07-101793 City or Federal Way Electrical Permit #: 07-101793-00-Eir_' '
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
4
Project Name: ST FRANCIS HOSPITAL ENTRY VESTIBULE
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Add (2) recessed lights in vestibule off of cafeteria
Owner Applicant Contractor 1
FRANCISCAN HEALTH SYSTEM EXCEL ELECTRIC OF TACOMA EXCEL ELECTRIC OF TACOMA
1717 S J ST 5832 S ADAMS SUITE A EXCELET077PH 10/8/07
TACOMA WA 98405-4933 TACOMA WA 98409 5832 S ADAMS SUITE A
TACOMA WA 98409 JI
Additional Permit Information
Electrical Fixtures
Circuits- Commercial 5
PERMIT EXPIRES Monday, October 1, 2007
Permit Issued on Wednesday, April 4, 2007
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 Washington
e City of Federal Way.
Owner or agent: Date:
FINALED
® THIS CARD IS TO REMAIN ON-SITE
CITY OF �OF Community Development Inspection Record .
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07-101793-00-EL
Owner: FRANCISCAN HEALTH SYSTEM
Address: 34515 9TH AVE S
FEDERAL WAY, WA 98003-6761
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close 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.
❑ Slab/Concrete Floor(4255) ❑ Ditch cover(4030) ❑ Pool Bonding (4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power (4275) ❑ Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical (4225) ❑ Ceiling Cover(4020) -❑ Final- Electrical(4055)
Approved Approved Approved
By C::__ 1i4,e_ Date `T t ; , -z" 1 By -' Date vi _tj,p ti , By.fes Date ._[(, -07 ,
❑ Under-slab groundwork(4295)
Approved
By Date
Fede Way REc�IVD O l 4 d q'-j
PERMIT '
COMMUNITY DEVELOPMENT SERVICES _ SF MF CO ME PL DE EN FP
• 333TFEDERVENUE SOUTH•PO BOX 9778 APR p A RI-11C ATI 0 N . 1
:
58N,ALWAY,OU 9•POBOX TD
.253-835-7607•FAX 253-835.7609
-+ www.dlwtlfederohon4.com C OF ccnERALWA
� „K��;;DEPT:
The following is required 8tliiHTltt n-an incomplete application will not be accepted. Please print legibly(in ink)or type.
22))'�`7• S PROPERTY INFORMATION
t>
SITE ADDRESS 5l 5 !V i Kr 4 e .c SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ LOT:SIZE(so
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Anad,separate page for lengthy legal dcsotptiun)
U PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING _0 PLUMBING ❑ MECHANICAL
0 DEMOLITION IYELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed descrpiption of work included on this er�mit /onl )
'/ �(� f�L%2G5G C( 115ivic l N C� SV 4 , A, ie. C7t T c0.•! er4 e 4 tro,
r6..._/c1_) `i
PROJECT NAME(Name of Business or Owner Last Name) .
I U PEOPLE INFORMATION
PROPERTY NAME c - PRIMARY PHONE
OWNER > 1 f7 C i IL v ( ) -
MAILING ADDRESS - CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
EY-Ce( 6Iec - c c4 '� elcorrtet (9c3 ) 475 -a/5Z)
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
51 g- SO A c:1C40t'S 514 IT- ( '12kcovna Lai A Otis 41oq (ate ) 35o - 'lo 1 1
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATI N DATE FAX NUMBER
`13- IcajflO D-1) (a0)147s -cos?
COPY of card requited ,.��!� CONTRACTOR'S REGISTRATION NUMBER - EXPIRA ON DATE E-MAIL ADDRESS
with Leah application `,/
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
( ) -
MAILING ADDRESS - CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant 0 Agent ❑ Other ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ( )
LENDER NAME 4 Per RCW 19.27.095:
Lender Information is required if project value exceeds$5,000
MAILING ADDRESS - CITY,STATE,ZIP - PHONE
( )
U DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ _ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA O PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC)
r PR'J • e • •I i
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
i_
SECOND
THIRD
•
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR ❑UNCOVERED?)
