11-100755 A Ali' City of Federal Way • • Electrical•
Community Development Services Permit #: 11 -100755-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax(253)835-2609 p q
Project Name: ST FRANCIS MEDICAL PAVILLION
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Low voltage wiring for new door holder.
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM FIRE SYSTEMS WEST INC(ELECTRICAL) FIRE SYSTEMS WEST INC(ELECTRICAL)
34515 9TH AVE S 206 FRONTAGE RD N FIRESWI055LW (6/19/11)
FEDERAL WAY WA 98003 PACIFIC WA 98047-1023 206 FRONTAGE RD N
PACIFIC WA 98047-1023
. 0itional Permit Informatior>r:._4 3 ,
Is Use Educational or Institutional? No Service greater than 999 Amps'? No
i EectcalFtures r ,a,
Low Voltage-Other(Commercial; 1
PERMIT EXPIRES Friday, February 24, 2012
Permit Issued on Thursday, February 24, 2011
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: (--
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THIS CARD IS TO REMAIN ON-SITE
Federal Way0 Construction Lection Record -,
INSPECTION REQUE TS: (253)835-3050
PERMIT#: 11-100755-00-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.
0 Final-Electrical(4055)
Approved
ByQ k Date 11—(J-1 \ ,
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
1. S •
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10 0 7- 5 5
CITY OF
Federal Way4 `iCTRI CAL
CITY OF FE PE IT APPLICATION
**Most electrical permits may be obtained on-line at www.cityoffederalway.com**
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SITE ADDRESS: <J, / t/(`
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
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PROJECT NAME •
(Tenant or Homeowner Last Name) 5 tri /) /i?&C( ei /O-A le
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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NAME PRIMARY PHONE
PROPERTY OWNER St FGto s l l" ( ) -
MAILING DR ADS E-MAIL
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CIT'Y�. , STAT 2I FAX
NAME PRIMARY PHONE
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MAILING ADDRESS 11�� / l,, / E-MAIL
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CONTRACTOR CITY STAT ZIP, FAX l ( .11
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME PRIMARY PHONE
PROJECT CONTACT (1( ) -7041.5.
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
PRINT NAME:
33325 8ih Avenue South♦PO Box 9718 1 Federal Way♦WA 1 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
ill 0 '-4.-
RESIDENTIAL COMMERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet
(including attached garage): Mdi.... 1-s Service/Feeder Additional Feeders
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
1S1 Service/Feeder 151 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
❑ Security Alarm System 151 Service/Feeder Additional Feeders
❑ Voice/Data Cabling 0- 60 amp x $ 71.00 x $ 32.00
❑ Other _
Area to be served by system: C90 61 - 100 amp x $ 80.50 x $ 39.00
1at 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 8i6 Avenue South♦PO Box 9718♦Federal Way♦WA 4 98063-9718♦253-835-2607♦fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160-April 9,2010 Page 2 of 2 k:\I-Iandouts\Electrical Permit Application