19-104565 Mechanical
City of Federal Way Permit #:19-104565-00-ME
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: BROOKLAKE SENIOR LIVING
Project Address: 32290 1ST AVE S Parcel Number: 172104 9039
Project Description: Replace existing RTU-unit will be in same location and slightly smaller in size.
Owner Applicant Contractor
BROOKDALE SENIOR LIVING BRETT ROEBUCKAIR SYSTEMS AIR SYSTEMS ENGINEERING INC
6737 W WASHINGTON ST SUITE 2300 ENGINEERING INC (GENERAL)
MILWAUKEE WI 53214 3602 S PINE ST AIRSYE*229KN(2/1/20)
TACOMA WA 98409 3602 S PINE ST
TACOMA WA 98409
Additional Permit Information
Mechanical Work Valuation9 16692 Is this an Online or O.T.C.application? No
Roof Top Units 1
PERMIT EXPIRES Sunday,22 March,2020
Permit Issued on Tuesday,September 24,2019
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 age t: ietti,Qt (-kc F( / Date: -(4,(019
THIS CARD IS TO REMAIN ON-SITE
�` Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104565 00 Address: 32290 1ST AVE S
Project: BROOKDALE SENIOR LIVING FEDERAL WAY WA 98003
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.
El Mechanical Rough-in(4165) 0 Gas Piping(4125) El Final-Mechanical(4065)
Approved Approved to release test Approved
1Vg M
By Date By Date By Date IZ
•
Rough Electrical ❑ Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
„..,_ ..A, RECEIVED PERMIT APPLICATION
CITY OF O
Federal Way SEP 2 3 2019 PERMIT CENTER+33325 8'h Avenue South+ Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609 +permitcente n,cityoffederalway.com
CITY OF FEDERAL.WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER I l _ 0 t 5 (S/ 5 _ '�/�/�l E.----
TARGET DATE /°//11// 9
SITE ADDRESS3I S-T !1 V t 5 0 4 SUITE/UNIT#'12 90
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ \Co Co GI/ . 00 7 2 I 0 4 - 9 0 3 9
TYPE OF PERMIT 0 BUILDING 0 PLUMBING gMECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT 6ROOY\DA1_ ()NMI)1\716N h6\i5F K\ 1U- MUA
F\AV,N\5l-k A1\D INS-1Ii1_1. I NtNnI CAKi-V
PROJECT DESCRIPTION t 0 U F-7 0'P P R Cut1(� UN\T - U1\1\--C \A \U \3 Y IMDetailed description of work to
be included on this permit only SA'M1.(!)CA-1 I ON ik x 1 c 1 f b
NAME PRIMARY PHONE
P,Ro0 DAIS 5EN\otk LIV11- J 25 2_51 4320
PROPERTY OWNER MAILING ADDRESS
G1 1-)1 W \,t)Ac-)i-1 IN C--(T, OR S t )-ke 2300 70-\64Ae 6RGUKbA\E ,Lt3.W
CITY V11LWA\k\k W 1 ZIP 532...!A-
NAMER! S`1 cl -1/AS
t KG IN 'f-19-.111�I NG C• PHONE 25') 512 A 5
94-g4-
CONTRACTOR
MAILING ADDRESS .1 CO 0 2 5 o ?W.- S1 E-MAIL
d t�°-}-k f e A 4.�'t
CITY
-TA CU MA VA97 z>p q'8 A 01 FAS 15 3 3Y77 (0.537
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE it
AIR5'1f\ )6 'I2`1c1 Z 1 / 10 \`1-13- DOWD() -60-Ill
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
5k (.0141M0off.1
CITY STATE ZIP FAX
PROJECT CONTACT
NAME V R��f 7 CC O(r 9)U O f\ PRIMARY PHONE
(The individual to receive and MAILING ADDRESS 4 5 E Cot-VIKA «0,1s, 7 E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING 0 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 authorised 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. �7
SIGNATURE: l,7 t'”' ��.1{�Z��""_"ac.70L CA DATE 9 -9 - L 0 )CJ
PRINT NAME: 5re-t-1 Roebv,lk
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ 1 Co I (a y 2 - od
Indicate how mans of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
T AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gast
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how mass 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
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER fDescribe)
•RAINS SHOWERS VACUUM BREAKERS
D'. KING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOS' :IBBS SUMPS WASHING MACHINES "TOTAL FIXTURES
GENERAL IN RMATION
CRITICAL AREAS ON PRO• a ? WATER PURVEYOR SEWER PURVEYOR VALUE EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
RESIDENTIAL — NEW OR ' I ITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED T• AL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT 0
OTHER(describe)
Area Totals "MIN
G PRO
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NE ADDITION
AREA DESCRIPTION
Area in Occupancy Group(s) Construction #of Additional Information
Square FeetType St• es
NEW :-*
ADDI •N
COM 'CIAL—REMODEL/TENANT IMPROVEMENTS
• - DESCRIPTION Area Occupancy Groups) Construction #of Additio, < Information
Square Feet Type Stories
To, BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-January 29,2016 Page 2 of 2 It:\Handouts\Pennit Application