08-105836 Elec rie.A
•City of Federal Way
Community Development Services Permit #: 08-105836-00-EL
P.O.Box 9718
anu,
Federal Way,WA 98063-9718 5 Inspection Request Line: (253) 835-3050
Ph.(253)835-2607 Fax:(253)835-2609 : ;
Project Name: ST FRANCIS HOSPITAL
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Low Voltage Nurse Call/Security Alarm system
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM MAJOR ELECTRIC INC MAJOR ELECTRIC INC
34515 9TH AVE S 18538 142ND AVE NE MAJOREI066MN (7/15/10)
SEATTLE WA 98003 WOODINVILLE WA 98072 18538 142ND AVE NE
WOODINVILLE WA 98072
• Additional Permit Information
Service greater than 1000 Amps9 No
Electrical Fixtures
Low Voltage- Other(Commercial 1
PERMIT EXPIRES Wednesday, December 9, 2009
Permit Issued on Tuesday, December 9, 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
.a• the City of Federal Way.
Owner or agent: /• fir, _, —_ _ Date: 1 Z - b - C'3
• THIS CARD IS TOMEMAIN ON-SITE
CITY of
Community Developdivent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-105836-00-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
— 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 (N Date (b_11._\
;
••
For inspector reference only
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
I. ill . .
CITY OE 1 1\10) 01, ,_ / 6 5 _ 34
Federat Way 1Y!' PERMIT
COMMUNITYDEVELOPMENT SERVICES G(� `R,[ SF MF CO ME�PL DE EN FP
3332FSTMRAL SOUTH.P099718 l.•li ' I TION
FEDERAL WAY.WA 98063-9718 D ( ,rtU
253-835-2607•FAX 253-835-2609 /
wu:w.cttuollederalwau.com �Fl..-
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
•
SITE ADDRESS! �, r V" �' SUITE/UNIT#_2_7-)
- ?�
ASSESSOR'S TAX/PARCEL# 1 r) ( LF3-Ar.-0:0_i LOT SIZE(s/) L-) f (9 T J
LEGAL DESCRIPTION(e.g.Acme Estates,Lot()St Ail Jp 4 MI
�b f
(Attach separate page for Lengthy Legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description f t.vor included on this permit oniq)
LOLk VO\ \ T-g.., (�cl\
kPROJECT NAME(Name o Business or Owner Last Name)�J} I�!
• PEOPLE INFORMATION
PROPERTY j �/(� (� I ( PRIMARY PHONE
OWNER 1�\ll�\ ���`,W-►Gd� AC 11 ��" -�� C'`1\ (
MAILING AD .•r. CITY,ST Z P -MAIL ADDRESS
\11"1 j J Yvvxkoe, ci,
CONTRACTOR /�C�OO/M��LPANY NAME(/ ire
LICANT NAMset (ley
,YV (F I EH / ..�
Ia•O � ��� �--` l., ,S�A � PHONEA`IY)Y %3 '2 )
CrIY OF FTE
1°►_9? 1 r�1 tiI ERAL WAY BUSINESS C�S NUMB
IIJr 12 �1 fL—M1 Et IlO
CONObv__ _okoco
I 'lY N ` E TE E-MAIL ADDRESS
1
61 a)
APPLICANT ,N\ P ANT NAML� OFFICE PHONE
P \by 1 Y1c,)IY-C . eQv ) ( IV ( )
ING$D49, -
TY, TA ZIP `ELL PHONE _
�oNSHIP TO PROJECT �j� IFAX NUMB/ER
0 Architect 0 Tenant ❑Agent)<Other COrj\ CtO'( ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ( ) -
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE.ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE O-6p\ I PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 1 Olt - `
SPRINKLERED BUILDING? XYES n NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? n YES Y�`NO
WATER SERVICE PROVIDER 0 LAKEHAVEN n HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN n HIGHLINE 0 PRIVATE(SEPTIC)
• 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 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{commercoo
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SE1S REFRIG.SYSTEMS
PLUMBING
BATHTUBS(orrub/shower Combo) LAYS)Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS IToilep
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 appli - '.n.
SIGNATURE: �. 1 �i 1 A DATE
I 81
Pr... Owner and/or Authorized Agent
FOR OFFICE USE ONLY
n NEW n ADDITION n ALTERATION E REPAIR i TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES C NO BASIC PLAN? C YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES n NO
NEW ADDRESS REQUIRED? r YES n NO UP/SEPA/SU? n YES n NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? n YES n NO
Bulletin#100-January 1,2008 Page 2 of 4 k\Handouts\Permit Application
1111
11.
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet U 0 to 100 amp $125.50 $76.50
(First 1300 ft2-$115.50;Each add'n 500 ft2-$37.00)
J Detached outbuilding or garage ❑ 101-200 amp 155.50 98.00
(Inspected with service) $48.50 U 201-400 amp 291.00 115.00
❑ Detached outbuilding or garage ❑ 401-600 amp 339.50 136.00
(Inspected separately) $76.50 ❑ 601 -800 amp 439.00 186.00
❑ 801 - 1000 amp 536.50 224.50
NEW MULTI-FAMILY(three units or more) U Over 1000 amp 584.50 311.50
Service Feeder
U Up to 200 amp $125.50 $37.00 ❑ Over 600 volts surcharge $98.00
❑ 201 -400 amp 155.50 76.50 ❑ Mast or meter repair $106.00
O 401 -600 amp 212.50 106.00
U 601 800 amp 272.00 145.50 ALTERED COMMERCIAL/INDUSTRIAL
U Over 800 amp 389.50 291.00 Service or Feeders
❑ 0 to 200 amp $125.50
ALTERED SINGLE/MULTI FAMILY U 201 -600 amp 291.00
❑ 601 - 1000 amp 439.00
Service or Feeder ❑ over 1000 amp 489.00
U 0 to 200 amp $96.00
❑ 201 -600 amp 155.50 U #of circuits to be added/altered
U over 600 amp 234.00 (1-5 circuits-$98.00;Add'n circuits,$7.50/ea)
U #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$76.50:Add'n circuits$7.50/ea) $98.00 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
U Mast or meter repair $57.50 ❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
U Service or feeder only $76.50
U Service and feeder $125.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $67.50
❑ #of service or feeders
(First service/feeder-$76.50;each add'n-$50.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $76.50
❑ 101-200 amps 98.00
❑ 201-400 amps 115.00
❑ 401-600 amps 155.50
❑ over 600 amps 168.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats U #of Signs
(First-$57.50;add'n-$17.50/ea) (First sign-$57.50;add'n sign$27.00/ea)
U Low Voltage r U Swimming pool/hot tub $115.00
Square Feet to be served by system(s) /�--���'L) (Includes additional circuit,if required)
0 Fire Alarm System U Yard Pole meter loops $76.50
S Security Alarm System U Additional Plan Review $115.00/hour
0 Voice Cabling (for modified submittals)
❑ Data Cabling
El ❑ Automation Fee on all Permits .. $5.50
1,2500 ft2-$67.50;
Each add'n 2500 ft2-$17.50)*Per WAC 296-46-910(5)(b)(i&iil
Bulletin#100-January 1,2008 Page 3 of 4 k\Handouts\Permit Application