09-100662 Electrical
City of Federal Way ((��
Community Development Services ' �; Permit #: 09-100662-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718 g ,-., b ;; Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p a
Project Name: VIRGINIA MASON MEDICAL CENTER- ORTHO CLINIC
Project Address: 33501 1ST WAY S Suite 220 Parcel Number: 926504 0010
Project Description: Installation of(6)new T-stats.
Owner Applicant Contractor
VIRGINIA MASON CLINIC A M H ELECTRIC LLC A M H ELECTRIC LLC
1100 9TH AVE 8913 W LAKE COCHRAN RD AMHELEL952BC 1/3/11
SEATTLE WA 98101-2756 MONROE WA 98272 8913 W LAKE COCHRAN RD
MONROE WA 98272
Service greater than 1000 Amps? No
Thermostat 6
PERMIT EXPIRES Saturday, February 20, 2010
Permit Issued on Friday, February 20, 2009
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 + City of Federal Way.
Owner or agent: J ' Date: ,-9 -, n��
FINALED
41,r •
THIS CARD IS TOAEMAIN ON-SITE .�
CITY OF CommunityDevelopnlent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100662-00-EL
Owner: VIRGINIA MASON CLINIC
Address: 33501 1ST WAY S Suite 220
FEDERAL WAY, WA 98003
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) 0 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
E Feeders/Sub-panels(4045) Ei Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date Date 2 —6,9' By Date it/2'`4'1
Final-Electrical(4055)
Approved
By Date 4, -‘/1 :7
•
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
• •
OF Am., () __ / 0 06 (0 2_
Federal, , PERMIT SF MF CO ME PL DE EN FP
COMMUNITY DEVELOPMEES
25 815
SOUTH•
OX 9718
32533-835-2E607EFAX 25983-86335-92761089 FEB 2 OAPPLI CATION
1�DERAL WAY,WA � ��;"'
www.cituoffederalwau.com �r
IY 1
The fol , •5 inec d�'k,n p"an uuwmpiete application will not be accepted. Please print legibly(in ink)or type.
��^"� \- /� ` ' • PROPERTY INFORMATION
SITE ADDRESS- 3,l 5C 1 Wt y SickTit\ 9 g Ce3 SUITE/UNIT#-
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sf1
LEGAL DESCRIPTION(e.g.Acme Estntvs,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION XELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work inchlclPd on this permit only)
PROJECT NAME(Name of Business or Owner Last Name) or 4440 (.t(L, ,f �
• PEOPLE INFORMATION
PROPERTY NAME t Q (` PRIMARY PHONE
OWNER v i b t b-%ia. J' 0 G1 tkevc;Gat, CatA`T tel- ( ) -
MAILING RESS CITY,STATE,ZIP /AtE-MAIL ADDRESS
I (CC cirw A tie_ r N.e_jUi °I 44 ►or
CONTRACTOR COMPANY NAME t i 1 APPLICANTT^NAME(' (� •
OFFICE PHONE
Mk ii Eitc- i, LLC T\� c� �l" -c- (L)-) )743 -735
MAILING ADDRESS PP CITY,STATE,ZIP i_ CELL PHONE
ct-
C b,OF FEDERAL WAY BUSINESSLICENSE NUMBER E�L,c4 EI PIItA1 k FAX NUMBER 1 —4 8
ac-o-) - toL5a-3-oo iL k11�-► 1aOC '" (i,15 )74i -1- sC)
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS ^
A F ( ELei5Q c 11.31 act E(eck-,4 . 14v.rt)tier al.int1
APPLICANT
COMP,,,OFTY NAME APPLICANT NAME OFFICE PHONE
CY^- tc/tc ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect ❑Tenant 0 Agent ❑ Other ( ) -
PROJECT NAME ('( PRIMARY PHONE E-MAIL ADDRESS
NA
CONTACT -1-1.irvA G-v-,Ti',v� Has ))_.-3\ -4 v 64
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CIIY,STATE,ZIP PHONE
( ) -
`1 • DETAILED BUILDING INFORMATION
EXISTING USE LAQ1 A� C) PROPOSED USE 14\eck•C:C,L\ C\v v\t C,
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
• •
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. 89.FT.
