07-102205 .- `4 r
r V City of Federal Way Perm #• 07-102205-00- �L
Community Development Services Plumbing
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: ST FRANCIS HOSPITAL LOADING DOCK/ELECTRICAL ROOM
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: STFI-Installation of(1)sump pump. [ ,,_ i a J
Via.�.-.4. 6....„';ti:
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM AUBURN MECHANICAL INC AUBURN MECHANICAL INC
FRANCISCAN HEALTH SYSTEM PO BOX 249 AUBURMI163BA 09/12/08
1717 S J ST AUBURN WA 98071 PO BOX 249
TACOMA WA 98405-4933 AUBURN WA 98071
Plumbing Fixtures
Sumps
CONDITIONS:
SUBJECT TO FIELD INSPECTION
PERMIT EXPIRES 'i lr , , April 009
Per <„ ex onTuesday, p1ril 24, 2007 �u�y r
I hereby certify that the above infor ation i . rect and that the construction on the above described property and
the occupancy and the use wil • in .z• .i.!nce - e laws, rules and regulations of the State of Washington
n• • -.eral Way.
Owner or agent: ''' �� �''' __ Date: y 04/4s 7'
DATE INSPECTOR AREA AND TYPE O'F INSPECTION
5--/C-b2 c.e...) tI PA Lf 4- *i. t iv�ae., s 1� ® }- F 1 ' f'
Jafzet ,r i% 20v.
`7-/2-07 . 4- `AQ /
THIS CARD IS TO MAIN ON-SITE µ
CITY OF ommunityDeveloprrWnt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102205-00-PL
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.
❑ Plumbing Groundwork(4190) ❑ Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover Approved Approved to release test
By Date By Date By Date
❑ Final-Plumbing(4075)
Approved
By - Date 7407
•
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Federal Way PERMIT
COMMUNITYDEVEWPMENTSERVICESPR 2 4 2007 SF MF CO ME EL— DE EN FP
33325 8THAVENUE SOUTH•PO BOX 9718 LI CATI O N
253-8
FEDERAL WA•Y,FAX WA 253-835-98063-9
Gay O F F E D ER 1u �
352607
WW1WW1 v.citinflecteraiway.com BUILDING DEPT.
The ollowin• is •,wired in ormation-an incom,lete a..lication will not be acc•,ted. Please •rint le.ibl- (in ink)or ,•.
• PROPERTY INFORMATION
SITE ADDRESS 31/4-\\5\5 m f\\1 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# .1 S U 4 5'
`I - 0 O Z f 0 LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) [aV 5 'r` sp L+ol
(Attach separate pagefor lengthy legal description)
■ PROJECT INFORMATIONIN�
TYPE OF PERMIT ❑BUILDING [)Y LUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit on1U)
Install \ 5unip ptsm P
PROJECT NAME(Name of Business or Owner Last Name) S( 1�ah Le'S /C gyp/ "tom /too Jr !1f/e___
El PEOPLE INFORMATION
PROPERTY NAMEPRIMARY PHONE
OWNER fir-
2(thS)IStE,rnJ ( )
MAILING ADDRESS CITY, TATE.ZIP
34 S 1 s '1 rr 1\ - S Fchxal Vvat) , WPt 98003
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Fbut,v n m -Vian'lLa I Chy(5 -\V _ J61-h n,Gn ('Ls 3 ) 83 S - .)1 VD
MAILING ADDRESS CITY,STATE,ZIP CELL.PHONE
P-O. i)bx 9,4(P) AU1O o 11 1 A c)18o1 I ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
20 -to -i c "� `�' 3_ '1 -B L 12 / 31 /ti, ( ) -
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
A O Ps u R 0 z 1 ka 3 e Pi / 1Z /6`e
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
AIWOUot1'1 1rn...c�- r-tcz1 Clnri5i'1nZ; .i6(hnson ( 253) ES3Y - cn80
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
P.o. I,o , 2461 PiU.bu.vn WPr `Ncc) t ( ) -
RELATIONSHIP TO PROJECT , //'�1� l FAX NUMBER
0 Architect o Tenant o Agent ®'Other(Describe)Vuh 3 c I a✓ ( ) -
CONTACTN PRIMARY PHONE E-MAIL ADDRESS
hv15\tnt- Jahnso/r) (1.s3) S838 - 4r-)80
LENDER Per RCW 19.27.095: Lender information is NAME
required protect value exceeds$5.000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
LL
• DETAILED BUILDING INFORMATION
EXISTING USE 1\o S P to l PROPOSED USE ItOS;Lt-
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 3J 0 00- act
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES o NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
• S
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
EXISTING PROPOS® TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of furture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo)
SHOWERS WATER CLOSIC15(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLPAS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
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 of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. (�� �} �`� �•�.. �^�
NAME/TITLE C..0 AA�X.tA&£ 29PAJAAJAA_ T 1) (t �flCj III ,YA/DATE �,2.r 01
(Signature) � (TitleRELATIONSHIP TO PROJECT ❑ Or ❑ Agent r�Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑YES o NO
ZONING DESIGNATION CHANGE OF USE? ❑YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100-January 1,2006 Page 2 of 4 k\Handouts\Permit Application
•
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 ft2-$107.50;Each add'n 500 ft2-$34.50) ❑ 0 to 100 amp $117.00 $71.50
❑ Detached outbuilding or garage ❑ 101-200 amp 145.00 91.50
(Inspected with service) $45.50 ❑ 201-400 amp 272.00 107.50
❑ Detached outbuilding or garage ❑ 401-600 amp 317.00 127.00
(Inspected separately) $71.50 ❑ 601-800 amp 410.00 173.50
❑ 801 - 1000 amp 500.50 209.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp $117.00 $34.50 ❑ Over 600 volts surcharge $91.50
❑ 201 -400 amp 145.00 71.50 ❑ Mast or meter repair $99.00
❑ 401 600 amp 198.50 99.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ 601 -800 amp 254.00 136.00
❑ Over 800 amp 364.00 272.00 Service or Feeders
❑ 0 to 200 amp $117.00
ALTERED SINGLE/MULTI FAMILY U 201 -600 amp 272.00
❑ 601 - 1000 amp 410.00
Service or Feeder ❑ over 1000 amp 456.50
❑ Oto 200 amp $89.50
❑ 201 -600 amp 145.00 ❑ #of circuits to be added/altered
❑ over 600 amp 218.50 (1-5 circuits-$91.50;Add'n circuits,$7.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$71.50;Add'n circuits$7.00/ea) $91.50 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $53.50 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $71.50
❑ Service and feeder $117.00
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $63.00
❑ #of service or feeders
(First service/feeder-$71.50;each add'n-$46.50) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $71.50
❑ 101-200 amps 91.50
❑ 201-400 amps 107.50
❑ 401-600 amps 145.00
❑ over 600 amps 157.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signs
(First-$53.50;add'n-$16.50/ea) (First sign-$53.50;add'n sign$25.00/ea)
❑ Low Voltage U Swimming pool/hot tub $107.50
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System U Yard Pole meter loops $71.50
❑ Security Alarm System U Additional Plan Review $107.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
U Automation Fee on all Permits .. $5.00
(Per System(s)lot 2500 ft2-$63.00:
Each add'n 2500 ft2-16.50)•Per WAC 296-46-910(5)@I(i&ii)Bulletin#100-January 1,2006 Page 3 of 4 k\Handouts\Permit Application