02-105169 Gity of Federal Way Fire Prevention System Permit #:02 - 105169 - 00 - FP
Community Development Services
33530 lst Way S
Federal Way,WA 98003-6210
f?h:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: ST FRANCIS OUTPATIENT IMAGING
Project Address: 34515 9TH S Parcel Nuxnber: 750451 0020
Project Descriprion: FPS-Add on to exsisting fire alarm system
Owner Applicant Contractor
ST FRANCIS MEDICAL SIMPLEXGRINNELL LP VECA ELECTRIC CO INC
1717 S J ST 9520 IOTH AVE S SUITE 100 PO BOX 80467
TACOMA WA SEATTLE WA 98108 SEATTLE WA 98108
98405-4933 (206)436-5200
PERMIT EXPIRES May 21,2003,IF NO WORK IS STARTED.
Permit issued on November 22,2002
I hereby certify that the above informarion 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: � Date: L ��Z 2�V 2
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. �« G CONSTRUCTION PERMIT APPLICATION
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�� PPLICATION NUMBER: - -'�
PPLICATION NUMBER: - -
PpLICATION IVUMBER: -
'*The foHowing�requirad informallon—Pleasa print(in ink)or type*•
Plaase note: ENctrk�l,Fire pnventlon S�►stams snd Enginaeriny parmits may roquin s separata appUcstbe.
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SITE ADDRESS: ��"i SI S ��� �1/P�Sf7✓7� ASSESSOR$TAX/PARCEL#t: ^, — — — — — — — — —
LE6AL DESCRIPTION OF SUdJ�CT PROPERT1f(ATTACH SEPARATE DESCRIPTION IF LENGTNY):
S�_ F.,tir,r iJ Hbs.►,��� !
TYPE OF PROJECT(Thts�pplkatbn): ❑BUILDIN6 p�WM�IN6 Ct MECFIANICAI. ❑OEMOLITION
❑ELECTRICAL ❑EN6INEERING I�FIRE PREVENTION SYSTEM
PRO]ECT DESCRIPTION(Provide detdled dascription): !.1��;n 'Ft) ��)CS�.f�'Mf2h , l�i%r �(�e//'+^
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PROaECT NAMEp S�. F/��, C.'I � O li �- �0 El �I1����{ S/Z'Z�i�1✓��J• -
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� PROP'ERTY OWNER: � onrrn� E: ,
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NALLING ADDRESS(S7REE!ADDRKS� .STA
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CONTRACTOR: �: a►riu��E:
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MAIUNG (STREEf ADDRE55:QTY,SfA7E,ZIP): EVENtNG E:
L V S Y�o� c � -
QT1f OF F�ERAL WAY BIbIN65 LI�NUF�qi: FAX NUMBER:
Z - 1 � - ( ) -
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(mPY d tard requi�ed) V � � �O
APPLICANT: a►Yi�E PN�E:
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MAIWIG STREE'f ;QTY.STATF.IIP): EVE/�QNG PHONE:
��L o 0 . S� ` (u, ,� h�/ ( d<)L�1 ' l'l� �
RElAT10NSMiP TO PR . FAX NUMBER:
o nrtcH�cr o�a�� r�6��R��Fsc�se�: ,��6ldnf�,c� {�, (2U6 ) I�!/ - /SAD
EMAiI ADDRE55:
CONTACT PER50N FOR THIS PRO]ECT: ❑PROPERTY OWNER �APPLICANT ❑CONTRACTOR
. �•
EXISrING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSEd VALUATION FOR IMPROVEMENTS: � r d�_�O O
SPRINIaERED BUILDINGt ❑YES ❑NO FIRE SUPPRESSION SYSTEM PROVOSED/REQUIRED: a YES ❑NO
WATER SERVICE PROVIDER: ❑LAKEHAVEN ❑HIGHLINE ❑TACOMA ❑PRIVATE(1NELL)
SEWER SERVICE PROVIDER: ❑LAK�HAVEN ❑HIGHLINE ❑PRIVATE(SEPTIC)
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**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMiEI!OF BEDROOMS: ESTIMATED SELLING PR2CE: �
FLOpR EXISl'ING S .FT. PROPOSED .FT. TOTAI,
BASEMENT
FIRST
SECOND
TMi�
FOURTH
OTHER FLQORS(DESCRIBE)
DECK
6ARAGE
HOW MANY FLOORS?
TOTAL:
Indicabe numba�oi aaoh typa ot flxtura
MECHANICAL
AIR NANDLIN6 UNIf(S) EVAPORATIVE COOLER(S� 6A5 t06(S) REFRIQ.SYSTEM(S)
B!Q(S) FAN(S} HOOD(S) WOODSTOYE(S)
80ILlR(S) FIREPI�ACE INSERT(S) IrAN6E(S) �_ MISC.( )
COM�RESSOR(S) FURNACE(5)
'',� bUCT(S) 6A5 PIPE OUT�ET(S� HEAT SOURC�: ❑EL6CTRIC o GiAS
PLUMBING
BATHTUd(S) LAYATORY(S) ,T_ URINAL(S) WATER ME�TER(S)
OISHWASHER(Sj RAIN WATER SYS. VACUUM dREAKER(5) ❑ ELECTRIG ❑GAS ,
DRINIaN6 FOUNTAIN(S) SMOWER(S) WASH MACMINE 04TLET
6AS PIPE OUTLET(S) SINK(S) �_ WA7'ER C�OSET(S) � MISC.( I
INTlRCEPTOR(S) SUMP(S)
I cartlir under p�naltY of perJury that tM�tornMtfon furnished by m�is trus and corrod to the best ot mr knowlsdqe,*nd
furthar,that I am audrorized by tha own�r ot tM sbo��prami�n to pMorm the work for whkh tfie parmit applicatbn b mad�. I
turthar aqroe bo hold hsrn►tass tM CItY of hdwal Wa�►as tq arry datm(indudinq cests,axp.nsa,and attor��►s'teas incurrad In tM
inwstlyatbn snd tlehnie ot sueh daia��whkh mar b�msde by sny pfnion,�dudin�!he undersiynrd,�nd Med apalnst the City of
F�d�rai Way,but only wMro wch elaim�ri�es out of tha nlfanta of tha dty,Meludiny Ib of(iesn and anpioyeas,upon the acwracy
of the iMormatba s NM bo th4 dty a s Wrt of thb apP�iestbp.
NAM�/TiTt.E: ' OATE: � / �(f �
o PROPERTY OWNE ❑APPL2CANT o CONTIUCTOR
FOR OFFICE USE ONLY•
❑NEW ❑ADDI'fION ❑ALTERATtON ❑REPAIR ❑TENANT IMPROVEMENT
CENSUS CODE: LOT SI7E:
ZOtMIN6 DESI6NATION: dUIlDDr6�lL ONLYT ❑YES ❑NO
COMP PtAN DESI6NATION I{�ASIC PLANT ❑YES ❑NO
SECTION T0IIYNSHIP RANGE NEW ADDRESS RE UIRED? ❑YES ❑NO
PLAtTED LOTT ❑YES ❑/t0 CNANGE OF USE? ❑YES ❑NO
COMMUNIfY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FED6tAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129