09-100973 .lec„tr><cal
City of Federal Way � ���� �
Community Development Services t„, ..8 Permit #: 09-100973-OO-EL
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: VIRGINIA MASON-ULTRASOUND
Project Address: 33501 1ST WAY S Suite D-118 Parcel Number: 926504 0010
Project Description: Misc. relocate electrical,add one 20/120V dedicated circuit, 1 walll sconce and 1 dimmer
switch for ultrasound room.
Owner Applicant Contractor
VIRGINIA MASON CLINIC H&M ELECTRIC INC H&M ELECTRIC INC
1100 9TH AVE PO BOX 799 HMELEI*077KR(5/19/09)
SEATTLE WA 98101-2756 MARYSVILLE WA 98270 PO BOX 799
MARYSVILLE WA 98270
S, 7 [dC +C7h rr 4Perndti tforill+cat1® A , {
Service greater than 1000 Amps9 No
�� y 91/r �� r ' l', \`�'�:� 1ri"--\� ','; :... r�� ,��; 4'i /� ri /lam
�. ..x.....a ; 9.', ;.. ... a S# !o p'a -- 4 ✓///�#a t e r,,r,r�ry/r�� ^'..
Circuits-Commercial 1
PERMIT EXPIRES Saturday, March 13, 2010
Permit Issued on Friday, March 13, 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 .I be in accordance with the laws, rules and regulations of the State of Washington
and 0r ity of Federal Way.
Owner or agent: ,�#i2�^G���� Date: 3 - /3. L?'
FINALED
3 *.'30
41/4
THIS CARD IS TO EMAIN ON-SITE
CITY OF �CommunitY DeveloprrMnt Inspection
n Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100973-00-EL
Owner: VIRGINIA MASON CLINIC
Address: 33501 1ST WAYS Suite D-118
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) 0 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 0,% Date 3 16 •-c-57 By Date 5- 0 7
.❑ Final-Electrical(4055)
Approved ,
By , Date ? ,O C-5,1
Iltf
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
-,3
FeeralWa V - -
dERMIT
COMMUNITY DEVELOPMENTSERVICES
SF MF CO M:el PL DE EN FP
333258",AVENUESOU7H•PO BOX 9778
im / /
253435-2607.
AX2534354609MAR 2 ?PLICATION
u vw.aeitoran au.a,m _ 5
'.yin la�d g inf RAL(` W A
The foilo i � •n an incomplete application will not be accepted, Please print legibly(in ink)or type.
2 • PROPERTY` INFORMATION /'� //
SITE ADDRESS 3 3 5 b I \STLogy S e,o-r1,., ( 5T F 16 0 r' SUITE/UNIT#_,/J 1!(\
ASSESSOR'S TAX/PARCEL# 3_Z. (o 6--- - .2_. ( 4CL LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
ratachaePwatePagefir line legal desatp6un)
Ill PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)C, r�.1 t
tv Sc.- 1 }�&,)))
e-. a e. f l G.C_-(-r-cod I 4 ari c. ZC7A 7.-b V D. eS c GQ
C.`, r�u` `� ) - L,.Sci 1 l Sc_�ni S ,d �s-wn e_ c-I:w.rne,r u..)-.-44.1". -c -- 1 A.14^11:1-5%.01101
s'c ,ry�
PROJECT NAME(Name of Business or Owner Last Name) V41,Y if.ta PQSC 1-04-1116nti_kArt
■ PEOPLE INFORMATION
PROPERTY NAME
1 PRIMARY PHONE
OWNER (.);r- ; ,;Q MA 5f,)--) <1:.,,c ( ) -
MAILING AD SS CITY,STATE,ZIP E-MAIL ADDRESS
1 l oo q-TIN Arse 5e/1-tit t P t o
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
it‘ hk e- ( s,-;c -=i;-,c... Lt� e. l' r-eu)Stef (3Ga ) 6.S-13 -e752) l
^�G ADDRESS CITY,STATE,ZIP CELL PHONE
P. r . Com' Maryso 1 le, LOA 4SrL t) ( 26b)119 - 2-5619CITY OF FEDERAL WAY 1SINESS ILKE NUMBER ! EXPIRATION DATE FAX NUMBER
( ) -
CONTRACTOR'S REGISTRATION mom EXPIRATION DATE E-MAIL ADDRESS
Wye.l e (.A4617 _V-- 577i 0 wcty„el_21e kr�le.c.cowl.
APPLICANT COMPANY NAME� APPLICANT NAME OFFICE PHONE
lq
( ) -
MAIT3NG ADD ESS CITY,STATE,ZIP CELL.PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect o Tenant ❑Agent ❑ Other ( ) -
PROJECT NAMEPRIMARY PHONE E-MAIL ADDRESS
CONTACT L, --6,c-e.......›--ii-e..-,- (2 , )77 9 -2-31,0 uxz1,L,Ake lec.caw
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 $2t17
SPRINKLERED BUILDING? in YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAIOrHAVEN a HIGHLINE ❑ PRIVATE(SEPTIC)
•
al PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?) •
GARAGE 0 CARPORT 0
NUMBER OF FLOORS SIM= reoroe= Toren Toni EMT=Sr TOTAL PROPOSED SP TOTAL Br
**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.
II01:CEAMCAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITHAPPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(c ;,9
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(,rTM/Shower c mna IAVS(a s URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS Rmi,q
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,stats,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, inch:ding 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: Vim/ t SL JYR%� DATE 3/1 //t3 4:1
Property Owner end/or Authorized Agent
a NEW a ADDITION a ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a.NO
ZONING DESIGNATION CHANGE OF USE?
a YES. a NO
NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU?
a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a NO
Bulletin#100-January 1,2009 Page 2 of 4 k\Handouts\Permit Application
• I
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
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 tt2-$121.00;Each add'h 500 lt2-$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
El Swimming pool(inspected separately) El 601-800 amp 460.50 195.00
$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
❑ Septic pumping system(inspected separately) $80.00 $103.0011
Mast or meter repair $111.00
NEW MULTI-FAMILY(three units or more) ALTERED COMMERCIAL/INDUSTRIAL
(Does not include circuits.)
Service Feeder
Service or Feeders
❑ Up to 200 amp $131.50 $39.00
0 0 to 200 amp $131.50
❑ 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 0 over 1000 amp 513.00
❑ Over 800 amp 408.50 305.50
❑ #of circuits to be added/altered
(1-5 circuits-$103.00;Add'ncircuits,$8.00/ea)
ALTERED SINGLE/MULTI FAMILY
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
❑ over 600 amp 245.50 ❑ Medical/Educational/Institutional Facility
❑ Additional plan review for
❑ I #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
0 Service or feeder only $80.00 0 61-100 amp 80.00 39.00
0 Service and feeder $131.50 ❑ 101-200 amp 103.50 51.00
O 201-400 amp 120.00 60.50
MOBILE HOME/RV PARK 0 401-600 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
O #of Thermostats
(First-$60.50;add'n-$18.50/ea) ❑ #of Signs
❑ Low Voltage (First sign-$60.50;add'n sign$28.50/ea)
Square Feet to be served by system(s) 0 Yard Pole/meter loops/pedestal $80.00
❑ Fire Alarm System 0 Portable Generator(transfer equipment) $100.50
❑ Security Alarm System ❑ Ditch cover/inspection only $120.50
❑ Voice Cabling
❑ Data Cabling
0
For fees not listed,contact the Permit Center at
1K 2500 ftp-$71.00;
Each add'n 2500 f2-$18.50) 253-835-2607
Bulletin#100-January 1,2009 Page 3 of 4 k\Handouts\Permit Application