10-104443 ' -s-
City of Federal Way Electrical
CommunityDevelopment Services
Permit #: 10-104443-00-EL
P.O Box 9718
Federal Way,WA 98063-9718 Inspection Request Line:
Ph (253)835-2607 Fax (253)835-2609 p q (253) 835-3050
Project Name: ST FRANCIS HOSPITAL
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Cabling and door access and access control cabling. this permit is for the rough-in cabling
only. Terminations will be provided by a separate contractor)
•
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM INTRACOMMUNICATION NTWK SYS IN 1NTRACOMMUNICATION NTWK SYS IN
34515 9TH AVE S (INSI) (INSI)
FEDERAL WAY WA 98003 4922 N PEARL ST INTRANS994JL(4/10/11)
TACOMA WA 98407 4922 N PEARL ST
TACOMA WA 98407
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Is Use Educational or Institutional9 No Service greater than 999 Amps9 No
Low Voltage-Other(Commercial' 1
PERMIT EXPIRES.Thursday; October 20, 2011
Permit Issued on Wednesday, October 20, 2010
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.
Owner or age : Date: /7—2e- - ,G
FINj! LED lo/c5/iO
THIS CARD IS TO REMAIN ON-SITE .
CITY®F45` • Construction Inspction Record
Federal WayINSPECTION RE UESTS: 253 835-3050
Q ( )
PERMIT#: 10-104443-00-EL Address: 34515 9TH AVE S
Owner: 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.
El Rough Electrical (4225) El Ceiling Cover(4020) Final-Electrical(4055)
Approved Approved Approved/1.4,24/27/1.4,24/27By Da /1.4,24/27By Date By Date�D-Z!�7s�
1 fir
❑ Rough Electrical Final Electrical Right of Way
Approved Approved \op(oved
By Date B. Date By Date
• 0' D ( 0 (7' LI (/ <3
Federal ACEIi0BI)ECTRICAL
ocTPER.
MIT APPLICATION
CITY*q;?estFFeQ A,/ i,; A 0 be obtained on-line at www.ci ,°.ederalway.com**
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PROJECT NAME
(Tenant or Homeowner Last Name) .5c" .'' t .41,8.4.e.4 'AteJ»j
CACI 1#17 l•-•.7 2#"2. - e- s's, �Gtass t°"yis. /
PROJECT DESCRIPTION e,{ ,a„o zzmc •,,
Detailed description of work to ' �0,4//Ao. 007' ' (.._ � 7%°"*r dv.LL
be included on this permit only Q.r rQ v,o ro 4137 O-/Zedr-t)
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PHONE
PROPERTY OWNER . .. cvxedo„Le /e,,"'r' Sys ...s . �zs3 )PRIMARY
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MAILING ADDRESS"CO ,el 0...10f *F. E-MAIL
CITY STATE ZIP 4 �O FAX
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NAME PRIMARY PHONE
"...Z-. 4/. S. 2 ( 753) 261 - 419/IP
MAILING ADDRESS
ELECTRICAL d/1'ZZ .v-s ,,-.r'�/ 6� e� jiI,�r E-MAIL s.ca6i), cep
CONTRACTOR CITY STATE ZIP FAR
7:,Aevsssa, GvI 9,o/> f/4° (713) a2 4 'idd
WA STATE CONTRACTOR'S LICENSE X EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
/ /
NAME ,/ PRIMARY PHONE
EAl-,44- �Ose-s-e•e (Lr3)7`/ - 4V/t''
APPLICANT MAILINGAADDDRESS ,� `REMAIL l
VC1/41,4.4.,400zipa
CITY STATE ZIP FAR
-748-e-41�n•�a- GeW ��W 9 (zf3 ) �F7 - el8'6
NAME PRIMARY PHONE
PROJECT CONTACT
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner.I certi fij that to the best
of my knowledge, the information submitted in support of this permit application is true and correct I cert{y that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorised 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 j31sd against the city,
but only wheresuch 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 apart f
application
SIGMA , / DATE /D-2B- .240 /G
PRINT /2,42y ✓SIAL
t
33325 8t°Avenue South♦PO Box 9718•Federal Way•WA•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
✓ y RESIDENTIAO CdlikVIERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet
(including attached garage): 13,Service/Feeder Additional Feeders
0 1C)t3 amg x$] 2 x$ :80.50
FEES: First 1300 ft2-$122.00; 101—•200 amp x$164:00 x$103:50
Each additional 500 ft2-$39.00 X131— 40Q amp x$3t7 00 x$121 00
NEW MULTIFAMILY (3 units or more) 401 600:amp x:$358.00 x:$143::50
Ise,Service/Feeder... Additional Feeders 601 8a amp x$463 00 x$196:0:0
801—1000:amp x:$565.00 x:$23150
201 400:amp x::$:164.00 x $:::80.50
Ever 100�f amp :> .x$6I6 00 'x$328,50
4P 1 60fl anpp x..$224:.00 x $1:11 5(1
601:::800 amp x:$287.00 x $15150 Over:600:volts:surcharge x$10150
OV-dfS00 aing x .$4410.50 x $307.OU
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
1St Sruuz/Feeder 1s,Service/Feeder Additional Feeders
0 : 200 asip x $10 l OQ
a 200 amp x$132.50 x$103:50
201..-600=amp x $164;00
201— 60:0 amp x:$30700 __. ..._...._. x:$1:21::00
Over:600 amp > x $24Fi 50
601- 1000 amp x$463 00 x$1:90 00
Over::1000 amp x:$8:15 50 x:$321.50
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 $.8.050 Plan Review required only for:
Service and'f'eeder 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 1 ,Service/Feeder Additional Feeders
gp Security Alarm System
❑ Voice/Data Cabling0 other c
Area to be served by system: S�00 61 100:amp x $ 80:50 V $ 39.00
1rt 2500 ft2-$71.00;each additional 2,500 ft2-$18.50 .101. 20b amp x $103 5fl x $ SI,Qf3
k .s� 201 400 amp X $121 Oo is $ 60;50
#of Thermostats 40.1.. 600.a ap $164 0 x $ 80;:50
First$60.50;each additional$18.50
Over 600::amp x ::::::::::::: 92.00
FEE CALCULATIONS
Yard Pole/meter loops/pedestal x$ 80.50 • Fees are determined by the scope of work as indicated.
Portable Generator(transfer equipment) x$101.00 • A$6.00 Automation Fee will be added to all permits.
Ditch cover/inspection only x$121.00 • For assistance in calculating fees or completing the
application form,contact the Permit Center at
253-835-2607
33325 8th Avenue South♦PO Box 9718♦Federal Way♦WA♦98063-9718♦253-835-2607 1 fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160—April 9,2010 Page 2 of 2 k:\Iandouts\Electrical Permit Application