92-102188 9�,��a� �g
CITY OF FEDERAL WAY B U I L D I N G P E R M I T PERMIT NO.: BLD92-2526
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 12/21/92
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 34515 9TH AVE 8
PARCEL NO.: 202104-9117
PROJECT DESCRIPTION: MED RECORDS/ADMIN/NURSE ADMIN & MTS RENOVATION
ONNER CONTRACTOR LENDER
ST FRANCIS COM HOSP - ADMIN SELLEN CONSTRUCTION
34515 9TH AVE S 228 9TH AVE S
FEDERAL WAY WA 98003 SEATTLE NA 98003
838-9700 682-7770
SELLEC372N0
..�.,?:X MEC?: PLM?: FLR--EXIST--PROP--- DWEILING UNITS: 0 COMP PLAN.........:? FEES:
TYPE OF NORK:TEN USE:COM 1ST.: 500: O:sf STORIES........: 3 REAUIRED PARK]NG..: 0 SPRINKLERS?......:? fINAL PLAN CHECK...* S 122.85
CENSUS CATEGORY.....:437 2ND.: 0: O:sf HEIGHT.....: 0.00 ft HA2ARD CLASS...:? PLCK-FIR carml only* S 9.45
OCCUPANCY GROUP---------- 3RD.: 0: O:sf VALUATION---------• REOUIRED SETBACKS------- FIRE FLOW....: 0 gpm BUILDING PERMIT....* S 789.00
:I1.1 :7 :? :? : OTHR: 0: O:sf EXIST..E: 0 FRONT.........: 0.00 ft SBCC SURCHARGE.....* E 4.50
TYPE OF CONSTRUCTION----- BSMT: 0: O:sf PROP...E: 17019 SIDE..........: 0.00 ft WATER SERVICE..:?
:1FR :? :? :? : DECK: 0: O:sf REAR..........: O.00:ft SEWER SERVICE..:7
OCCUPANT LOAD------------ GAR.: 0: O:sf RECEIVED.:12/08/92
. 0: 0: 0: 0: TOTL: 500: O:sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.:? ? FANS..........: 0 BOIIERS/COMPRESSORS WATER CLOSETS......: 0 URINALS........: 0 TOTAL FEES S 325.80
GAS PIPING.: 0 ft HOOD..........: 0 0-3 HP......: 0 BATH TUBS..........: 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT NORK.....: 0 3-15 HP.....: 0 SHOWERS............: 0 SUMPS..........: 0
GAS HWT....: 0 WOOD STOVES...: 0 15-30 HP....: 0 LAVATORIES.........: 0 VAC BREAKERS...: 0
CONV BURNER: 0 FURN>100K.....: 0 30-50 HP....: 0 S1NKS..............: 0 DRAINS.........: 0
BBQ........: 0 MISC..........: 0 5+ HP.......: 0 DISH WASHERS.......: 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS--------- ELEC WTR HEATERS...: 0 OTHER FIXTURES.: 0
RANGE......: 0 <=10,000 CFM: 0 ABOVE GRWND: 0 LAUN WSHR WTLTS...: 0
GAS LOGS...: 0 > 10,000 CfM: 0 UNDERGRWND.: 0
AL 1MITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I 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.
OWNER OR AGENT �h� -� DATE ��-�� l/� �
bld_prmt 10/23/92
,
• �[ Pet'(111i � �l L�� �'�- :�� :�'.�;
_ CiTY OF FEDERAL WAY � �
• BUtLpfNa pERMiT APPtICAT10N �� , �
" ' ' ' " . ' " —P�eace Print— '
BOX i TENANT NAME; �X�ST/N� I�IDS�/T�4L F�t�l1GT�oN,s �
OWNER � � ITE LOCA710N
OWNER'S ADDRESS Nt,q)TH' / C�n l�P ON
'� bESCRI6E JOB �
'TFiE'PROPERTY IS OWNED BY: SINGLE/MA RIED PARTNERSNIP ' CORPORATlON �,�,r,^
BOX 2 COHTRACTOR'S NAME SELLEN GDNST,aUGTlD.h/,�CONTRACTOR'S REa,#S� G�1E`37l D
'�Car A�U T ba presemed
� CONTRACTOR'S ADDRESS ZZS /V . CITY„S��-r.r[� G(1�4 pHON Z�6� - 7�p
EXPIRA"f ION DATE� • Z 9�„ . � qB�a 9, ,
— aa--
I HAVE READ CHAPTER 18.27,010 RELATINQ 70 DEFINlTIONS OF GENERAL CONTRACTORS AND SPECIALTY CON7RACTORS AND .
