07-102630 ,
t .
City of Federal Way . '1Electrical Permit #: 07-102630-00-EL A
Community Development Services �
�
P.O.Box 9718
Federal Way,WA 98063-9718 to
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: ST FRANCIS HOSPITAL ICU/PCU EXPANSION
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Phase 2 consists of the ICU/PCU. **Added 20,000 sq/ft L/V for Data,Nurse Call,Security
and Fire Alarm wiring.** a/Z((4
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM HAMMES COMPANY MADSEN ELECTRIC
FRANCISCAN HEALTH SYSTEM 1325 4TH AVE SUITE 1035 MADSEE*140P8 4/30/08
1717 S J ST SEATTLE WA 98101 3939 S ORCHARD ST
TACOMA WA 98405-4933 I TACOMA WA 98466
Additional Permit Information
Electrical Fixtures
Low Voltage-Other CommerciaL.20,001 Low Voltage Burglar Alarm -Cor 20,001 Low Voltage Fire Alarm-Comma 20,001
Servic Feeckr,,201-400 amps-Cc 3
PERMIT EXPIRES Thursday, July 3, 200$
Permit Issued on Monday, July 9,`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
and the City of Federal Way.
Owner or agent: 5770-Z / Date: Z1 d
OtS. 611
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•. , . ' • THIS CARD IS TO R AIN ON-SITE. . t
. � .: Community Developme t Inspection Record
CITY OF ^'�
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102630-00-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 A roved Approved
By Date By S Date//x/11--r. By Date
❑ Temporary Power(4275) 0 Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
`
0 Rough Electrical(4225) ❑ Ceiling Cover(4020) ❑ Final -Electrical(4055)
Approved Approved .. Approved
l
CL
By �� Date 7..zz- cf By e 5 Date 7"7.< , By ,,,. ,. Date Z /e-,'G-'
UFER Ground (4295)
Approved
By Date
For inspector reference only
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
DATE INSPECTOR AREA AND TYPE OF 1rSPECTION
7./b. ea 40 .ve...es�, 50-4770-V / �''•GG;�
"t -70 0 S govi- ;L4 iC 1-25 iN. - 42.11- A
7.3(.6 P/A. -z. 7332>/frE
S•12 .63 0) 3gA240"- - ��
RECEIVED
Federa way MAY 1 20 7 PERMIT �--7 - ��z
COMMUNITY DEVELOPMENT SERVICES SF MF CO ME Or�L)PL DE EN FP
3332FED AVENUESOUTH98063-OT I8 E Dr�E 'F� pLI CATI ON ���
FEDERAL WAY,WA 98063-� Q !' V ER TD
253-835-2607•FAX 253-835-2609 BUILDING D t / 28 / 07
an:r.ciiI4Orjederr iWatt.COM
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY�Q� INFORMATION
SITE ADDRESS- 6,4 \ eel ae- 'a`•(. SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# 70 t"t s l - D o C) LOT 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 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this 1permit only)
c
-0,0,2_ 1.�- .. . cmc cu.?.z...,.... . yth.� a�eq,-ait�C_� " \L�o Co .� GY ..„.....\\�4
‘o,,_8„,„...._ c�a�k a,,. ���._ Cgs- 42.0 )ter cre.a_- 1m r b�.' c - •v 1 crrA. t LO
("fit c t c_iA .. eke e1.1:p;P^v-k'
c' 1 I PCO I ,e1\ Vin" ..... ()ca-I:J.-L.
PROJECT NAME(Name of Business or Owner Last Name) 3't" L-\5i \ - ‘.....c.....4..,..... ,• tet:- I-
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER ..+�1�aC 4_.n. ,\A ` \STATE,ZIP ( MAIL' ))1'1 4 4L is
MAILING ADDRESS
V1 \`1 5- ? - L'.0t.,r-.:- i W J! 'INAS--49 3
CONTRACTOR C MPANYNANAME
�-�J APPLICANT NAME OFFICE PHONE
6terfia
-7-E. LING ADDRESS l CITY,STATE,ZIP CELL PHONE
<=� 1Up9r). ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
V ( )
COPY of card inquired CONTRACgp REGISTRATION NUMBE C/ EXPIRATION DATE E-MAIL ADDRESS
with each application r\/1 W I / b 7� L
APPLICANT COMPANY NAME VV PLICANT NAME OFFICE PHONE
� �IC04t$ CoI�'1q '( (no(a) '� - q oo
_ l MAILING A•DDDDRRRRE,��SS1 , ` iso / �+ CIITY,,,STATE,ZIP
, ,6 q 1 CELL�PHONE p Ci [1 ^�
1 Jj,r/V1 /`11,G iv.RELATIONSHIP TO PROJECT l il,.). `- j s eC,J`.` "`. I WAS l,6`:\ (Wb)FAX b e L - -7oi a�
',+/ice+"/ ❑ Architect 0 Tenant 1)l4gent '0 Other reOW4`bq - gatit
PROJECTPRIMARY PHONE E-MAIL ADDRESS
CONTACT c C KA-NW. - (a'3.' ) ii'* -y a-CO ctC:. -\+`otAcunnen 4-%t 0 . _ss".•.
LENDER NAME Per RCW 19.27.095:
)." 44'....3--. Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE 4a.i. PROPOSED USE _ 1%m
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ i11 S 1 a.l)as
SPRINKLERED BUILDING? errES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? '°4ES 0 NO
WATER SERVICE PROVIDER CerAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 1eLAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
■ PROJECT FLOOR AREAS
AREA DESCCT.*►'TION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
**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 INSERT'S HOODS(Commereial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SE lb REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSHIb(Toilet)
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 of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. ' jam
NAME/TITLE etsy -lk
k, DATE u 1°1°1
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner Agent ❑ Contractor 0 Architect iisOther
FOE OFFICE BBB ONLY,;-,
o NEW o ADDITION o ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES ❑NO
ZONING DESIGNATION CHANGE OF USE? o YES ❑NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—April 2,2007 Page 2 of 4 k\Handouts\Permit Application