16-102004 ikr 0 Ph
City of Federal Way
Community&Econ.Dev.Services Permit #: 16-102004-OO-PL
33325 8th Ave S F ILE
Federal Way,WA 98003
Ph (253)835-2607 Fax:(253)835-2609 Inspection Request Line: (2
53)835-3050
Project Name: ST FRANCIS HOSPITAL-MEDICAL OFFICE BUILDING
Project Address: 34509 9TH AVE S Unit 202 Parcel Number: 750451 0010
Project Description: Install(2)new sinks for associated tenant improvement work
,
Owner Applicant Contractor
ST.FRANCIS HEALTH SYSTEM STIRRETT JOHNSEN INC STIRRETT JOHNSEN INC
PO BOX 2197 5555 WESTGATE RD NW STIRRJ*281B6(5/1/16)
TACOMA WA 98401 SILVERDALE WA 98383 5555 WESTGATE RD NW
SILVERDALE WA 98383
Plumbing Fixtures
Other Plumbing Fixtures 1 Sinks 2
PERMIT EXPIRES Sunday, October 23, 2016
Permit Issued on Tuesday,April 26, 2016
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and t e se will be in accordance with the laws, rules and regulations of the State of Washington
an the City
�*71',ofFederal Way. ) J
Owner or agent: - J V 2 W//-A,im Date: /1 i r)I 6 aol b
i ,
fU4Pt0
Ink 9
THIS CARD IS TO IN ON-SITE
CI °F Construction Ins ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 16-102004-00-PL Address: 34509 9TH AVE S Unit 202
Project: ST. FRANCIS HEALTH SYSTEM FEDERAL WAY, WA 98003
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 Plumbing Groundwork(4190) 0 Rough Plumbing(4230) 0 Gas Piping(4125)
Approved to cover Approved Approved to release test
'By Date .By Date 4'L7/i By Date
0 Final-Plumbing(4075)
Approved
By O., Date (,((0 i Ise
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
.1 -
SJI JOB 111119
PER"'of
APPLICATION
Federal Way (BUILDING PERMIT: 16-100604-0*cVcD
// — —
PZ--
APR 262016
PERMIT NUMBER ! K� ��
— — — — TARGET DATE CITY OF FEDERAL WAY
NIT'# YYf1
SITE ADDRESS SUITE/U
34509 9th Avenue, Federal Way 202
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 7,839
5—. _0_ /_ _l_ - 0 Q 1 0
TYPE OF PERMIT ❑ BUILDING I PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT DR. CLENNEY OFFICE T.I.
PROJECT DESCRIPTION Install 2 sinks
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER St. Francis Hospital
MAILING ADDRESS E-MAIL
34515 9th Avenue S.
CITY STATE ZIP
Federal Way WA 98003
NAME PHONE
Stirrett Johnsen Inc. 360-308-2080 _
MAILING ADDRESS E-MAIL
CONTRACTOR 5555 Westgate Road NW diane@sjimech.com
_ CITY STATE ZIP FAX
Silverdale WA 98383
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
STIRRJ*281B6 5 / 1 / 16 20-04-100200-00-BL
NAME PRIMARY PHONE
Stirrett Johnsen Inc. 360-308-2080
APPLICANT MAILING ADDRESS E-MAIL
5555 Westgate Road NW diane@sjimech.com
CITY STATE ZIP FAX
Silverdale WA 98383 360-698-1832
NAME PRIMARY PHONE
PROJECT CONTACT Diane Almojuela 360-308-2080
(The individual to receive and MAILING ADDRESS E- L
respond to all correspondence 5555 Westgate Road NW diane@sjimech.com
concerning this application) CITY STATE ZIP FAX
Silverdale WA 98383
NAME
PROJECT FINANCING S t. Francis Hospital UbcOWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW19.27095) 34515 9th Ave. . S. , Federal Way WA
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 arty 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: jt
C DATEPRINT NAME: /f/ 6249
lJ J � -
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
M
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of eachtype offvcture 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(can)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING 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 fhb/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
. DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Uti)ity) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES C 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?
❑Yes❑ No ❑Yes 0 No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
Y_ x. �,ky xr
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
GARAGE ❑ CARPORT 0
OTHER(dese) F �
EXISTING -_.PROPOSED TOTAL
Area Totals
HOMES'ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square FeetType Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Groups) Construction #of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application