15-105764 174S"..4"11Clly of Federal Way • • Mechanical
Community 3 Econ.rev.Services Permit #: 15-105764.00-ME
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: LIFE CARE CENTER
Project Address: 1045 S 308TH ST Parcel Number: 082104 9042
Project Description: Install new ductless mini-split system for cooling in elevator room.
Owner Applicant Contractor
FEDERAL WAY CONVALESCENT 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
Air Conditioners-Stand Alone Un 1 Ducting 1
PERMIT EXPIRES Saturday, June 11, 2016
Permit Issued on Monday, December 14, 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
d the f F eral Way. I �(
Owner or agent: � Date: _V `
C.T,roF '4A • THIS CARD IS TO . AIN ON-SITE r
Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 15-105764-00-ME Address: 1045 S 308TH ST
Project: FEDERAL WAY CONVALESCENT ( FEDERAL WAY, WA 98003-4706
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) Cl Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By DateDate ��
• s
❑ Rough ElectricalCI Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECE ® PERMI' APPLICATION
Federal Way NOV 12 2015
CITY OF /FEDERAL WAY
PERMIT NUMBER / `� _ / D� TARGET DATE /a4 V3
SITE ADDRESS `J ((((//// `r / l SS•�� SUITE/UNIT#
1645 G
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 9 g,rrig60 Oqs al LE _ go Lk a_
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING MECHANICAL 0 DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECTU'f c 6&41e.) � -6 If 6661 t ng
5-1-ekiL new dot 6s I'Ya Lir) I -g I' 5
PROJECT DESCRIPTION ., '�,�r ani[ I I� L() / dL� (LO vY�, J
Detailed description of work to �I 1 v!1/
be included on this permit only
NAME PRInARy PHONE
PROPERTY OWNER I • D SS E-MAIL
C Y c $ ^ •
ZIP
NAME /. PHONE
RI ) 1 rI , 1 j l..! /�-X L /• E-MAIL
MAILING ADDRESS.l.Y6 '
CONTRACTOR a P ►1 �
CITY
T Y I 4,_ ,ST.7TEn ZIPq �/t+6q FAX
W,� rsCRI�'��AC_' QT LAElFT� lJ`/i `..__.._ EXPIRATION
XIRTII N/DATE FEDERAL WAY BUSINESS LICENSE#
l(r�{f C����JJJV` zY/S/�
Er 5 G �/ i,r,,^ „ __ _/Lri9
PRIMARY PHONE
APPLICANT MAILING ADR S (`�J ` I/`✓-(�//J' E-MAIL
CITY STATE ZIP FAX
NAME
PROJECT CONTACT U�. „ talc C9(L ,
(The individual to receive and MAILING ADDRESS /j Bo, �' w 3 L f 6 j/ 1-p " �'�J 6�(J � V V I
respond to all correspondence �/ N 4
csej
concerning this application) CITY
�M s ZIPc Lteog gig .3g
NAME 1 1. �j
PROJECT FINANCING 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 to the city as a part of this application.
SIGNATURE: ebi\-LEL'1 6-6ei l 1 r DATE 5
PRINT NAME: �e- 6/),_lJ"� 1 Jl}LS , ( Av '�../Jq`-" ' )S
Bulletin#100-October 26,2015 Page 1 of 3 k:\Handouts\Permit Application
•
VALUE OF MEC ANICAL WORK
MECHANICAL PERMIT $ q5 �
indicate how many of each type offacture 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 sinks) TOILETS WATER PIPING
DISHWASHERSRAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(xitehen/utility) WATER HEATERS(electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ 1 ) q
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
2-1 n Yes ❑ No s 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 El CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY"
ESTIMATED SELLING PRICE$ # OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area m Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
TOTAL IILD II 4 . � *) .
TENANT AREA ONLY
Pte ? LY ti,
Bulletin#100—October 26,2015 Page 2 of 3 k:\Handouts\Permit Application