BASEMENT
FIRST ` j-
SECOND 1C'CCv161 �C l( � \\1.0 V*\ E 54 CVO/NM-
-THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR 0 UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS EXISTING PROPOS® w
TOTAL TOTAL SF TOTAL PROPOSEDSF TOTALS?
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type offixture ixture to be instoilnd 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 SEMS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(orTtrb/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS Crones
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 ' %nciuding its officers and employees, upon the accuracy of the information supplied to
the city as a part
�of--th�is:
b 1 applicati
lJ
SIGNATURE: V r -
DATE �� '/
0�l
' operty 44' r and/or Authorized Agent
FOR OFFICE USE ONLY
o NEW o ADDITION ❑ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES ❑NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100-January 1,2009 Page 2 of 4 k\Handouts\Perniit Application
• •
...Ins.
ELECTRICAL PERMIT INFORMATION
*NOTE: an automation fee o $6.00/will be charged for all permits.
RESIDENTIAL v COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 ft2-$121.00;Each add'n 500 ft2-$39.00) U 0 to 100 amp $131.50 $80.00
U 101-200 amp 163.00 103.00
❑ Detached outbuilding or garage(w/service) $51.00
U 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
U Swimming pool(inspected separately) $120.50 U 601-800 amp 460.50 195.00
0 801 - 1000 amp 562.50 235.50
❑ Hot tub/spa/sauna(w/service) $51.00
U 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
NEW MULTI-FAMILY(three units or more) ALTERED COMMERCIAL/INDUSTRIAL
Service Feeder (Does not include circuits.)
Service Feeders
U Up to 200 amp $131.50 $39.00
U 0 to 200 amp $131.50
0 201 -400 amp 163.00 80.00
U 201 600 amp 305.50
❑ 401 -600 amp 223.00 111.00
U 601 - 1000 amp 460.50
❑ 601 -800 amp 285.50 152.50 ❑ over 1000 amp 513.00
U Over 800 amp 408.50 305.50
❑ #of circuits to be added/altered
ALTERED SINGLE/MULTI FAMILY (1-5 circuits-$103.00;Add'n circuits,$8.00/ea)
Service or Feeder COMMERCIAL/INDUSTRIAL PLAN REVIEW
U 0 to 200 amp $100.50 $103.00 plus 35%of Permit Fee
U 201 -600 amp 163.00 U Service- 1,000 amps or greater
U over 600 amp 245.50 U Medical/Educational/Institutional Facility
❑ Additional plan review for
U #of circuits to be added/altered modified submittals $115.00/per hour
(1-4 circuits-$80.00;Add'n circuits$8.00/ea)
U Mast or meter repair $60.50 TEMPORARY SERVICE
Service or Feeder Each Add'n
MANUFACTURED HOMES U 0 to 60 amp $ 71.00 $32.00
U Service or feeder only $80.00 U 61- 100 amp 80.00 39.00
U Service and feeder $131.50 U 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
❑ it of service or feeders U Over 600 amp 183.00 92.00
(First service/feeder-$80.00;each add'n-$52.50)
MISCELLANEOUS SERVICE/EQUIPMENT
6 #of Thermostats
(First-$60.50;add'n-$18.50/ea) r S 3_ C>a ❑ #of Signs
U Low Voltage (First sign-$60.50;add'n sign$28.50/ea)
Square Feet to be served by system(s) U Yard Pole/meter loops/pedestal $80.00
❑ Fire Alarm System U Portable Generator(transfer equipment) $100.50
❑ Security Alarm System
U Ditch cover/inspection only $120.50
❑ Voice Cabling
❑ Data Cabling
0 1at.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