10-102083 City of Federal Way Electrical
Community Development Services Permi• • t #: 10-102083-00-EL
P.O.Box 9718 F/ LE
Federal Way,WA 98063-9718
Inspection Request Line: (253)
Ph:(253)835-2607 Fax(253)835-2609 p q 835-3050
Project Name: ST FRANCIS HOSPITAL-NURSERY
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Installing L/V voice/data cabling for new nursery.
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM TRITON COMMUNICATIONS LLC TRITON COMMUNICATIONS LLC
34515 9TH AVE S PO BOX 11194 TRITOCL965K4 (7/1/10)
FEDERAL WAY WA 98003 TACOMA WA 98411 PO BOX 11194
TACOMA WA 98411
•
s
•
Is Use Educational or Institutional? No Service greater than 1000 Amps? No
' ._. a F,. V
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Low Voltage-Other(Commercial 1
P MIT EXPIRES Thursday, May 19, 2011
ermit Issued on Wednesday, May 19, 2010
I hereby certify that the above ' f 'ation is correct and that the construction on the above described property and
the occupancy and theu.e III •e in• a ,*rdance with the laws, rules and regulations of the State of Washington
d the City of Federal Way.
Owner or agent: , / / Date: 6—e.17 "/C)
FINALED 6"/ /1(7 1°
• THIS CARD IS TO AIN ON-SITE
OF Construction Ins ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 10-102083-00-EL Address: 34515 9TH AVE S
Owner: 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.
0 Rough Electrical(4225) 0 Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved Approved
By Date By\ Date , S.
t ,6 By Date a-2•/d
0 Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
411
41111,' 4. ,
° i 0 D 3 3
C F
iTY o
Fe El) ELECTRICAL
MAS 1, 9 ,):.:'``PERMIT APPLICATION
tql-W A�o ctrical permits may be obtained on-line at www.cityoffederalway.com**
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SITE ADDRESS: 3 q 57 Q
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# 5 _ O � � � CURRENT/PROPOSED USE
PROJECT NAME
wne
/-/>(Tenant or Homeowner Last Name) Ar / din® Q l'n
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PROJECT DESCRIPTION
Detailed description of work to �1cA/'S
Ase7 .
be included on this permit only
NAME PRIMARY PHONE~
PROPERTY OWNER T,pi,�G 1SCa41l i/ A /r 5 Sq(-t - ( ) -
MAILING ADDRESS / E-MAIL
31-(5`(s-- 9ru--- , t-t-e- r.
CITY 4 STATE ZIP FAX
.WAY riA1,MOC2 3 ( ) -
NAME /� PRIMARYIPHONE
7? 1 �A/ (-.c I44(1.cN J'C41IDi/-r kL..e.. (gm )[>dc3 -c
kAILI
G ADDRESS MAE- IL
ELECTRICAL N0• p 1( I 4g'1"*.►7tiNIAu
CONTRACTOR CITY STATE ZIP FAX
.1.--;V-69"MA WA 7'`1VI ( ) -
WA STATE CONTRACTOR'S LICENSE S EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE k
'''7"ocL9(5.A 4 o yi 30 // 2o-40—0/6/8"-110-84
NAME / PRIMARY PHONE
APPLICANT ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 2 f - J_N . a' )42A -P-),79
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 ho •I harmless the City of Federal Way as to any claim(including costs, expenses,and attorneys'fees incurred in
the investigation and •: ense of such claim), which may be made by any person,including the undersigned, and filed against the city,
but only where suc aim • -es out of the reliance of the city, including its officers and employees, upon the accuracy of the
information suppli-, • t ci a part of this application.
/
SIGNATURE: DATE 'r6
PRINT N ,,I' :ADS (AA/gr
/
33325 8t Avenue South•PO Box9718•Federal Way•WA•98063-9718♦253-835-2607•fax:253-835-2609•www.cityoffederalway.com
Bulletin#160—April 9,2010 Page 1 of 2 k:\Handouts\Electrical Permit Application
RESIDENTI" CAMERCIAL
NEW SINGLE FAMILY RESIDENCE • NEW COMMERCIAL
Total Square Feet 1st 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 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
1srService/Feeder 1st Service/Feeder Additional Feeders
0- 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
❑ oSecurity Alarm System
1
Voice/Data Cabling 0- 60 amp x $ 71.00 x $ 32.00
❑ Other S' ) 61- 100 amp x $ 80.50 x $ 39.00
Area to be served by system: g VVVV
st 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50
101-200 amp x $103.50 x $ 51.00
'1
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
#of Signs FEE CALCULATIONS
First$60.50;each additional$28.50 • Fees are determined by the scope of work as indicated.
Yard Pole/meter loops/pedestal x$ 80.50 • A$6.00 Automation Fee will be added to all permits.
• For assistance in calculating fees or completing the
Portable Generator(transfer equipment) x$101.00 application form,contact the Permit Center at
Ditch cover/inspection only x$121.00 253-835=2607
33325 8th Avenue South•PO Box 9718•Federal Way•WA•98063-9718♦253-835-2607•fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160-April 9,2010 Page 2 of 2 k:\Handouts\Electrical Permit Application