09-100389 City of Federal Way • Electrical
Community Development Services Permit #: 09-100389-00-EL
P.O.Box 9718 '
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 ._,...tis.
Inspection Request Line: (253) 835-3050
Project Name: ST FRANCIS EMERGENCY
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Installation voice and data cabling for modular furniture.
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM TRITON COMMUNICATIONS LLC TRITON COMMUNICATIONS LLC
34515 9TH AVE S PO BOX 11194 TRITOCL965K4 (7/1/10)
SEATTLE WA 98003 TACOMA WA 98411 PO BOX 11194
TACOMA WA 98411
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'Addit /fper . ® ,1•9., �E r `�' ''
Service greater than 1000 Amps No
,.>, ,$ .. „iElectrics fixtures'
Low Voltage-Other(Commercial 2,40C
PERMIT EXPIRES Friday, January 29, 2010
,r , Permit Issued on Thursday, January 29, 2009
I hereby certify that the ab/ve informaticn is correct and that the construction on the above described property and
the occupancy and the se will be in accordance with the laws, rules and regulations of the State of Washington
1(
and the City of Federal Way.
�o'Zg
Date:
ter;
Owner or agent:
FINALED cei
• THIS CARD IS TO *MAIN ON-SITE
CITY OF " Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100389-00-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.
•
❑ UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ 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 BC .. � Date \ ? n et By Date
❑ Final-Electrical(4055)
Approved
•
By Date Z � 'C')
•
•
.
•
For inspector reference only _
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
A
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` • 1 — / •. , 3 V .2.1
Federal ills
V PERMIT
COMMUMTYDEVELOPMENTSERWCES SF MF COM PL DE EN FP
3332ENUOH• OBOX9711A� 2 PPLICATION
FEDERAL58rfAVWAYES WAUT98063-P9778 �/ ��g
253-835-2607•FAX 253-835-2609
www.aluoffederaiwau.com
The ��..
olio ERAL WA
f wi�(fslrequYd oD • • •n-an incomplete application will not be accepted. Please print legibly(in ink)or type.
I
• PROPERTY INFORMATION
SITE ADDRESS 5 -
-7 l 9 7 SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# ---a. $)
_ LOT SIZE(
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) ' ^�4 til ,4; 7 q/- s.(-'1-14 (/ '- 12�/'t!i lCA1 [ /)7`
(Attach separate Page for lengthy legal desmp6on)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
PROJECT NAME(Name of Business or Owner Last Name) /2 / 'vii.' -L /
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER 97 .-- `Fes- M' 46,-,,,-4 (444 ( ) -
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
-i--i 4! C -re.e4 NI.l .,.../A., 1.1.1 Ci",';;.,
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
1.419 il) /O14101,AAiC.:•l0Aroi('f f 615k- ty xA_ (.104 ) '-', -,Q. - ?
MAILING ADDRESS ,STATE,ZIP / CELL PHONE
,? !i;'1 Tj4 `7PY1/ ( - . ) - ,�� -9
CITY OF DERAL WAY BUSINESS LICENSE NUMBER 'EXPIRATION DATE FAX NUMBER
( ) -
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADD
APPLICANT COMPANY NAME / APPLICANT NAME OFFICE PHONE
h1.'. �r,rn 4t(AV! 4OC10( S ---:S54 ('Zav ) '-2 - 9-.1
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
-7, /Ot l y LiEcT 4COv 44 k/,4 ( )
RELATIONSHIP PROJ I FAX NUMBER
0 Architect ❑ Tenant 0 Agent 0 Other ( ) -
PROJECT NAME L PRIMARY PHONE E-MAIL ADDRESS
CONTACT 3 /s Wyc.4_.- (aiu'(g) Y.3 - %.-.0.1-- .9
LENDER NAME / Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE 0 PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
BASEMENT SQ.FT. SQ. FT. SQ.FT.
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS I O I PROPOSED I TOTAL TOTAL=STING Sl TOTAL PROPOSED Sl TOTAL sr
**NEW HOMES ONLY'° NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
II FIXTURES
Indicate number of each type of fixture 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(commeroiaU
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(o:Tub/Shower Combo) LAVS(Bathroom smtco) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roeey
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.
