15-100820 "' 0 1 Mechanical
City
Federal
De .Services Permit #: 15-100820-00-ME
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2807 Fax:(253)8354609 FILE Inspection Request Line: (2
53)835-3050
Project Name: HALLMARK MANOR
Project Address: 32300 1ST AVE S Parcel Number: 172104 9073
Project Description: Remove and replace existing boiler system
,
Owner Applicant Contractor
HALLMARK CARE CENTER AIR SYSTEMS ENGINEERING INC AIR SYSTEMS ENGINEERING INC
3001 KEITH ST NW (GENERAL) (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
Is this an Online or O.T.C.application? .No
Mechanical Fixtures
Boilers 1 Gas Piping 1
PERMIT EXPIRES Sunday, August 30, 2015
Permit Issued on Tuesday, March 3, 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
4n(d t ty�f F eral Way.
Owner or agent I Date: � --I,
THIS CARD IS TgigEmioN ON-SITE
4ACITY OF • Construction Ipection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-100820-00-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) El Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By� r Date 3%—%$
0 Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
FrieriWav
MPERMI• APPLICATION
RECEIVED
PERMIT NUMBER
I5 _ PO 0 8` 20 _ M � FEB 23' 2015 3/ ` 045
- - CITY OTArEFI3ML.WAY
SITE ADDRESS CDS SUITE/UNIT#
g 66 14 i4i/6. 6
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ I5 -7 2m14be / i a l b 4- - 9 1 3 5
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING VMECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT 4,&J' yr 6u-k_`�� &fW 6 6 l t, ,/' R / I r1 / c v-Ki-
PROJECT DESCRIPTION 1 i& I�kTh2.-d 106 L 111R✓� `k'.1 - i 1 `J , Ce)(16-1-1,0
Detailed description of work to u�-i 1 � 7 '� �1�T 6(- 1(1 &il�c,V3 19 ( -it&
be included on thispermit only ...1.4'may ,i , ' j `` /�
! 'U,/1 t T l,� L✓�+� t4�
rin IX\ o n .
NAMEPRIMARY PHONE
PROPERTY OWNER �--� I I +cel 11 1 1 Vim-+ 1 Q i Ll', ,_47 -�sg5
MAILING ADDRESS -'�j ez 1 J i . f w E-MAIL 1
CITY U y V,id ¶TE ZIP 1
•
NAMEA('(./' �'^l_ e� G 1� �t �' PG 35 -5-1 -11-4- LA
MAILING/i�11 ADDRESSrC �\ .' ,n,'> ,'/ E-MAIL
SI IO)
CONTRACTOR �/�/� /U� ` r '� // ( JAI �j�/.jb00 /�
CITY'T , ;j�1 QJIj,,4<1 F , /� STATE^ ZIP,/'l�') 4 / � .,,% ✓ '..i —L –1
/ 1 I'��.1.�611 G/'S E Tvl ! I �, ..EXPIRATION/U FEDERAL WAY BUSINESS LICENSE#
NAMEpti1.46.4c/n1 6 f. PRIM RY PH
Bri L,0 e......e.„1(ull9
MAILING ADDRESS -
APPLICANT 1st 3 �' i � t �X S< L ,� G�U./�.A•ui
CITY..-1.--.4 ,:i)ryvi C;, T ZIP q rq :J` J �-- � .- -3 1
NAME'T� g r. _ _ 11 ,
PROJECT CONTACT �L/�v�6-,�"11 7j.)?H7"7 61 `c�i i i �.�
MAILING ADDRESS _ AI '1 ..
The individual to receive and 0. 4t-
respond to all correspondence
1 W
concerning this application) CITY T T ZIPc:4 , „6:1
F
NAME �`
PROJECT FINANCING E/"l, 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 ilalfiance 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: A' C DATE z -1 /- 15
PRINT NAME: 7-5-e-641.„6.6,_ 0 IIk(k. ,
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
• VALUE OF MECHANICAL WORK i
MECHANICAL PERMIT a`1.
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDI4NG UNITS FANS j ' T . 'a * GAS PIPE OUTLETS ! OTHER(Describe)
CONDfTIONER FIREPLACE INSERTS " ' HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING I GAS PIPING WOODSTOVES
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(Kitehen/Utility) WATER HEATERS(Eirctrie)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
no $
EXISTING/PREVIOUS USE LOT SIZE)In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
n a6�1 li Y,� ^_ ( J j _ j� ❑Yes ❑ No ❑Yes o No
RESIDENTIAL - NEW, OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
jr la NT s
FIRST FLOOR(or Mobile Home)
................................................................................................................................................................................................
S � ND F OOR
C `
COVERED ENTRY
GARAGE ❑ CARPORT ❑
...............................................................................................................................................................................................
OTHER).describe} )
9�
EXISTING PROPOSED TOTAL
Area Totals
*A7st,IT HOMES OILY
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL—NEW/ADDITION
Area Construction # o
AREA DESCRIPTION Occupancy Group(s) Additional Information
In Square Feet S les
17 t BUILDING
,Z 6ki ; dig`' a,rvre hitt 3 tit ,
/ ,ate^ ��;.
iei
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
TENANT AREA ONLY
j� � :..aW '• �•ll,3s�,� � s,3,1�fir.'. Vitt. .. ...., � ....�s��. "�i.' ...:��.< ..., K5,4x .,....
� � r
Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application