03-100827 . R— — EfVED
" COld�fRU�N PERMIT APPLICATION
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F�� `� � �j:, PPLICA C1N NUMBER: - c�� -' �
� �� � PPk.�CATION NUMBER` - -
C17Y UF FEDERAL WAY PPLI N NUMBE . ' _ _*� - —
BUILDING DEPT, — — — —
**The following�required iMormation-Please prirrt(in ink)or type**
Please note: Electrical,Fire Prevention Sy►stems and Engineering permits may fequire a separate application. ��\��
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SITE ADDRESS: 34509 9th Awenree Soudi,Suit+e 110 (Bui/ding Permit#02�105369�0-G1DJ
ASSESSOR'S TAX/PARCEL#: 750451-0���
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TYPE OF PRO7ECT(Thas application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING X FIRE PREVENTION SYS�N
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p�/C1X.06 y�
PR07ECT DESCRIPTION(Provide detailed description):Add and rebcade sprink/ers fn�nerv�p Lab/ocat+�d on the hr�t iJhoi in hhe
noidiwestsMe of tl�e bui/ding.A//ex�iinJ spiinkAeis sha//be rep/aced wiiii quick resppntse type sprink/e�s,
PROJECT NAME: J�t'. F�ancis Medica/D�ce Bui/ding Onco%qv
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PROPERTY OWNER: �ME� DAYRME PHONE:
Franciscan Heaith Svstem (253) 591�6 _ 5
MAILING ADDRE55(STREEf ADDRE55;CIfY,STATE,IIP):
1717 South)Street,Tacoma WA 98405
CONTRACTOR: N�E� DAYTIME PHONE:
Fire Svstems west (253) 833-1248
MAILiNG ADDRESS(STREET ADDRE55;C1lY,STATE,ZIP): EVENING PHONE:
219 Fror�tage Road North,Suibe B; Pacific,WA 98047 (253) 833-1248
CI'lIY OF FEDERAL WAY BUSINE55 LICENSE NUMBER: FAX NUMBER:
19-87-000014-00-BL (253) 735-011�
CONTRACTORS REG75TRA7ION NUMBER: DCPIRAIION DATE:
(wpyofcardrequ�red) FIRESWI14061 10/03J03
APPLICANT: �E: DAYTIME PHONE:
Paui G.soze {253)833-1248
MAILING ADDRE55(SIitEET ADDRE55;QTY,STAIE,IIP): EVENING PHONE:
219 Frontage Road North,Suibe B;Pacific,WA 98047 (253)833-1248
RELATIONSHIP TO PRQ]ECT: FAX NUMBFR:
❑ARCHITECT ❑TENANT X OTHER(DESCRIBE): Project Designer (25 833-Y248
E-MAIL .
CONTACT PERSON FOR THIS PROIECT: o PROPERTY OWNER X APPLICANT ❑ CONTRACTOR �°�firesys6emswest.com
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EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: ,f79��
SPRINKLERED BUILDING? X YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES ❑ NO
WATER SERVICE PROYIDER: ❑ LAI�HAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAI�HAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: �
' • • •• •
FLOOR EXISTING .FT. PROPOSED .FT. TOTAL
BASEMENT
FIRST
SECOND
TMi�
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
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) FIREPLACEINSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(5)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑GAS
DRINIQNG FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP{S)
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I certify under penalty of perjury that the information furnished by me is true and correct bo the best of my knowledge,and
further,that I am authorized by the owner of the above premises to pertorm 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,expens�,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
Federai Way,but only where such ciaim arises art of the reliance of the city,including its oPficers and employees,upon the accuracy
of the information sup lied to the city as a part of this application.
NAME/TITLE: DATE: 2/27/03
❑ PROPERTY OWNER ❑APPLICANT X CONTRACTOR
FbR OPFiCE USE ONLY::':'
❑ NEIN a A�DITION ❑ALTERATION a REPAIR ❑TENANT IMPRONEMEPlT
CENSUS CODE: LOT SIZE;
ZONING DESIGNATION': BUILDING SHELL ONLIf� ❑YES � Na
COMP PLAN DESIGNATION BASIC PUiN? ❑YES ❑ NO
SECTI{}N TOWf+lSHIp RANGE HEW ADQRfSS REQUIRED? o YES ❑ NO
RLATFED LOT? ' ❑YES' ❑NQ CF#ANGE'QF USE? ' o YES Q NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9�18•FEDERAL WAY,WA 98063-9718•253-661�000•FAX:253-661-4129
www.cityoffederalway.com