11-103538 City of Federal Way • • Llect' ical
Community Development Services Permit #: 11-103538-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609F I LE Ins ection Re uest Line: (253)835-3050
Project Name: MEDICAL IMAGING ON FIRST
Project Address: 33915 1ST WAY S Suite 130 Parcel Number: 926504 0150
Project Description: Adding/altering 0-200 amp service for X-ray machine in
Owner
and remodel
Owner Aonlicant Contractor
ESM BUILDING LLC ELECTRIC SYSTEMS LLC ELECTRIC SYSTEMS LLC
320 106th Avenue NE Unit 100 PO BOX 1982 ELECTSL979KE(5/5/13)
Bellevue,WA 98004-5791 SUMNER WA 98390 PO BOX 1982
SUMNER WA 98390
Addi nfor l.ation
Is Use Educational or Institutional No Service greater than 999 Amps? No
Alt. Srvc/Feeder 0 to 200 amps(C 1 Circuits-Commercial 5
PERMIT EXPIRES Wednesday, August 29, 2012
Permit Issued on Tuesday, August 30, 2011
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
, and .ty of Federal Way.
Owner or agent: Date: 040/)
Pit
,W to <
..-4w1 ,,, THIS CARD IS TO MAIN ON-SITE
CITY OF 0Construction In ection Record
Federal Way INSPECTION REQU TS: (253) 835-3050
PERMIT#: 11-103538-00-EL Address: 33915 1ST WAY S Suite 130
Project: ESM BUILDING LLC FEDERAL WAY, WA 98003
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 hack of this card.
0 UFER Ground (4295) Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approvcc!to place concrete
By Date B Date 0-3y // .By Date
El Pool Bonding(4195) El Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) ElRough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date Bc'CS Date 9 _el _l/ By ,I Date et^`a` --1 t .
El Final Electrical(4055) '
Approved
B.<7....... Date,D— 7_((
•
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
1IlO3
CITY OF „ ✓
Federal Way ELECTRICAL RECEIVED
PERMIT APPLICATION AUG 3 0 70,1
**Most electrical permits may be obtained on-line at wwrttoaR „ WAY
rr.,., V .l�i., le ."$', .•• \
SITE ADDRESS: 3391c .11.,,a .•.,�..\u .ru .,,r, r d '✓.'... ,,.. `\� ,: .Y,r.t.. , �,�:'
C �� I,. ! S'1) TE 130 -Feb5 3
SUITE/UNIT/SPACE# AS SOR'S TAX/PARCEL CURRENT OPOSED USE
CO� 04 - d leo
PROJECT NAME
(Tenant or Homeowner Last Name) Mab t CAL t %/V:k(s't 14 LI
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
) -
NAME PRIMARY PHONE
G/5-pattevs LLC (Z5 ) -4 000
MAILING ADDRESS E-MAIL
ELECTRICAL `�J,G l92c-tc T'
CONTRACTOR CITY STATE ZIP �� �e' FAX (44
S U/VW L4JA 9 V350 (t 3)176 -4 ao
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
Ld1 7i 1C+E. .5"--/ S '13 20-407- t02,443O-BL
NAME PRIMARY PHONE
APPLICANT ' ADDRESS
(.. C`fSTEA LLC _ ( ) -
MAILING E-MAIL
CITY STATE ZIP FAX
( ) -
N (26_ / PRIMARY PHONE
PROJECT CONTACT `T'EV 2ND(� 3)400 _4/ova
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: (44.A DATE 6��jiJ/
PRINT NAME: th AJ
33325 8th Avenue South•Federal Way♦WA♦98003-6325♦253-835-2607♦fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160—January 1,2011 Page 1 of 2 k:AHandouts\Electrical Permit Application
I
:
RESIDENTIAL COMMERCIAL
IIINEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet
lsi Service/Feeder Additional Feeders
(including attached garage):
0- 100 amp x$132.50 x$ 80.50
FEES: First 1300 ft2-$122.00; 101- 200 amp x$164.00 x$103.50
Each additional 500 ft2-$39.00
201- 400 arm) x$307.00 x$121.00
NEW MULTIFAMILY (3 units or more)
401- 600 amp x$358.00 x$143.50
lq,Service/Feeder Additional Feeders6 01- 800 amp x$463.00 x$196.00
0- 200 amp _x $132.50 x $ 39.00
801- 1000 amp x$565.00 x$236.50
201 -400 amp x $164.00 x $ 80.50
Over 1000 amp x$616.00 x$328.50
401 -600 amp x $224.00 x $111.50
601 -800 amp x $287.00 x $153.50
Over 600 volts surcharge x$103.50
Over 800 amp x $410.50 x $307.00
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
lstService/Feeder Additional Feeders
ls,Service/Feeder t $132 50 x$103 50
0- 200 amp x . .
0- 200 amp x $101.00
201 -600 arnp x $164.00 201- 600amp x$307.00 x$121.00
Over 600 amp x $246,50 601- 1000 amp x$463.00 x$196.00
Over 1000 amp x$515.50 x$328.50
Added or Altered Circuits
1-4 circuits$80.50;each additional$8.00 Added or Altered Circuits
1-5 circuits$103.50; each additional$8.00
Mast or meter repair $60.50
Mast or meter repair $111.50
MANUFACTURED HOMES PLAN REVIEW FEES
Service or feeder only x $ 80.50 Plan Review required only for:
Service and feeder x $132.50 • New,or alteration to, service of 1,000 amps or greater
• Medical/Educational/Institutional Facility
$103.50 plus 35%of Permit Fee
(Permit Fee x 35% = +$103.50=Plan Review Fee)
Plan review for modified submittals $105.50/hour
MISCELLANEOUS SERVICE/EQUIPMENT
LOW VOLTAGE TEMPORARY SERVICE
0 Fire Alarm System
ls,Service/Feeder Additional Feeders
0 Security Alarm System
CI Voice/Data Cabling 0- 60 amp x $ 71.00 x $ 32.00
0 Other 61- 100 amp x $ 80.50 x $ 39.00
Area to be served by system:
.101-200 amp x $103.50 x $ 51.00
I.,2,500 ft2-$71.00;each additional 2,500 ft2-$18.50
201-400 amp x $121.00 x $ 60.50
#of Thermostats 401-600 amp x $164.00 _x $ 80.50
First$60.50; each additional$18.50
Over 600 amp x $184.50 x $ 92.00
FEE CALCULATIONS
Yard Pole/meter loops/pedestal x$ 80.50
• Fees are determined by the scope of work as indicated.
Portable Generator(transfer equipment) x$101.00 • A$6.00 Automation Fee will be added to all permits.
Ditch cover/inspection only x$121.00 • For assistance in calculating fees or completing the
application form,contact the Permit Center at
253-835-2607
33325 8th Avenue South•Federal Way•WA•98003-6325•253-835-2607•fax:253-835-2609•www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 2 of 2 k:\Handouts\Electrical Permit Application