10-101762 • • Electrical
City of Federal Way
Community Development Services Permit #: 10-101762-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Inspection Request Line:
Ph:(253)835-2607 Fax (253)835-2609EJLE
p q (253)835-3050
Project Name: ST FRANCIS HOSPITAL 3RD FLOOR SCU MODIFICATIONS
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Electrical work for kitchen & restroom tenant improvements.
Owner Applicant Contractor ,
FRANCISCAN HEALTH SYSTEM STEVE KANE H&M ELECTRIC INC
34515 9TH AVE S KANE MANTHEY ARCHITECTS,INC HMELEI*077KR(5/19/11)
FEDERAL WAY WA 98003 11521 E MARGINAL WAY S SUITE 110 PO BOX 799
TUKWILA WA 98168 MARYSVILLE WA 98270
�• ,,. , .. ,,,
Is Use Educational or Institutional Yes Service greater than 1000 Amps? No
1t4,1/4 y i,$� •@i
Circuits-Commercial 13 Low Volta""1:41:
e-Other(Commercial; 1
PERMIT EXPIRES Wednesday, June 22, 2011
Permit Issued on Tuesday, June 22, 2010
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: arc y � ___ Date: Cr/2 2 I i C�
THIS CARD IS TO REMAIN ON-SITE ,
CITY of ' 4
Construction Initction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 10-101762-00-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 UFER Ground (4295) 0 Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
•
El Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date B3(5 Date L,3—(0 By Date
❑ Final-Electrical(4055)
Approved
By(.,fck Date n, l rc-i Zi ,
•
0 Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
K
IVO
. ReCe 0 • , ,
CITY OF 4W118 ".411111111t. p,i)R 3i) 2010 _/
L 0 - i o / 2 ‘7
Federa fepet`I ECTRICALq//o
PERMIT APPLICATION
**Most electrical permits may be obtained on-line at www.cityoffederalway.com**
,iw;" PROPERTY INFORMATION
SITE ADDRESS: ?y‘5 61-t h me 47, V w , wp, q ;,oc )
SUITE/UNIT/SPACES ASSESSOR'S TAX/PARCEL S CURRENT/PROPOSED USE
1 5 0 4- S I - 0 Ca 2- 0 Ivc c4tA/•;e.,6
', ' PROJECT INFORMATION
PROJECT NAME f 12-A ilG7 1-ko`,1/ T
iAL-3rU.V12 .Ii 1-Acot coe-A IGy
(Tenant or Homeowner Last Name) fSCF't l5
i Ci`ccLems it, 5")k -ter '-i i c401 rY) re trov vv\/4ht ;(4
PROJECT DESCRIPTION 12e piaci_ Osistl'rv) oCta_ i i/ 4i1-ckev\j c),1e e ' f t- Svi l ei
Detailed description of work to i
be included on this permit only Writ O v(/`. Al..-re R.L K3c% CAP-r-A u'rS IN L1' '1 t,4?' t.e-, r 'i-
i R (2Rgeff(24712M Iti K tTet . ovaLerTS ,4 40 -la1+yt Net.
t PEOPLE
NAME PRIMARY PHONE
PROPERTY OWNER Y-ANICA"-C 3 1401--f N `3't'�7Tc-i j Ceic .c1/20\0 ( 263) `-Z.'-6,e) .
MAILING ADDRESS
011 SotAfh .J, Street rit; o[S01-)C?C Ith.Gt19
CITY STATE ZIP FAX
11`tVii Wu1 W P 961-05 (2�i3) 4249 -w421
NAME PRIMARY PHONE
VI k,t-A r✓ t>2-te- , I 1.1C. Cv1043ne 5re i` )) (. 6;t14-58 - 1
MAILING ADDRESS E-MAIL
ELECTRICAL e1 ib Cet ase, ogNsie.b 0,ktv\lec.,c)o1
CONTRACTOR CrrY STATE ZIP FAX
)40kir 5v►11c., WA `iF 3'7o ( 3�b)W' - 050Z-
WA
�5c�L
WA STA CONTRACTOR'S LICENSE S EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
1fiFA t,ek 01/Y-12.-- i Ic1 / I ) 1t'
INAME PRIMARY PHONE
APPLICANT Src\lG Y to446,M<tlp'IE{ tom' -H)T CT (2t' ) 60 -78c9i"
MAHANG ADDRESS E-MAIL
115 2-1 6,MavM rrl t S. 54.1 te, 110 ;41t., tcMarrlitt�o(cii.1
CITY STATE ZIP FAX
.- 1'444i1A WA /&ice ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 4.10, nce, rcw'Si_e1( (2CIo)77 9 - '2 00
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 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: DATE 4/2-1/.200
PRINT NAME: '3/1:4 Yr ►t%
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 1 of 2 k:\Handouts\Electrical Permit Application
, to, • •
RESIDENTIAL COMMERCIAL
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) 4.01- 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
1st Service/Feeder lst 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 i i 0 3,5o t%h g,-i•4
1-5 circuits$103.50;each additional$8.00
Mast or meter repair $60.50 i(a 7.6-0 &35g
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 Ist Service/Feeder Additional Feeders
O Security Alarm System
® Voice/Data Cabling ( ,}�fj 0_ 60 amp x $ 71.00 x $ 32.00
• Other ��` I 61-100 amp x $ 80.50 x $ 39.00
Area to be served by system: L f` _J
1st 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50 101-200 amp x $103.50 x $ 51.00
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
#of Signs
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 8`"Avenue South♦PO Box 9718•Federal Way♦WA♦98063-9718♦253-835-2607 1 fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160-April 9,2010 Page 2 of 2 k:\Handouts\Electrical Permit Application