16-102106 • RECEIVED1111
CITY OF11.1"440MAY U 3 2016... PERMIT APPLICATION
Federal Way
CITY OF FEDERAL WAY
CDS
PERMIT NUMBER ! _ (llll� l O ✓ 1'„� f S e,_ - Fe �1
V TARGET DATE
17-
SITE ADDRESS SUITE/UNIT#
34509 - 9th Ave S. 202
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 2000. 7 5 0 4 5 1 0 0 1 0
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING e FIRE PREVENTION
NAME OF PROJECT St. Francis Medical Office Bldg
PROJECT DESCRIPTION
Detailed description of work to Fire Alarm System Alteration:Add 8 devices to existing FACP.
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Franciscan Health System
MAILING ADDRESS E-MAIL
34509 9th Ave S
CITY STATE ZIP
Federal Way WA 98003
NAME PHONE
Guardian Security Systems (206)349-5889
MAILING ADDRESS E-MAIL
CONTRACTOR 1743 First Ave S. kveliz@guardiansecurity.com
CITY STATE ZIP FAX
Seattle WA 98134 (206)628-4990
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
GUARDSS233K5 09/ 30 /16 19-98-105663-00-BL
NAME PRIMARY PHONE
Guardian Security Systems 206.349.5889
APPLICANT MAILING ADDRESS - E-MAIL
1743 First Ave S. kveliz@guardiansecurity.com
CITY STATE ZIP FAX
Seattle WA 98134 206.374.2852
NAME PRIMARY PHONE
PROJECT CONTACT Karina Veliz 206.349.5889
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 1743 First Ave South kveliz@guardiansecurity.com
concerning this application) CITY STATE ZIP FAX
Seattle WA 98134 206.374.2852
NAME
PROJECT FINANCING 0 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 the city as a part of this application. j Q
SIGNATURE: DATE 75/2/ 1 v\
PRINT NAME: Karina Veliz
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
•
VALUE OF MECHANICAL WORK
MECHANICAL 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.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commreiai)
BOILERS FURNACES HOT WATER TANKS(cas)
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(orTub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Unity) WATER HEATERS(Eio tsir)
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 Ila 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
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT 0
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMESONLY**
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
AreaConstructionGroup(s) Construction #of Additional Information
in Square FeetType Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-January 1,2013. Page 2 of 3 k:\Handouts\Permit Application