08-103416 a•
City of Federal Way • ,
Community Development Services Electrical Per 1 #: 08-103416-00-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 ICU/PCU EXPANSION
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Installation of L/V nurse call.
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 Amps? No
Electrical Fixtures
Low Voltage-Other(Commercial 30,001
PERMIT EXPIRES Thursday, July 17, 2008
Permit Issued on Wednesday, July 16, 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 accord. ce with the laws, rules and regulations of the State of Washington
City of Federal Way.
Owner or agent: ' ' s Date:
PIN
L Ot(
• 14k. , THIS CARD IS TO WAIN ON-SITE
CITY OF \ ° OommunitY p t Develo m Inspection Record
p
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-103416-00-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
❑ 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 679
B4 Date
For inspector reference only
D Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
REC
ENE D WI
, ,
=l�Yaf JUL 16 2008 0 0 s
Federal wayPERMIT
coMMumTY DEVELOPMENTs c s `� SF MF CO ME PL DE EN FP
33325RALWESWA 9 + 71®F FEVCATION
FEDERAL WAY.WA 9 I Tu �� ""- -
253-835-2607.FAX 253-835-2609
www.cittio)lederalwa4.com ��
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
� • PROPERTY INFORMATION
SITE ADDRESS • ` ^t
f\\FQc_PSUITE/UNIT# G� fJ�ASSESSOR'S TAX/PARCEL# R - 0 ® v�> LOT SIZE(sj) t4\
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) \(()\ \ . iN% I Z�(Attach separate page for lengthy legal description) \j11
• PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ){ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DE3CRIION( ouide detailed d� �krk included on this permit onlall
PROJECT NAME(Name of Business or Owner Last Name) `L c1/4, 7(ck .
n S t
• PEOPLE INFORMATION
PROPERTY NAME C r/ `^ ��(y �/� PRIMARY PHONE
OWNER \aceto ` l`iCCL\ I ' 1 rAI ( )
+{MAILING ADDRESS \ ( •�jn/STATE,
/ZIP /V`��/G�/ E-MAIL ADDRESS
fl '1 �J ` 1 �`` V,l O 1 V l t\ 003
CONTRACTOR COMP NAME PLICANT NAME O FICE PHQN
1a.B4A c -Y\c 1... c �rdo� Y 3 21151-1.
WIG C T TE,ZIP J CELL PHONE
CI OF FEDERAL WAY BUSIN S LICENSECy✓� NUMBER EXPIRATIOk DATE F��JNUMBFRtw -617(56^ _
CONTRACTOR'S EGI TI,NUMBER' 6 \ 3i i b EX TION DATE E MAIL ADDRESS
MT)
(,ff�'/
T)Z �m�J —7 13 In
APPLICANT PANY NAME PLIC T NAM; OFFICE P
a \ec ric i0( . I �S� ( r
MAILIN S CITY, TATE. P CELL PHO
—
RELATIONSHIP TO ECT /� FAX NUMBER
❑ Architect ❑Tenant ❑Agent Other Q J c*< Y ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ( ) -
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
1
E.
•• � '
• PROJECT FLOOR AREAS e
AREA DESCRIPTION EXISTING'" PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE) 1tw\ I r.,-ft o
DECK(❑COVERED OR ❑UNCOVERED?) V t)
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 INSERT'S HOODS(Commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS dor nib/Shower Combo) LAYS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSEIS(Toile)
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 , this ap�on.
( 7) i66%.
SIGNAT •I ,�.r I AWL ✓1 A // DATE
dirty i er and/or Authorized Agent
FOR OFFICE USE ONLY
c NEW n ADDITION n ALTERATION c REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY? n YES C NO BASIC PLAN? c YES n NO
ZONING DESIGNATION CHANGE OF USE? n YES n NO
NEW ADDRESS REQUIRED? r YES n NO UP/SEPA/SU? n YES n NO
PLATTED LOT? n YES ❑NO DEMO PERMIT REQUIRED? c YES n NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application
•0 i•
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$115.50:Each add'n 500 ft2-$37.00) ❑ 0 to 100 amp $125.50 $76.50
❑ Detached outbuilding or garage ❑ 101-200 amp 155.50 98.00
(Inspected with service) $48.50 ❑ 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) ❑ Over 1000 amp 584.50 311.50
Service Feeder
❑ 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
❑ 401 600 amp 212.50 106.00 ALTERED COMMERCIAL/INDUSTRIAL
U 601 -800 amp 272.00 145.50
❑ 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
U 601 - 1000 amp 439.00
Service or Feeder ❑ over 1000 amp 489.00
❑ 0 to 200 amp $96.00
❑ 201 -600 amp 155.50 ❑ #of circuits to be added/altered
❑ over 600 amp 234.00 (1-5 circuits-$98.00;Add'n circuits,$7.50/ea)
❑ #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
U Service- 1,000 amps or greater
❑ Mast or meter repair $57.50 ❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $76.50
❑ 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 ❑ #of Signs
(First-$57.50;add'n-$17.50/ea) (First sign-$57.50;add'n sign$27.00/ea)
Low Voltage ❑ Swimming pool/hot tub $115.00
Square Feet to be served by system(s� (Includes additional circuit,if required)
❑ Fire Alarm System U Yard Pole meter loops $76.50
❑ Security Alarm System U Additional Plan Review $115.00/hour
❑
Voice Cabling „p (for modified submittals)
❑ � r� ox
( ti U Automation Fee on all Permits .. $5.50
2500 ft2-$67.50:
Each add'n 2500 ft2-$17.50)'Per WAC 296 l6-91 o(5)(bii&tU
Bulletin#100-January 1,2008 Page 3 of 4 k'1Handouts\Permit Application