11-100184 '
City of velopm • Plumbing
Way Permit #: 11-100184-00-PL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: ST FRANCIS MEDICAL PAVILION
Project Address: 34503 9TH AVE S Parcel Number: 750451 0050
Project Description: Remove/replace electric hot water heater on 2nd floor
Owner Applicants Contractor
ST FRANCIS MEDICAL CTR ASSOC AMERICAN MECHANICAL CORP AMERICAN MECHANICAL CORP
1717 S J ST PO BOX 1136 AMERIMC071BH (01/10/13)
TACOMA WA MONROE WA 98272 PO BOX 1136
98405-4933 MONROE WA 98272
Water Heaters. 1
PERMIT EXPIRES Wednesday, July 13, 2011
Permit Issued on Friday, January 14, 2011
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
nd the City of Federal Way.
Owner or agent: '•1*--- Date: 1-"'1 —1/
FAW4b i/i /ii
THIS CARD IS TO REMAIN ON-SITE
I�°F Construction InsOtion Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 11-100184-00-PL Address: 34503 9TH AVE S
Project: ST FRANCIS MEDICAL CTR ASSOI 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.
0 Plumbing Groundwork(4190) El Rough Plumbing(4230) Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
El Final-Plumbing(4075)
Approved
By pz, Date ///gii
C3 Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
• • _ 100 ( 84
°F,',,A" PERMIT
F
� Federal Way SF MF CO ME ,.(*-P-1-). E EN FP
�C� �
COMMUNITY DEVELOPMENT SERVICES APPLICATION I,.N
253-835-2607•FAX 253-835-2609
.u;,;r,ii L fhthOrefu_a cnnt
JAN 1 4 2011
SITE ADDRESS SUITE/ T#
( 1\- -. 4 )-P—... 'i,3\-"\-\c' CITY OF FEDER4w1a ' _\9
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# CDS
TYPE OF PERMIT 0 BUILDING >c PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT \�\, p1` �cK, \\� '
(Tenant Name/Homeowner Last Name) II Q(' V! A \C C �l ���
PROJECT DESCRIPTION >��� �� \ \���
Detailed description of work to Jc \ -E _;0_.. c..\\
��
be included on this permit only
....•• .„ 'Y PHONE
PROPERTY OWNER ti,1 C., C C\Pc,„ `\\o�\_�
MAILIN ADDRESS . & E-1NAII.
Ct G ADD
‘0 CONTRACTOR ,017 )NIN. \\ \,0 'Ilk' c..••CAN{yC_ x "\vQC
VNI\ciTY C:).cNC2C(2— \\gl. T 6%1M-- -''- ' teA14' ,•...-- (:)'\^i
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL AY BUSINESS LICENSE#
NAME -_- PHONE
`c`c,\Q o `C \Q\15
APPLICANT MAILING ADDRESS E-MAIL
CITY I STATE I ZIP _--FAX
PROJECT CONTACT N I' \ '.ONE
1114
(The individual to receive and /.1, w zoo, _ --- -_> - %_/,'Ll.respond to all correspondence nvG ADDRESS '
concerning this application) -Q-- �cM \\ - ,,c)
IVY ST TE` I'
, \• k rm e
a
;_ 'c ' CONTACT NAME: PHON 'MAIL
Alit , It 1111 ft
-.I ' --
PROJECT FINANCING NAME :� OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS.CITY.STATE.ZIP PHONE
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 ere such laim arises out of the elia • of the city, including its officers and employees, upon the accuracy of the
informal n up"'fed t, the city'' a part oft ap- nation.
SIGNATURE J a, le 'w — (� DATE(\
\OC; \ \
\ _
PRINT NAME. ' \\ \V cCb \‘....- :::::: 'E^
Bulletin#100-April 14,2010 Page 1 of 3 k:\Handouts\Permit Application
i •
VALUE OF MECHANICAL WORE{ $ (a copy of bid or estimate must be provided)
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 OUTLH,'TS OTHER(Describe)
AIR CONDONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
ititegtitgiG of llEt�� �\ �'m'ry$
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remail.
BATHTUBS(or Tub/Shower Combo) LAVS(stand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TO"1ALFII( TRES,
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 ❑ No
'$., „ " EI At * NEW Off'4, D Ol
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
13ASEMNT
FIRST FLOOR(or Mobile Home)
SECOND rt7OFt.i
COVERED ENTRY
GARAGE D CARPORT ❑
OTI-I fdesr
EXISTING PROPOSED TOTAL
Area Totals
*11NEW HOMES ONLY*'
ESTIMATED SELLING PRICE$ #OF BEDROOMS
Area Construction #of Additional Information
AREA DESCRIPTION in Square Feet Occupancy Groups) Typerie
Sto s
NEvv BUILDING i a F'
ADDITION
Area Construction #of Additional Information
AREA DESCRIPTION in Square Feet Occupancy Groups) Type Stories
•v ° ; �
Tf�I`�SHUILDING "�:.` %� ��s`� / , > ,,d.•, / � • „
TENANT AREA ONLY
i y� .
' A1U01!ILY ,k
Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Application