CHAPT�R 18.27.114 WHICH PROHIBlTS ISSUINO PERMITS Wl?HOU7 PROOF OF REGISTRA�TION.
BOX,3 CONTACT AERSON PHON � f -
BOX 4 SEWE�O15TRIC7 �WA�'�A DISTRIC'f
BOX 5 ESTIMATEd pROJECT COST ��7 EXISTlN� BUILDING VALUA710N __ /9 , 5o D , o-DD
80X 6 PROPERTY TAX ACCOUNT NUM�ER za�Z�O 9!!
LEGAL DESCRIPTION s�L� .4T7'.4r�ac1� .
(If necessary, please submit a:eparata page wlth the laqa1 descrlptlon,)
K.C. Plat Rec�rdlnp # �
BOX 7 BUILQINO S�UA�� FO�TAGE:, (Exlatinq/Proposad) 1Sr� FL00�� ND F1.40R ' '_::_,_,/ ��,�r
3AD - FLOOA_..�..._.J d SEMENT__..._^„_/,;x�t�4eY�E DECK_.�....I�-- GARAGE^,� � r,�-.
BOX 8 ( j SiNGLE FAMILY • ( NEW CONSTRUCTION � �
( ) MULTIFAMILY(NO, OF UNITS a ��� ��,EXIS7lN0 STRUCTUA� �
{ ) C4MMERCIAUIN�U6TRIAL TDTAL AREA OF PROPEATY _ 25 AG/�'S ,. � ��e��.
�-�. . .
BOX 9 PLUMBINO FlXTUa�5((ncludlnp rouph�ins) . MECHANICAL APPLIANCES— BASlC FE�g —�
NO::,,..: '_WATERCLOSETS �• QAS PIPIN�, FEET• ��• ., „ �,,,. , �
BAYHTUBS � !�n.,.��URNACE, ELEC. �,�A5� � _
.�,�—.SHOWERS � :,� ' QAS HOT WATER N�ATER"' ' - '" ' �• - �
,,, ��IAVATORIES • - • CONVERS�tON BURNER�- - . �_ . _, ,...
� . _ SINKS � � ,BOILER,SIZ� 8T11 �
....,._DISHWASHERS ._„JqIR l�ANDLINO UNITS ' ' " � $- `____�
', EL�CTRIC HOT WATEA HEA7ER ••, ..�.. � NEA7 PUMPS; SlZE , �.,,.. . .
��_IAUNDRY WASHER OU7'LE1' .�UNIT N@AT�RS s `�
,,., URINAL3 ' ' ' '�"�'AlR COOLINO UNITS,51ZE� � s' . -' -
, ,—..�_DRINKIHQ FOUNTAINS • -�COMMERCIAL HOOD ',,. $.
._.,_SUMPS,SPRINKL�R VACUUM BAEAKER5 ��,OTHER � � W
,_�..._..QRAINS �• . ._. . .... _.. . . . . .. _ , _ ..—
._..�OTHEp ' ' - � -•r---�
� `._.' TOTAL�IXTUR�S . _ - . ., .... . , . _ -- • . ._ _ S;
. - s• � �-
' • ' '� '� 'TOTAL MECHANICAL FEE S
I CERTIFY UNDER PENALTY OF P�RJURY 7NAT THE INFORMATlON FURNISNED BY ME IS 7RUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND FURTHERYHA71 AM AUTHORIZED BY TH�OWNEROF YHE ABOYE PREMISE5T0 PERFORM THE WORK�OR WHICN PERMITAPPLICATION IS
MADE.I FURTN�RAGREE TO SAVE HARMLESS Tli�CITY OF��b�RAI WAY ASTOANY CLAIM(INCLUAINO COSTS,EXPEN$E5,AND A'�i'ORNEYS'
FEES INCURREd!N INVESTiGATIQN AMD DEFENSE bF SU�N CLAIM),WHICH MAY BE MADE BY ANY PERSON, INCLUDINa TNE UNDERSIGNED,
AND FfIED AQAlNST 1'HE CITY OF FEDERAI WAY,etlT ONIY WHERE SIJCH CLAIM AHISES OUT OF THE RELIANCE OF THE CIlY,INCLUDINQ ITS
OFFICERS ANO EMPLpYEES, UPON TFl�ACCURACY OF TF{� INFORM�ATION SUPPLIED TO THE CITY AS A PART OF THIS APPI.iCATION..
J 1 '
oWNER/A6 ` '�� � ='�; DATE: ,r ` ` " `'��-
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