13-103133 RECEIVED
jUL162013 - 3L �
CITY OF
Federal Way cFrErattkICAL
PERMIT APPLICATION
**Most electrical permits may be obtained on-line at www.citjyoffederalway com**
PI PE TX°INFORMATION .,.
SITE ADDRESS: j n,,34 515 9th Avenue South
�/ - "'" ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
Kitchen$A®0
0 7 5 0 4 5 1 0 0 2 0 Hospital
ry h�� A" �' A a ar �6 r
PROJECT NAME
(Tenant or Homeowner Last Name) St Francis Hospital — Kitchen
Modify existing fire alarm system. Work performed by
PROJECT DESCRIPTION Sequoyah Electric.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Franciscan Health System ( (253)) 874-2227
MAILING ADDRESS E-MAIL
34515 9th Ave S.
CITY STATE ZIP FAX
Federal Way WA 98003 ( ) -
NAME PRIMARY PHONE
Sequoyah Electric ( )425-$14-6000
MAILING ADDRESS E-MAIL
ELECTRICAL 15135 NE 92nd St.
CONTRACTOR CITY STATE ZIP FAX
Redmond WA 98052 ( )425-$14-6005
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
SEQUOEL977S9 1 / 29 / 15
NAME
PRIMARY PHONE
APPLICANT SimplexGrinnell ( )206-291-1400
MAILING ADDRESS E-MAIL
9520 10th Ave S, Suite 100 jastebbins@simplexgrinnell.co
CITY STATE ZIP FAX
Seattle WA 98108 ( ?06-291-1500
NAME PRIMARY PHONE
PROJECT CONTACT Janet Stebbins/SimplexGrinnell ( 206)291- _1468
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 uthe 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: r,„ � l-.460"-A ar,e ,�/_ • AI.. DATE 07/15/2013
1110V
PRINT 1 '. nPi- StPhhins/SimplPxC;rinnpl1
33325 8`"Avenue South•Federal Way 1 WA♦98003-6325♦253-835-2607♦fax:253-835-2609•www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 1 of 2 k:\Handouts\Electrical Permit Application
RESIDENTIAL COMMERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 1st Service/Feeder Additional Feeders
(inducing 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 amp x$307.00 x$121.00
NEW MULTIFAMILY (3 units or more) 401- 600 amp x$358.00 x$143.50
1st Service/Feeder Additional Feeders 601- 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
l Service/Feeder 1st Service/Feeder Additional Feeders
Q- 200 amp x $101.00 0- 200 amp x$132.50 x$103.50
201-600 amp x $164.00 201- 600 amp 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
• Fire Alarm System 1st Service/Feeder Additional Feeders
❑ Security Alarm System
❑ Voice/Data Cabling 0- 60 amp x $ 71.00 x $ 32.00
❑ Other 3 000
61-100 amp x $ 80.50 x $ 39.00
Area to be served by system:
101-200 amp x $103.50 x $ 51.00
let 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 r 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
-Electrical
City of Federal Way {{��
Community&Econ.Dev.Services Permit #: 13-103133-00-EL
33325 8th Ave S
Federal Way,WA 98003 FILE
Inspection Request Line: 253 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: ST FRANCIS HOSPITAL KITCHEN REMODEL
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Low voltage wiring for fire alarm modification.
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM JANET STEBBINS SEQUOYAH ELECTRIC LLC
1717 S J ST SIMPLEX GRINNELL LP SEQUOEL977S9(1/29/15)
TACOMA WA 98405-4933 9520 10TH AVE S SUITE 100 15135 NE 92ND ST
SEATTLE WA 98108 REDMOND WA 98052
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures'.
Low Voltage-Fire Alarm(Comm( 1
PERMIT EXPIRES Sunday, January 12, 2014
Permit Issued on Tuesday, July 16, 2013
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: Date:
.. THIS CARD IS TO IN ON-SITE
"TM OF Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 13-103133-00-EL Address: 34515 9TH AVE S
Project: FRANCISCAN HEALTH SYSTEM FEDERAL WAY, WA 98003-6761
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.
❑ UFER Ground (4295) 0 Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) El Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
By Date < , 2,L 1
El Rough Electrical ❑ Final Electrical ❑ Right of Way
- - • Approved Approved Approved
By Date By Date By Date