15-106011 s }
• Mecnal
City of Federal Way �(,//,
Community&Econ.Dev.Services Permit #: 15-106011-00-ME
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 failed water source heat pump serving day room#2
,
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 984093602 S PINE ST
TACOMA WA 98409
Additional Permit Information
Is this an Online or O.T.C.application No
Mechanical Fixtures
Compressors/Heat Pumps 1
PERMIT EXPIRES Saturday, May 28, 2016
Permit Issued on Monday, November 30, 2015
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
the C" Fe er I Way. i {
Owner or agent: r)O1A1 Date:
n
INA
, ,Irit%.
• THIS CARD IS TO MAIN ON-SITE v.CITY OF
Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 15-106011-00-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 1." Date 1 I I 7`(le
® Rough Electrical 111 Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
► f } I 0
FeOf ,p,
deral. y PERMIT APP4c#T
•
NOV 3 0 2015
PERMIT NUMBER 13 _ 1 0 0 ( 1 _ FEDERAL
TARGET DATE CITY � t RAL.WAY
CDS
SITE ADDRESS SUITE/UNIT#
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ q ,1 12,rni q,86 ► I . i o - q i g 5
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING /// MECHANICAL ❑ DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT ft(i I f I I n6( i S-0) - Dam R6Om.
PROJECT DESCRIPTION « � `^/ c ��/�e
Detailed description of work to S �/ ungQ �l i �- !�,•
be included on this permit only ULA
— PR
PHOV
PROPERTY OWNER
NAME! , �5J ✓ -<-( ) -ate/
MAILING ADDRESS g 3647i i CA, n , • E-MAIL
CITY✓_ci L`� IUIu�J QT ZIP9• ,i
CJI
04
IN RZ v E-MAIL
CONTRACTOR `C' pt��
(C( CITYT nr\a, �STg R ZIP �,{/ /),1 /J rg g g j t+..7
$ ►�'1r[';� rT I�ICyE E1 IJLJ /TI•�IIN DATV FEDERAL WAY BUSINESS LICENSE#1
_ .. li-!yrf`��ll •�T+( '(/jam �J 1 ,
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME
J�\(_,` c/ e in /Wz. PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS ,/
respond to all correspondence � �LL— � i'� ��
concerning this application) CITY STATE ZIP FAX
NAME ..-
_..
PROJECT FINANCING OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim), which may be made by any person,including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application
SIGNATURE: ' 231A43Yf *(31 DATE i 1 —024 1 5
PRINT NAME: 5 ,JC k 6(L&L
Bulletin#100—October 26,2015 Page 1 of 3 k:\Handouts\Permit Application
• • •
LIO$ O F,cHAL WORK
MECHANICAL PERMIT '%`]J/ti
Indicate how many of each type offixture to be installed or relocated as part of this project.Do not include gxisting fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTT-I5 �le ribe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)BOILERS V 9
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES tL. V Li"' '' I
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 Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(K)tchen/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(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
r-1` i i;ml �n p� r) 5 ' '[ () ❑Yes ❑ No ❑Yes ❑ 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
DOK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES oNLI'**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
NEW tiiiiLDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
.TOTAL.BUILDIN a..
TENANT AREA ONLY
\ A At a a s
Bulletin#100-October 26,2015 Page 2 of 3 k:\Handouts\Permit Application