03-101346 City of Federal Way
Community Development Services Electrical Permit #:03 - 101346 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: ST FRANCIS MOB SLEEP LAB
Project Address: 34509 9TH S Ave- 5 Parcel Number: 750451 0010
Project Description: Install(12)low voltage thermostats serving HVAC units in hospital.
Owner Applicant Contractor
Hospital Bsp StFrancis AIR SYSTEMS ENGINEERING INC. AIR SYSTEMS ENGINEERING INC.
2002 ADV DEP PD#5282869 909 S 28TH ST 909 S 28TH ST
TACOMA WA 98409 TACOMA WA 98409
(253)572-9484
Electrical Fixtures
Esi icriti.:TJ.4r - ; Qtatiiti btity
Thermostat I 12
PERMIT EXPIRES October 4,2003.
Permit issued on April 7,2003
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: • �L. nit 1 A Date: Li Alit-7 AY;
5 , 2c C
RECEIVED
APR 0 7 20P, CONSTRUCTION PERMIT APPLICATION
1�- CITY OF FEDERAL WAY APPLICATION NUMBER:, 01 �1,3 {d- to E2
BUILDING DEPT. APPLICATION NUMBER: - -
APPLICATION NUMBER: _ _ - _ _ _ _ -
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
,�, �■ PROPERTY INFORMATION
SITE ADDRESS: 3'1 S 03
/1-ut. �SnoC1`l ASSESSOR'S TAX/PARCEL#: 4 - O O J 0
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
LOT 3 OP WEST CAMPUS OUSRiSS PARC ACCORDING TO THE PLAT THEREOF IlCOIEDED
IN VOLWE 17 OF PLATS AT PAGES 70-04,RECORDS OP ICING CCU NTY,WASHINGTON,
TOQETHlR WITH THAT PORTION.OF LOT 2 OF SAID PLAT OEM MORE PARTICULARLT DESCRIBED
Al FOLLOWS,
OEGIMCNG AT THE SOUTH&IEST CORNER OF SAID LOT 3,THENCE ALONG THE SOUTH LINE THEREOF .�
B$ 461E1 2114.0 FEET,THENCE 501 14'431U 30370,THENCE MSS 4013"W 217,50 PEET TO THE WEST
LANE OP SAID LOT 2,THENCE ALONG SAID tUEST LINE NOI 1441'E 303.70 FEET TO THE POINT OP
TYPE OF PROJEC BEP '' CONTAINING 14.3 ACRES,MORE OR LESS.
X'ELECTRICAL ❑ EENNG1INEERING ❑ rri.cc rmcv criIWI bYSI EM
PROJECT DESCRIPTION(Provide detailed description): S1 ( `2 1tS,0 fro k ,gs .�
SQ i-tr►c•� WCAC erg u;,p ma-nt.
PROJECT NAME: C'(2 tX\CtS M eel .OC- cQ [?Luka t Jk Lth-
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: `e' ��^1 l^per' DAYTIME PHONE:
LING ADDRESS
' (223)s 7a - 9 LIE tl
ET ADDRESS;CITY,STATE,ZIP U
EVENING PHONE:
36 0 a S. P; T(�t�rnJ o� k) 9409 ( ) s
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
/ 3 - 0 0 o a o 6 - O O (23)38-3 - 6337
CONTRACTOR'S REGISTRATION NUMBER: I Q S r Q O C s EXPIRATION DATE: / O
APPLICANT' NAME: C DAYTIME PHONE:
1 P1-e,�o�n ( 3)5-ia -9
MAILING ADDRESS REST DDRESS;CITY,STATE,ZIP): EVENING PHONE:
3boa S. �,(\fL_ I of Y,a , LAM gE-4O9 ( )
RELATIONSHIP TO PROJECT: I FAX NUMBER:
0 ARCHITECT ❑TENANT X OTHER(DESCRIBE):(A Y' (263 3&3-40
MAIL ADDRES '
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑APPLICANT CONTRACTOR beV P()aSe-I , WS
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ I C/)000. 0
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑YES o NO
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
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
• FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
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:1) I\ j �1 3',QA,D((1 DATE: q/1 /03
❑ PROPERTY OWNER ❑APPLICANT le CONTRACTOR