SIGNATURE: DATE
Property Owner and/or Authorized Agent
'
r r “I''''''---',14,“- .p3S F ,x +:- ,yr. 11
a NEW O ADDITION O ALTERATION O REPAIR O TENANT IMPROVEMENT,
BUILDING SHELL ONLY? O YES ONO BASIC PLAN? OYESONØ
ZONING DESIGNATION CHANGE OF USE? o YES O NO
NEW ADDRESS REQUIRED? OYES ONO UP/SEPA/SU?
OYES ONO
PLATTED LOT? O YES a NO DEMO PERMIT REQUIRED? O YES a NO
'
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application
• •
ELECTRICAL PERMIT INFORMATION
*NOTE: an automation fee of$6.00 will be charged for all permits.
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
U Single Family Square Feet
Service or Feeder Each Add'n
(First 1300 ft2-$121.00;Each add'n 500 ft2-$39.00) ❑ 0 to 100 amp $131.50 $80.00
O 101-200 amp 163.00 103.00
❑ Detached outbuilding or garage(w/service) $51.00 ❑ 201-400 amp 305.50 120.50
❑ Detached outbuilding or garage(inspected separately) $80.00 ❑ 401-600 amp 356.00 142.50
❑ Swimming pool(w/service) $80.00 ❑ 601-800 amp 460.50 195.00
❑ Swimming pool(inspected separately) $120.50 ❑ 801 - 1000 amp 562.50 235.50
❑ Hot tub/spa/sauna(w/service) $51.00 ❑ Over 1000 amp 613.00 327.00
❑ Hot tub/spa/sauna(inspected separately) $80.00
❑ Septic pumping system(w/service) $51.00 ❑ Over 600 volts surcharge $103.00
❑ Septic pumping system(inspected separately) $80.00 ❑ Mast or meter repair $111.00
ALTERED COMMERCIAL/INDUSTRIAL
NEW MULTI-FAMILY(three units or more) (Does not include circuits.)
Service Feeder Service or Feeders
❑ Up to 200 amp $131.50 $39.00 ❑ 0 to 200 amp $131.50
0 201 -400 amp 163.00 80.00
0 201 -600 amp 305.50
0 401-600 amp 223.00 111.00
0 601 - 1000 amp 460.50
❑ 601 -800 amp 285.50 152.50 ❑ over 1000 amp 513.00
❑ Over 800 amp 408.50 305.50
❑ #of circuits to be added/altered
ALTERED SINGLE/MULTIFAMILY (1-5 circuits-$103.00;Add'n circuits,$8.00/ea)
Service or Feeder COMMERCIAL/INDUSTRIAL PLAN REVIEW
❑ 0 to 200 amp $100.50 $103.00 plus 35%of Permit Fee
❑ 201 -600 amp 163.00 ❑ Service- 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
❑ over 600 amp 245.50
❑ Additional plan review for
❑ #of circuits to be added/altered
modified submittals $115.00/per hour
(1-4 circuits-$80.00;Add'n circuits$8.00/ea)
❑ Mast or meter repair $60.50 TEMPORARY SERVICE
Service or Feeder Each Add'n
MANUFACTURED HOMES ❑ 0 to 60 amp $ 71.00 $32.00
❑ Service or feeder only $80.00 ❑ 61-100 amp 80.00 39.00
❑ Service and feeder $131.50 ❑ 101-200 amp 103.50 51.00
O 201-400 amp 120.00 60.50
MOBILE HOME/RV PARK ❑ 401-600 amp 163.50 80.00
❑ #of service or feeders ❑ Over 600 amp 183.00 92.00
(First service/feeder-$80.00;each add'n-$52.50)
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats
(First-$60.50;add'n-$18.50/ea) ❑ #of Signs
❑ Low Voltage / '/C) (First sign-$60.50;add'n sign$28.50/ea)
Square Feet to be served by system(s) .•2:4V ❑ Yard Pole/meter loops/pedestal $80.00
0 Fire Alarm System ❑ Portable Generator(transfer equipment) $100.50
❑ Security Alarm System ❑ Ditch cover/inspection only $120.50
a Voice Cabling
.0.Data Cabling
0
1.t 2500 ft2-$71.00; For fees not listed,contact the Permit Center at
Each add'n 2500 ft2-$18.50) 253-835-2607
Bulletin#100-January 1,2009 Page 3 of 4 k\Handouts\Permit Application