description of work to to existing FACP. Joint venture between SimplexGrinnell (design/
be included on this permit only engineering/materials/permit) and H&M Electric (install) .
NAME PRIMARY PHONE
PROPERTY OWNER Virginia Mason Clinic 253-874-1652
MAILING ADDRESS E-MAIL,
33501 1st Way South
°ITY Federal Way STATE
IP
98003
... . . NAME PHONE
H&M Electric 360-658-0501
MAILING ADDRESS E-MAIL
918 Cedar (PO Box 799)
CONTRACTOR
CITY STATE ZIP FAX
Marysville WA 98270
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
HMELEI*077KR 05 / 19 / 15 19-93-103797-00-BL
NAME SimplexGrinnell PHONE 206-291-1400
APPLICANT MAILING ADDRESS E-MAIL
9520 10th Ave S. , Suite 100
CITY STATE ZIP FAX
Seattle WA 98108 206-291-1500
PROJECT CONTACT NAME SimplexGrinnell/Janet Stebbins PHONE206-291-1468
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) 9520 10th Ave S, Suite 100 jastebbins@simplexgrinnell.co:
CITY STATE ZIP FAX
Seattle WA 98108 206-291-1500
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME D OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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 �i 01/30/2014
f`',''” a'f ,>7_id,P Yel /j��ikVi DATE
PRINT NAM Janet Stebbins
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Perinit Application
• •
MECHANICAL FIXTURES
VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
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 GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(cas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURES"
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'rub/Shower Combo) LAVS(Hand Sinks) TOIL1 IS WATER PIPING
T
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/umiry) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EffiSTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION r q
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT 0
OT-I (describe)rbe)
1
EXISTING PROPOSED TOTAL
Area Totals
I'owN-EW'HOMES ONLY** .M?
ESTIMATED SELLING PRICE$ #OF BEDROOMS
pig k 101 N a _,
INilri (P' 1� ® I ;r ... EW/ bITIQ '! � r, .
Area Construction #of
AREA DESCRIPTION Occupancy Group(s) Additional Information
in Square Feet Type Stories
i NEWivtl dl "= -. ( � rdh
Ili i1
ADDITION
Y) �^: iia"' 4 'i 341a4- 3j'�` "
SIAL` � Iii MP,R ,,„, -u
AREA DESCRIPTION ` re8 Occupancy Group(s) Construction #of Additional Information
in Square Feet Te Stories
TIT!
1''(TAL BUIL*0,
TENANT AREA ONLY
110k- 1441i r
PROJECT AREA 017.1" !k
Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application