94-101989 CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT PERMIT NO.: FPS94-0047
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 10/25/94
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 34719 S 6TH AVE S
PARCEL NO.: 202104-9178
PROJECT DESCRIPTION: FIRE PROTECTION SYSTEM — EVERGREEN EYE CENTER
(U/G PLUMBING UNDER SEPARATE PERMIT FP394-0041) THI3 PERMIT IS FOR BIIILDING SYSTEM (ABOVE
GROUND) .
OUNER CONTRACTOR LENDER
JOHN JARSTAD, DR. MD PATRIOT FIRE PROTECTION, INC.
9 9TH AVE STE#101 2004 A 48TH AVE. CT. E.
RAL WAY WA 98003 TACOMA WA 98424
927-5646 926-2290
PATRIFP099CF
SPRINKLERS?........:Y HOOD & DUCT?.......:? FEES:
# ZONES..........: 2 OTHER.....: FINAL PLAN CHECK...* $ 15.00
FIRE ALARM SYSTEM?.:? EXTENT OF NORK...:? SPRINKLER FEE......* $ 162.00
# 20NES..........: 0 FINAL PLAN CHECK...* S 90.00
STANDPIPE?.........:? FIRE DEPT FEE.....,* E 133.50
UG FIRE SERVICE?...:?
FIXED SYSTEM?......:?
TOTAL fEES S 400.50
INSPECTION RECORD
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
1 CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
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OWNER OR AGENT , v DATE �-��r��y�����/.
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��CEIVED �
�.•� � City of Federal Way C��'T 131994
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�� r APPLICATION FOR BUILDING PER11�t�aFFE�U�.,pRgA�L;IN�AY
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PLEASE PR/NT APPL/CAT/ON#:���9 -- bO�7
STT�' I.QCATIQN Address 3 47/ a. �j�� � r�,� � �
Tenant (if known) Lot #
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Building Owner Name Address
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Nature of Work �j�� C G.� �G �
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LEGALDESCRIPTION ��G� n���IprION
the east one fourth af the sa�th half of the ea5t haif of the west
— halF of t,he northeast c�ar-ter aF the saltJ�wes�t c{.�ar-ter of sect�on
20, to�msh�p 21 ra�th, ranqe�}east, W,M., h Khq Cwr�,
Wash��qF�n; except the saith 50 feet t.her-eof fa-road; and ex�ept
the north 380 feet tl�er-eof. S�tuate In the caritt�of K�nq, state
P/ease Comv/ete Reverse Side
C00492 IRev 4/931
UCT�E I> Existing Propos :e
iit includes: ❑ Building ❑ Plumbing I� Mechanical ❑ Other
e of Work: � Residential � New ❑ Remodel ❑ Number of Units_ ❑ Deck
� Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1 st Floor�sq ft 2nd Floor 2✓03�'sq ft 3rd Floor �`" sq ft Existing Floor Area """ sq ft
Area Basement 37$(� sq ft Decks sq ft Garage � sq ft Proposed Total Area ` "` sq ft
� Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ Rroject Veluatian s S � t`j r�/�' :�
Zoning (� Lot Size 37 �Q S' �'r >F3cisting Bldg Va[aatiort ' S
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_.._. __...._ _ _._. _. __ ___. . . ....
T;ENDER -
Name Address
City State Zp
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1NECHAAITCAL<CQNTRACT0�2
Contractor Name Address
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licensa # /�T 1 O — Expiration Date 9,�9 5 Verified � Yes ❑ No
PLUMBING CONTRACTOR `
Contractor Name Address
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Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
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_.........._............_......._._.._......_............_........
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PLTJMBING FI7fTURE:;CQUN'I`
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Orains Total Fx�t�re.Catint_.,,.,:,;;:...._...:..;
____ . _ __.
_.... . .._ . ....____ _ _....._..
MECHANICAY.; U1�iIT �OUNT:
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Ta�ks
Gas Hwt Hood Boilers Above Ground
Conv Burner Duct Work 0-3 Tons U�derground
BBQ's Wood Stoves 3-1 S Tons ;Total Unit Caun!<
DISCLAIMER: 1 certify under pe�alty of perjury that the informetion furnished by me is true and correct to the beet af my knowledge and further that 1 am eutharized by tM owi
of the ebova premiaes to perfortn the worlc for which permit epplicetion is made.t further agree to sava harmles�the City of Federal Way ea to eny claim(including costs,expansos,
a�d attomeys'tees i�curred in investigation and defense of such cleim►,which may be made by any person,including the undersigned,and filed egainst the City of Federal Way,
but only where such cleim erises out of the reliance of the City,including itc ofticers and empbyees,upo�the accuracy of the informatian supplied ta the City as a pert of this
epplication.
Owner/Ayent: �� � �r'�aQ.Q/ Date: ��— �3�9