17-105018 t t 1
f
Plumbing
CommunityyfFederal
elopm`ent t. Permit #:17-105018-00-PL
33325 8th Ave S
Federal way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fa,c(253)835-2609
Project Name: ST FRANCIS HOSPITAL-OUTPATIENT CENTER UPS
Project Address: 34515 9TH AVE S Parcel Number:750451 0020
Project Description: In room 346&347,install dialysis box with waste,vent and domestic cold water service.Install
(2)new backflow assemblies w/airgap.Route airgap drain line to nearest existing indirect drain
location.
Owner Applicant Contractor
JOHN ELSWICKFRANCISCAN HEALTH RYAN BURRELLWESTERN MECHANICAL WESTERN MECHANICAL
SYSTEM—W CONTRACTORS CONTRACTORS INC
1717 S"J"ST 1911 SW CAMPUS DR SUITE 321 WESTEMC919QL(1/15/18)
TACOMA WA 98405 FEDERAL WAY WA 98023 1911 SW CAMPUS DR SUITE 321
• FEDERAL WAY WA 98023
E �W NR�Y /t' uf4 d`3'L ,5t E
•
la<� i a 54
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Other Plumbing Fixtures 8
PERMIT EXPIRES Tuesday,17 April,2018
Permit Issued on Thursday,October 19,2017
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 anz e City of Federal Way.
Owner or a•.' • ������ Date: (OA 61 Ai-
THIS CARD IS TO REMAIN ON-SITE f '
CITY� Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 105018 00 Address: 34515 9TH AVE S
Project: JOHN ELSWICK FEDERAL WAY WA 98003-6761
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.
•
Q Plumbing Groundwork(4190) 0 Rough Plumbing(4230) Final-Plumbing(4075)
Approved to cover Approved Approved
By Date By(� ice, Date 1 �� t By 0_,„4:14,1, Date
Rough Electrical Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
OCT„4„Likk, 1 s 2017 PERMIT APPLICATION
CITY CITY OF FEDERAL WAY
Federal Wad COMMUNITY DEVELOPM PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+uermitcenter(ukityoffederalway.com
PERMIT NUMBER 1; 1 _ I D 0 1 - e 1_, f i , 1 1
_ _ TARGET DATE
SIITTEADDRESS SUITE/UNIT#
/'4516- 11 AVt, S. 0QmJA qQno3 o, p6
17-
PROJECT VALUATION
ONIN4YS6E6SOTAX/PARCEL
$ itei
>.. 0C) 15 fgy 5 1 - 6 S & 0
TYPE OF PERMIT ❑BUILDING KPLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT D1a-`05r3 box 1,40i hbA ,n 344 es,p3W7
PROJECT DESCRIPTION OI"A rl%w�"U I core_ driti,�� e.4- A.me`”' 1%1)64- re fie- (1,01r, 4..,U&
Detailed description of work to 2-AE...,-, P1/4-04"(fir J' (ssiS koxei w1 5 -ive.nk- 0 Iv...Kilt c..D'i
be included on this permit only (AYSuvite-. Zrts40.14 a.de.4 ba/Jcs1o. ussam.bkes lid 4,1r501 ,9.444,1.4.0-If04Pt Ati lit +a n.a.e-st- Alatss� iftArreci- drum le t.4 -0l.
NAME J PRIMARY.PHONE
frel.✓A`r6COLA Nem-11+" 465 "A- 253 &AI- Hloi
PROPERTY OWNER MAILING ADDRESS_ E-MAIL
CIS. 0. W h STATE Zn yV
IAME PHONE
4e)I,ktAlr\ h►lechix.niscaa
Con4T-4.41-m-5 2,C3 -1'!le -q 51N
'MAILING ADDRESS E-MAIL
CONTRACTOR 1911 5G ',1� 5 r.l 1 Q/� ?fir es♦_�Kpc��y�'ek. U,
rCUY eae/frA,k VV TATE ZIi FAX
Ul t5 .2373 tic" 1/7`�
WA STATE CONTRACTOR \CENSE# //'�` EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
60E51'6 IAL 919 at._ I / t 5 iago,V an-G°1 -bLl7oca-00-B4
N PRIMARY PHONE
NL1ar� rrc,U� PRIMARY
gHCe 1151114
MAILING ADDRESS MAIL
APPLICANT 'q 4` SW � �KS b. . 3,' beWCSt-unMei h.uS
CII I Aaj STATEki ZIP F
NAGE 1drA.rrYiu �3 PHONE' 157441
PROJECT CONTACT
MAIL ADDRES MAIL
(The individual to receive and l 1 5 /'- m A.• 4` A be $, ^otecx,0 S
respond to all correspondence J 'Jo
�0. ,-C A q,.�y
concerning this application) ° ` l � G� W 1'C Z�$D.23 'FT'
253 elq& 1c50
NAME
PROJECT FINANCING ❑ OWNER-FINANCED
When value is$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,J s application. p
AP
�� DATE I/�/I�
SIGNATURE: � j`' - ff ff
PRINT NAME: ? 0.f1t `
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
1
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(Commercial(
BOILERS FURNACES HOT WATER TANKS(Gas)
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 Tub/Shower Combo) LAVS(Hand Sink.( TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS Li OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS �- 1i� ` ,IS )G
DRINKING FOUNTAINS SINKS(Kitchen/Utdiry) WATER HEATERS(a(ectr,c) L. r 130.64.10/3-S
HOSE BIBBS SUMPS WASHING MACHINES l 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 0 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
DECK
GARAGE ❑ CARPORT ❑ ��
OTHER de „ a ,
Area Totals EXISTING PROPOSED TOTAL. _.
** HOMES 11 Y" ` - 7~" °, j
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
Area in Construction #of DESCRIPTION Occupancy Group(s)
Additional InformationSquare Feet Type Stories
A
NNW BUILDINf: °jr rw u
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Construction #of
Square Feet Occupancy Group(s) Type Stories Additional Information
TOTAL BUILD Ct a- g5i u
141 �i ''s �� �'" ,; 17io
TENANT AREA ONLY
ROJ7,cor
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application