03-100278City of Federal Way
Community Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:03 -100278 - 00 - ME
Inspection request line: 253.835.3050
Project Name: ST FRANCIS HOSPITAL - AMBULATORY SERVICES BUILDING
Project Address: 34515 9THiS�46 Parcel Number: 750451 0020
Project Description: MECH - Revise existing HVAC system in portion of 1st floor (central sterile area). Work includes the
relocation of registers/diffusers, fire/smoke dampers, per plans and subject to field inspection.
Owner
Applicant
Contractor
ST FRANCIS MEDICAL
AIR CONDITIONING COMPANY INC
AIR CONDITIONING COMPANY INC
1717 S J ST
835 N CENTRAL AVE SUITE 132
835 N CENTRAL AVE SUITE 132
TACOMA WA
KENT WA 98032
KENT WA 98032
98405-4933
(253) 854-8444
Mechanical Valuation..........................................5000
Over the Counter Permit......................................Yes
Mechanical Fixtures
Desdri tion _
W,
Air Handling Units 17 Ducts 17
PERMIT EXPIRES July 20, 2003, IF NO WORK IS STARTED.
Permit issued on January 21, 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: Date: 7r�
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DECEIVED CONSTRUCTION PERMIT APPLICATION
FederCITY OF JAN 2 1 2003 APPLICATION NUMBER: oo 1 - O Z_7 _Y - ego
Way
al ay PPLICATION NUMBER: _ _ _ _ _ _ _ _ _ _
CITY OF FEDERAL WAY APPLICATION NUMBER: _ _ -
BUILDING DEP
**The following is require 'information — Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
^ PROPERTY O.
MATION
SITE ADDRESS: 3 4 SI S i�� A-rcr 5o. ASSESSOR'S TAX/PARCEL #: � � D � � L - O b Z Q
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): ExshaSme \A-V A -C- 'S./ � r
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PROJECT NAME:--/�.nc.'�
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME: DAYTIME PHONE:
rllw.w 4 S Gwvy �G+��'ti 5V Y'c V✓N ( )
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, IP):
11 l'1 sbl�rh -� --�" e--4' "c�ovw. k la1,f� 9 8 4o S
NAME:
DAYTIME PHONE:
La I? S
— "3a,r�i -
(Z --S.5 ) 8 - 64 44
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
A
(copy of card required) f' S LL
T
L Q C ,L K Q
Io /ice - ®3
NAME: DAYTIME PHONE:
0'" �O ( ZS!) ) 6S74 - 8444
MAILING ADDRESS (STREET AD SS; CITY, STATE, ZIP): EVENING PHONE:
$3 C e- X132- ( ) -
RELATIONSHIP TO PROJECT: A FAX NUMBER:
❑ ARCHITECT ❑ TENANT & OTHER ( DESCRIBE): 60v-` �kvlr I ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT skCONTRACTOR
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? AYES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
FI1
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•• ••• AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
(� AIR HANDLING
UNITS)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE GAS LOG(S)
COOLER(S)
FAN(S) HOOD(S)
FIREPLACE INSERT(S) RANGE(S)
BATHTUB(S) _
DISHWASHERS) SYS.
DRINKING
FOUNTAINS)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
FURNACE(S)
GAS PIPE OUTLET(S)
PLUMBING
LAVATORY(S)
RAIN WATER
SHOWER(S) OUTLET
SINK(S)
SUMP(S)
REFRIG.SYSTEM(S)
WOODSTOVE(S)
—� MISC.( x1117 u~Vwc-
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKERS) ❑ ELECTRIC ❑ GAS
WASH MACHINE
WATER CLOSET(S) MISC. ( )
MSCI ATMFR/SIGNATURE RLC
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: DATE:!
❑ PROPERTY OWNER ❑ APPLICANT X CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ 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