15-101873 r
• S Electrical
CityCommunity
of FedeEcon.alD Way Permit #: 15-101873-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,Fax
98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 FII_Ep q
Project Name: ST FRANCIS HOSPITAL
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Install new transformer and panel to serve(4)charging stations.
Owner Applicant Contractor
JOHN ELSWICK CHRIS BARKER THOMPSON ELECTRICAL
FRANCISCAN HEALTH SYSTEM-W COFFMAN ENGINEERS CONSTRUCTORS INC
1717 S"J"ST 1601 FIFTH AVE SUITE 900 THOMPECOO8CW(2/16/16)
TACOMA WA 98405 SEATTLE WA 98101-1620 PO BOX 45260
TACOMA WA 98445
Additional Permit Information
Is this an Online or O.T.C.application? No Is Use Educational or Institutional? Yes
Service greater than 999 Amps? Yes
Electrical Fixtures
Alt.Srvc/Feeder 0 to 200 amps(C 1
PERMIT EXPIRES Saturday, October 31, 2015
Permit Issued on Monday, May 4, 2015
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 Fed ral Way.
154Owner or agent: Date: /Y/S—
SO
•
' THIS CARD IS TO IN ON-SITE
CITY OF
1101.1 0 Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 15-101873-00-EL Address: 34515 9TH AVE S
Project: JOHN ELSWICK FEDERAL WAY, WA 98003-6761
S.heduled 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.
O UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By KA5 Date S(.r( (s- By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
#0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ,0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
O Final-Electrical(4055)
Approved
By yt /J Date is 11 t. 11 c
j Rough Electrical CI Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
Aalma) E1CTRICAL
CITY OF
Federal Way APR 16 2015 PERMIT APPLICATION
CITY OFFEDERAL WAY / +
PERMIT NUMBER /� i O /CT 7 3 _ Y.
SUITE/UNIT/SPACE#
SITE ADDRESS: 34515 8th Ave South - Federal Way, WA 98003
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$12,000 750451 - 0020 _ Hospital
PROJECT NAME St. Francis Hospital
(Tenant or Homeowner Last Name)
Install new transformer and panel to serve 4 charging stations
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER St. Francis Hospital ( 253) 944 - 8100
MAILING ADDRESS E-MAIL
34515 8th Ave South
CITY STATE ZIP FAX
Federal Way WA 98003 ( ) -
NAME PRIMARY PHONE
Thompson Electrical Constructors Inc. ( 253) 539 _ 0999
MAILING ADDRESS E-MAIL
ELECTRICAL 150 100th St. South
CONTRACTOR CITY STATE ZIP FAX
Tacoma WA 98444 ( 253) 539 - 0101
WA STATE CONTRACTOR'S LICENSE S EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE it
/ /
NAME PRIMARY PHONE
Coffman Engineers (206) 623 - 0 717
APPLICANT MAILING ADDRESS E-MAIL
1601 fifth Ave. Suite 900 barker@coffman.com
CITY STATE ZIP FAX
Seattle WA 98101 ( 206) 624 _ 3775
NAME PRIMARY PHONE
PROJECT CONTACT Chris Barker
( 206) 623 - 0717
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 lai ari es out o the reliance of the city, including its officers and employees, upon the accuracy of the
information supplild Fh cit as this application.
SIGNATURE: I
I t0 "V DATE 4/2-1s-
PRINT NAME: �� \ Ll G.(2'
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application