07-100393 0005 `fit
c,T,c,( te,r- CONSTRU ON PE - IT APPLICATION
NV f-' RECEIVED APPLICATION NUMBER:6_
APPLICATION NUMBER: _ _ _ 1_40_ _ 313
,IAN * 4 ZOO APPLICATION NUMBER: _ _ - _ - _ _
**The1factypv 0E rr 'information—Please print(in ink)or type**
CTY
Please note: Electrical,FireeleiglaPgysiems and Engineering permits may require a separai#applica ion.,
■ PROPERTY INFORMATION
3`f c( 0/ - 3l
SITE ADDRESS: 34700 1t. PJace S _ TAX ASSESSOR'S TAX/PARCEL# 215470004O'
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
4 EAST CAMPUS MEDICAL CENTER DIV#1 LOT A FEDERAL WAY BLA#04-100826-00-SU REC#20041221900002 SD BLA BEING LOTS 3&4
SD PLAT
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING o MECHANICAL D DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING X FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Add 34 new pendent sprinklers in new office space on the second floor.
PROJECT NAME: Building B second floor TI `1 C I h \/6,Sf -h kS L.L- C
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
OWNER VC Investments LLC PHONE
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
OWNER MAILING ADDRESS
CONTRACTOR: NAME: DAYTIME PHONE:
Fire Sprinklers,Inc. 253-826-0099
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
1014 North St.Suite#200,Sumner,WA.98390 253-826 -0099
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
20-05-100633-OOBL (2/31(0-7 253-826-1033
CONTRACTOR'S REGISTRATION NUMBER: ( EXPIRATION DATE:
(copy of card required) FIRESI*988RJ —121-311400,
l2 t‘
APPLICANT: NAME: DAYTIME PHONE:
Mike Maguire 253 826-0099
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
SAME AS ABOVE ( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE):SPRINKLER CONTRACTOR SAME AS ABOVE
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER X APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS $
Z4% vci
SPRINKLERED BUILDING? X YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSE' 'EQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: getAKEHAVEN ❑ HIGHLINE o TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: to\LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC)
I
**NEW n,`_•SIDENTIAL CONSTRUCTION ONLY**
4
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) o 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 sup•lied to the ity as a part of this application. 1-4
j 7
NAME/TITLE: � DATE: F d-- G� t
o PROPERTY OW - ❑ APPLICANT p-CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION o ALTERATION ❑ REPAIR o TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? o YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES o NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? o YES ❑ NO
PLATTED LOT? o YES ❑ NO CHANGE OF USE? ❑ YES o NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX: 253-661-4129
www.otyoffederalway.com