03-102634G41ofFederal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: VIRGINIA MASON CLINIC
Project Address: 33501 1ST X X04 S
Mechanical Permit #:03 -102634 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 926504 0010
Project Description: Install (2) new diffusers, (1) new fire/smoke damper, replace (1) existing eggcrate with new diffuser,
minor ductwork mods, and (4) air balance fan terminal units
Owner
Applicant
Contractor
Mason Clinic Virginia
MACDONALD MILLER FAC SOL INC
MACDONALD MILLER FAC SOL INC
1100 9TH AVE
MACDONALD MILLER FAC SOL INC
MACDONALD MILLER FAC SOL INC
SEATTLE WA
PO BOX 47983
PO BOX 47983
98101-2756
SEATTLE WA 98146
(206) 768-4258
Mechanical Valuation..........................................2500 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
DescriptionQuanti '` Description uanti Description_ Quanti
Ducts 45 Fans
CONDITIONS:
1) Smoke and fire dampers shall be installed and be accessible for inspection and servicing. All smoke dampers shall be
tested by the fire department prior to issuance of permit final.
PERMIT EXPIRES December 23, 2003.
Permit issued on June 26, 2003
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 and
the City of Federal Way.
Owner or agent: ;�%_ ''`� c �; Date: 21�
me-c�'� P. I 6e.", C4 0 �4 (3 - ce� - e!� a ce-�
a
CITY OF
Federal WAPECEIVED
Acat
CONSTRUCTION PERMIT APPLICATION
PPLICATION NUMBER: - 2 -
PPLICATION NUMBER: _ _ -
PPLICATIONNUMBER:
JUN((��
**The fo owmgai0equired information — Please print (in ink) or type**
Please note: El i rFiR:"VAII i stems and Engineering permits may require a separate application.
B I
PROPERTY•• •
SITE ADDRESS: '`'3501 fjMS 7- Wd 4 S &a ro-- ASSESSOR'S TAX/ PARCEL #:I ,� l
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING o PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERIING ❑ FIRE PREVENTION SYSTEM /
PROJECT DESCRIPTION (Provide detailed description): iTlhLL t ' %i E, R2 i2i15'd
i.
PROJECT1 / 11 l I / 01 L II / v
■ PROJECT INFORMATION
PROPERTY OWNER:
CONTRACTOR:
NAME: I DAYTIME PHONE:
V s CL )/C'_ ( ) -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
33,511 a&SE 12hY 51VITI1F6L2WL &WX t0h ZZ603
NAME:
DAYTIME PHONE:
M N ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
of &D ?3 --1- �C d &
( )
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
f� 22
Qo(e )wt
LL
Jt
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required) J1 �C i 1 t� U
/-1/ l 3
/
APPLICANT: NAME: DAYTIME PHONE:
M e l G�1) 4; `� -523
MAILING ADD ESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
A(AQ[)r)A,1ALDL 566 Oji' 6 ( ) RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT OTHER ( DESCRIBE): GQ ��} ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT o CONTRACTOR
PR03ECT INFORMATION
EXISTING USE: MLO, )M CUA EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:F�^�^%j ��� C (� PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO it
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
■ PROJECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
Indicate number of each type of fixture
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
AIR HANDLING UNIT(S)
SECOND
GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
THIRD
HOOD(S)
WOODSTOVE(S)
BOILER(S)
FOURTH
RANGE(S)
�_ MISC. c SCk)
COMPRESSOR(S)
OTHER FLOORS (DESCRIBE)
:3 pif~7 vl-',C/
P P
�
DUCT(S)
DECK
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
GARAGE
HOW MANY FLOORS?
BATHTUB(S)
TOTAL:
URINAL(S)
WATER HEATER(S)
DISHWASHERS)
]TSCLATMER/SIGNATURE BLC
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of
Federal Way, 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.
NAME/TITLE:An �' DATE: Sr
❑ PROPERTY OWNER ❑ A LICANT CONTRACTOR
Fna f1FFTrF I ISE ONLY:
❑ NEW v` w❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
Indicate number of each type of fixture
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
MECHANICAL
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
AIR HANDLING UNIT(S)
EVAPORATIVE COOLER(S)
GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
FAN(S)
HOOD(S)
WOODSTOVE(S)
BOILER(S)
FIREPLACE INSERTS)
RANGE(S)
�_ MISC. c SCk)
COMPRESSOR(S)
FURNACE(S)
:3 pif~7 vl-',C/
P P
�
DUCT(S)
GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S)
LAVATORY(S)
URINAL(S)
WATER HEATER(S)
DISHWASHERS)
RAIN WATER SYS.
VACUUM BREAKER(S)
❑ ELECTRIC ❑ GAS
DRINKING FOUNTAINS)
SHOWER(S)
WASH MACHINE OUTLET
GAS PIPE OUTLET(S)
SINKS)
WATER CLOSET(S)
MISC. ( )
INTERCEPTORS)
SUMP(S)
]TSCLATMER/SIGNATURE BLC
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of
Federal Way, 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.
NAME/TITLE:An �' DATE: Sr
❑ PROPERTY OWNER ❑ A LICANT CONTRACTOR
Fna f1FFTrF I ISE ONLY:
❑ NEW v` w❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.ciLyoffederalway.com