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08-101925 . City of Federal Way . Community Development Services Electrical PerMit #: 08-101925-00-EL P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050 Project Name: ST FRANCIS HOSPITAL �, a } Project Address: 34515 9TH AVE S Parcel Number: 750451 0020 Project Description: Low voltage application to install nurse call,locator,and public address systems on ICU/PCU(3rd floor) and ED (1st floor) • Owner Applicant Contractor FRANCISCAN HEALTH SYSTEM SIMPLEX GRINNELL LP SIMPLEX GRINNELL LP 34515 9TH AVE S 9520 10TH AVE S SUITE 100 SIMPLL*988BG 2/11/10 SEATTLE WA 98003 SEATTLE WA 98108 9520 10TH AVE S SUITE 100 SEATTLE WA 98108 Additional Permit Information Service greater than 1000 Amps? No Electrical Fixtures Low Voltage-Other Commercial.. 1 PERMIT EXPIRES Saturday, April 18, 2009 Permit Issued on Wednesday, April 23, 2008 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. agent: '..`i • ( G�Z. 0 . r ,j� ,�) i 1'�-•��}G C7�'7 v 1.irl.�.l��te: � . Z Z, .C 5 Owner or ll F( WAU s zz/c)1:1• DATE INSPECTOR AREA AND TYPE (if INSPECTION FOP • THIS CARD IS TO R AIN ON-SITE CITY OF . Community Developme t Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 08-101925-00-EL Owner: FRANCISCAN HEALTH SYSTEM Address: 34515 9TH AVE S FEDERAL WAY, WA 98003-6761 This card is part of your required inspection documents. 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) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255) Approved Approved Approved to place concrete By Date By Date By Date — 0 Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service (4235) Approved Approved Approved By Date By Date By Date ❑ Feeders/Sub-panels(4045) ❑ Rough Electrical (4225) ❑ Ceiling Cover(4020) Approved Approved Approved By Date By Date By Date ❑ Final-Electrical(4055) Approved By Date • For inspector reference only _ 0 Rough Electrical 0 FINAL-Electrical Approved Approved • By Date By Date • E EIV C ? _ / 0 / V2 CITY OF V- Federal Way — — COMMUNITY DEVELOPMENT SEI2YIC65 2 3 2008 PERMIT SF MF CO MEWL DE EN FP 333258"'AVE NUEIrli•PO99718 pLI CATI O N Tu FEDERAL WAY,,WWA 98063.97171 8 / / 253w835-2wwT 9FEDERAL A eraU,om The following is requir. rmation-an incomplete application will not be accepted. Please print legibly(in ink)or type. • PROPERTY INFORMATION SITE ADDRESS 3` S 17 (V n thAAve . Jo V SUITE/UNIT# ASSESSOR'S TAX/PARCEL# 1 S 0 4 S 1 - 0 0 P. 0 LOT SIZE(sJ) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal description) • PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL LI DEMOLITION *ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlU) LO w V OW(A.q.. C l�-Q P-94)(4 C.&1'l IJV\- f 1%A.S l7.LQ..Q N..)tkAce- ._1L( W C 4 0.rl(L LWj WC, J&act ee‘:2 '` 540}-C,-✓-%.5 . 4. Fro-n- Naspl'f&I , la (a b PROJECT NAME(Name of Business or Owner Last Name) ( • PEOPLE INFORMATION PROPERTY NAME ,, PRIMARY PHONE ( Z OWNER 1-1(a/V\1.,t' N eaak Sij5 erY1 (2;3 H42 - 'HII I MAILING ADDRESS t�J CFIY,STATE,ZIP E-MAIL.ADDRESS 34 516 win-1-11 C • S Seal:-(-it, LOA C(gDD'3 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE /// 5inn pLmc611"3-u2R V-�-t- O'tzecLr ( l ) I - 1#4- 00 MAILING©i MAILING ADDRESS CITY,STATE,ZIP CELL PHONE cl S a.c, lo"^ due. Sa-kt'c,. .too Szc.#tte 1.)-)4t `ig toy (Zc ' ) Lcr r icFtoB CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER ��/I�. VI • C • IOGj L}C', ' bp • C3 L.- (Zoz., ) Z-cti - is Do rifk\V CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS >i M P l l• k �(5 C? 2F 'l 1 O t O KD r S 1 Yvtp u.SC.3 v1 vueit i,l.Ccryv‘ ,. APPLICANT COMPANY NAME ,,, APPLICANT NAME OFFICE PHONE 71y1,\piuC C1V1Vti'LLte Ka_tIrv( C'Oe_eir ('leis )V1I - ILI'VD MAILING ADDRESS CITY,STATE,ZIP CELL PHONE °.S).b 1041^ ,A-Npf. S .111 CO Se.&t(-(.t., w A `'IS L O (Zv L7) V11 - 14(v c{ RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect D Tenant 1,'Agent ❑ Other (Itao )Za( - I Sc'o PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS CONTACT Imo(-In; 0'(Z,ZG.( ( iCit) VII - 1414 iCC(tc;{f SivY\?IG1[JO Ir o y.vvt,Li- • Ct1vr LENDER NAME Per RCW 19.27.095: is.)i,/ Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - IN • DETAILED BUILDING INFORMATION L EXISTING USE IN-e--1M-0 C OY\- k.Z")+— PROPOSED USE 13 Q) �rc"''�-ST• yr - ' VI---1 EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 11 3� i;v + SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER El LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE u PRIVATE(SEPTIC) • (/�( �(1 ) X 60- ! ! PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(❑COVERED OR ❑UNCOVERED?) GARAGE ❑ CARPORT ❑ EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF NUMBER OF FLOORS **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ ■ FIXTURES Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(Commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS dor Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS moiler) ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS SIGNATURE 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. t SIGNATURE:44441i R A)h, A`{ rr�i.��L L'1 r i�� DATE J 11 0 8 Pr erty Owner and/or Authorized Agent FOR OFFICE USE ONLY D NEW D ADDITION Jl ❑ALTERATION c REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES c NO BASIC PLAN? c YES c NO ZONING DESIGNATION CHANGE OF USE? c YES D NO NEW ADDRESS REQUIRED? c YES D NO UP/SEPA/SU? c YES o NO PLATTED LOT? c YES c NO DEMO PERMIT REQUIRED? D YES c NO Bulletin#100-January 1,2008 Page 2 of 4 k\Handouts\Permit Application