07-106743 r
City of Federal Way ` r
Community Development Services Electrical Permit #: 07-106743-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax'(253)835-2609
Inspection Request Line: (253)835-3050
Project Name: CHILDREN'S HOSPITAL-X-RAY
Project Address: 34503 9TH AVE S Suite 300
Project Description: Altering 3 existing feeder panels,including circuit wor:, ,rk , Parp tuber: 0050
floor. per ion thhird ind
Owner Applicant
MEDICAL REAL ESTATE SERVICES,LLC ASTOR ELECTRIC tractor
AS 105 CENTRAL WAY SUITE 203 2739 15 ..II AVE NE ORE IBU /31
KIRKLAND WA 98033 REDMO A 98052 TOR; 1BU 1/31/09
2 9 152ND AVE NE
I DMOND WA 98052
A rmit I m i 11
Service greater than 1000 Amps9 No i
//�� , '
Ele al FixtAr /
Alt. Serv./Feeder up to 2 3
r
MIT EXPIRES Monday, December 8, 2008
ermit Issued on Friday, December 14, 2007
y certify that th o . ormation is correct .•d that the construction on the above described property and
e cupancy and th- •se will be in accordance with 'e laws, rules and regulations of the State of Washington
- and the City • Federal Way.
ner or age. : —'
�� Date: I2. ��/C.R
THIS CARD IS TO REMAIN ON-SITE
cm(OF �� Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-106743-00-E L
Owner: MEDICAL REAL ESTATE SERVICES, LLC
Address: 34503 9TH AVE S Suite 300
FEDERAL WAY, WA 98003
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) 1 10 Pool Bonding(4195)
Approved to place concrete Approved
Approved
By Date By Date
BY Date
- ❑ Temporary Power(4275) ❑ Service(4235) IrBy Feeders/Sub-panels(4045)
Approved
Date Approved
By Date Approved
BY Date
❑ Rough Electrical (4225) ❑ Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved
Approved
BY �„A,` Date 1-Y _ g By�Cs Date /-3/--D e By Icja/ Date •I Z'C-
❑ UFER Ground (4295)
Approved
By Date
I
i
j
For inspector reference only_
0 Rough Electrical
0 FINAL-Electrical
Approved
(� Approved
By Date By ��,"�) Date ?i /2-- 0<=)
•
RECEIVED Submit by Email i -Print form
.. 'JEC 1 4 2007 d L ( a
CRY OF _
Feder* layh_� PERMIT SF MF CO M EL PL DE EN FP
33325 8,"AVENUE Sourx• •• °E r ��
FEDERAL WAY.WA 98663-9718 APPLICATION m
253-B35-2607•FAX 253-8352609
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 34503 9th Ave"S SUITE/UNIT#300
ASSESSORS TAX/PARCEL• F750451 1- as r OS 0 WT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION 13 ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlul
Install new X-Ray equipment for existing clinic. New feeder and panels.
l—4A-40.P.'" I00' PlfioV F,p Ver L yw Pte.(
(- - * ø '^' con, A 147A4.0 Pueder-- oft., µ-....)
I- 1.60-"e fin& S#,oV Fermis.-- 44,- /xw Z'24.1 Nta•c1"(2"1'
PROJECT NAME(Name of Business or Owner Last Name) Children's Hospital Clinic
• PEOPLE INFORMATION
PROPERTY NAME 5nn p PRIMARY PHONE
OWNER d [ a (C--- SV/C 3 l' If�l ,Y],� ( )
MAILIN( 01- 1 / ` ry ;T� LL 1 fUa) E-MAIL ADDRESS
CONTRACTOR COMPANY NAME Astor 'V�y/q`- APPLICANT NAME OFFICE PHONE I
Astor Electric Derek Little (93-S1 2 $ - 2-err i
MAILING ADDRESS2739 152nd Ave NE cm, STATE,ZIPRedmond, WA 980 (ELL PH ONE 4258645a
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
20-07-106216-00-BL 12-31-2008 ( ) -425256
IM
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
astorel931bu 1-31-09 derekl@astort
MI
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Astor Electric Derek Little ( ) 4252562 '
MAILING ADDRESS2739 152nd Ave NE CITY,STATE.ZPRedmond, WA 98% `ELL PHONE 4258645 1
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑Tenant ❑Agent ❑ othercontractor ( ) _4252562i
PROJECT NAMEDerek Little PRIMARY PHONE 425 256-2988 E-MAIL
L ADDRESSderekl @astcilLe4 't..
CONTACT ( ) - II
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY.STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE medical clinic PROPOSED USE same
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
ERIST04O PROPOSED TOTAL TOTAL=WING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offlxture 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 OUILE iS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(COmmercus
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SE lb REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom sans) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CL OSh1b ruse)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 tto be made by any person, including the undersigned, and filed against the city, but only
where such claim a e rel •. - of the city, lading its officers and employees, upon the accuracy of the information supplied to
the city as a part of t ./
SIGNATURE: Al � DATE I I/ (((4//7
' perry Owner and/or Authorized Agent
FOR OFFICE USE ONLY
❑NEW ❑ADDITION o ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES 0 N BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—August 16,2007 Page 2 of 4 k\Handouts\Permit Application
It
■
•
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet ❑ 0 to 100 amp $120.50 $74.00
(First 1300 ft2-$111.00;Each add'n 500 ftz-$35.501
❑ 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 ALTERED COMMERCIAL/INDUSTRIAL
❑ 601 -800 amp 262.00 140.50 y
❑ Over 800 amp 375.50 280.50 �, '\�1 Service or Feeders
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
❑ 0to200amp $92.50 �q
❑ 201 -600 amp 149.50 CA 6 #of circuits to be added/altered
❑ over 600 amp 225.50 (1-5 circuits-$94.50;Add'n circuits.$7.00/ea)
❑ 4 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
LI 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
o 1=t 2500 ft2-$65.00;
Each add'n 2500 ft2-17.00)•Per WAC 296-46-910(5)(b51&S
Bulletin#100-August 16,2007 Page 3 of 4 k11-landouts\Permit Application