GARAGE El CARPORT ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL rory sosrnro SF TOTAL PROPOSED Sr rar fL Sr
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
■ FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS - FIREPLACE INSERTS HOODS(commercial)
COMPRESSORS FURNACES RANGES
DUCTS; GAS LOG SETS REFRIG.SYSTEMS
PLUMBING ,
BATHTUBS tar rub/shower combo) LAVS(sarhreom skik5l URINALS MISC(Describe)
DISHWASHERS - RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS rose)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
•
SIGNATURE
I certify under.penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorized by the owner of the above premises to perform 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, 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 of Federal Way,but only where such claim
arises out of the reliance o the cit , uding its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE
DATE
(Title)
RELATIONSHIP TO PROJECT ❑ Owner O Agent ❑ Contractor O Architect LI Other
❑NEW o ADDITION ❑ALTERATION D REPAIR o TENANT IMPROVEMENT. •
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? u YES o NO
ZONING DESIGNATION CHANGE OF USE? D YES o NO
NEW ADDRESS REQUIRED? D YES ❑NO UP/SEPA/SU? o YES ❑ NO
PLATTED LOT? D YES o NO DEMO PERMIT REQUIRED? o YES ❑NO
•
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Bulletin 8100—January I,2007 Page 2 of k\Handouts\Permit Application
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:` ELECTRICAL PERK, .• FORMATION
•
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 ft2-$111.00;Each add'n 500 ft2-$35.50) ❑ 0 to 100 amp $120.50 $74.00
❑ Detached outbuilding or garage ❑ 101-200 amp 149.50 94.50
(Inspected with service) $47.00 ❑ 201-400 amp 280.00 111.00
❑ Detached outbuilding or garage ❑ 401-600 amp 327.00 131.00
(Inspected separately) $74.00 ❑ 601 -800 amp 423.00 179.00
❑ 801 - 1000 amp 516.50 216.00
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 563.00 300.00
Service Feeder
❑ Up to 200 amp $120.50 $35.50 ❑ Over 600 volts surcharge $94.50
❑ 201 -400 amp 149.50 74.00 ❑ Mast or meter repair $102.00
❑ 401 - 600 amp 205.00 102.00
❑ 601 -800 amp 262.00 140.50 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 375.50 280.50 Service or Feeders
❑ 0 to 200 amp $120.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 - 600 amp 280.50
❑ 601 - 1000 amp 423.00
Service or Feeder ❑ over 1000 amp 471.00
❑ 0 to 200 amp $92.50 •
❑ 201 - 600 amp 149.50 ❑ it of circuits to be added/altered
❑ over 600 amp .225.50 •(1-5 circuits-$94.50;Add'n circuits,$7.00/ea)
❑ # of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$74.00;Add'n circuits$7.00/ea) $94.50 plus 35%of Permit Fee
❑ Service - 1;000 amps or greater
❑ Mast or meter repair $55.00 ❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $74.00
❑ Service and feeder $120.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $65.00
❑ #of service or feeders
(First service/feeder-$74.00;each add'n-$48.00) Commercial/Industrial Service or Feeder.Ampacity
❑ 0- 100 amps $74.00
❑ 101 -200 amps 94.50
❑ 201 -400 amps 111.00
❑ 401 -600 amps 149.50
❑ over 600 amps ' 162.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats ❑ #of Signs
(First-$55.00;add'n-$17.00/ea) (First sign-$55.00; add'n sign$26.00/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $111.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $74.00 •
❑ Security Alarm System ❑ Additional Plan Review $111.00/hour
•
❑ Voice Cabling (for modified submittals) •
❑ Data Cabling ❑ Automation Fee on all Permits .. $5.00
I•'2500 ft2-$65.00;
Each add'n 2500 ft2i 17.00) 'Per WAC 296-46-930(5 Ni 8
Bulletin#100-January),2007 . Page 3 of4 k\Handouts\Permil Application