21-100858City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: CENTER FOR WEIGHT MANAGEMENT
1'roject Address: 34503 9'V1 1 AVE S
Mechanical
Permit #:21-100858-00-ME
Inspection Request Line: (253) 835-3050
Parcel Number, 750451 ODf ; 1
Project Description: Uninstall then reinstall ductwork and diffusers for tenant improvements.
Owner
Applicant
Contractor
CLISE PROPERTIES
BRETT ROEBUCKAIR SYSTEMS
AIR SYSTEMS ENGINEERING INC
1700 7TH AVE SUITE 1800
ENGINEERING INC
(GENERAL)
SEATTLE WA 98101
3602 S PINE ST
AIRSYE*229KN (2/1/22)
TACOMA WA 98409
3602 S PINE ST
TACOMA WA 98409
Additional Permit Information
Mechanical Work Valuation?... ....... __ .................. 8000 Is this an Online or O.T.C. application?.................. Yes
Ducting
Mechanical Fixtures
PERMIT EXPIRES Tuesday, 31 August, 2021
Permit Issued on Thursday, March 4, 2021
I hereby certify that the above information 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
Washinci on and the City of Federal Way.
Owner or agent: Date:
_�k
rirr ar-
Federal Way
PERMIT #: 21 100858 00
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 34503 9TH AVE S Unit 230
Project: CLISE PROPERTIES FEDERAL WAY WA 98003
..Scheduled inspections. may. be.failed if this card is not.on-site- DO NOT LOS E TI 11 S C_:1RD. Inspections are listed as Llose to sequential order as possible
(read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if
you are unsure about any of the inspections or the inspection sequence. On -going inspections are logged on the back of this card.
0 Mechanical Rough -in (4165)
0 Gas Piping (4125)
0 Final - Mechanical (4065)
Approved
Approved to release test
Approved
By Date
By
�.26 2
Date
By ( Date
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
4%�_
CITY OF
Federal Way
PERMIT NUMBER A I _
RECEIVED PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
MAR 0 2 2021 253-835-2607 + FAX 253-835-2609 + permitcenterCcityoffederalway.com
�MM a[Ty owar
? !T-jT �2_S' TARGET DATE
SITE ADDRESS 34503 9th Ave South SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL # 750451-0050
@ p
000.00
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MFCHANFCAI ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
St Francis Medical Pavilion: Center for Weight Management TI
PROJECT DESCRIPTION
Detailed description of work to
Unistall/ Reinstall Duct and Diffusers
be included on this permit only
NAME PRIMARY PHONE
St Francis Medical Pavilion LLC 253-835-8100
PROPERTY OWNER
MAILING ADDRESS
34503 9th Ave South
E-MAIL
Info@Saint.Francis.org
CITY STATE ZIP
Federal Wa 7 WA 98003
NAME
Air Systems Engineering Inc.
PHONE
253-572-9484
MAILING ADDRESS
3602 So Pine St
E-MAIL
brettr@asei.ws
CONTRACTOR
CITY
Tacoma
STATE
WA
ZIP
98409
FAX
253-383-6337
WA STATE CONTRACTOR'S LICENSE #
AIRSYE"229KN
EXPIRATION DATE
2/ 1 / 21
UBI # 600 099 211
NAME �
Air Systems Engineering Inc.
PRIMARY PHONE
253-572-9484
-- --
APPLICANT
MAILING ADDRESS 3602 So Pine St
E-MAIL
CITY Tacoma
STATE ZIP 98409
WA
FAX
PROJECT CONTACT
NAME Brett Roebuck
l
PRIMARY PHONE
MAILING ADDRESS See Contractor
E-MAIL brettr@asei.ws
(The individual to receive and
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
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,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
SIGNATURE: _ �3r`" �`""� DATE March 2, 2021
PRINT NAME: Brett Roebuck (for ASEI)
—
Bulletin #100 —February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application
MECHANICAL PERMIT
VALUE OF MECHANICAL WORK
Indicate how marky of eaclt (lipe of
txture to be installed or relocated as
part of this project. Do not include existill rxtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
x OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS )commercial)
DUCE &
BOILERS
FURNACES
HOT WATER TANKS IG—)
Diffusers
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
VALUE OF
1T
Indicate how mazky of each Wpe o installedi or relocated2 rs ro' cL Do not include exist&l rxtures to remain,
BATHTUBS )orTub/ShowerCombo) LAVS jlla TOILETS WATER PIPING
DISHWASHERS INWATER SYSTEMS INALS OTHER (Describe)
DRAINS SHOWERS VACUUM
NK1NG FOUNTAINS SINKS )Kitchen/utility) WATER HEATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL F
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
... ......... ....... .«...... .......... ..... ...... .....;;,.....,w _ »,.._......._,.......
BASEMENT
FIRST FLOOR (or Mobile Home)
SECONDFLOOR
-• ...... ..- _._.....__ .. ....,..,.......„. ....-...__....._.� ..
_ ...................... .......»......
COVERED ENTRY
DECK
..
GARAGE El CARPORT El
�.......�.». .................. _.. ». ....., � .. „ ww.. «..,..,.
OTHER (describe)
Area Totals
EXISTING
PROPOSED
TOTAL
-NEW HOMES ONLY**ESTIMATED
SELLING PRICE
# OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
Square FeetType
Occupancy Groups)
Construction
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
S uare FeetType
Occupancy Group(s)
Construction
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 - Febmary 19, 2020 Page 2 of 2 kAHandouts\Permit Application