09-100246 (rcy of Federal Way • MElectrical
Community Development Services Permit #: 0.9-100240-00=E L
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: HALLMARK MANOR
Project Address: 32300 1ST AVE S Parcel Number: 172104 9073
Project Description: Low Voltage door access for approx 19 doors
•
Owner Applicant Contractor
HALLMARK CARE CENTER DOVICH ELECTRIC DOVICH ELECTRIC
PO BOX 723548 PO BOX 703 DOVICE*136PA(8/0310)
ATLANTA GA 31139-0548 TURNER OR 97392 PO BOX 703
,,yy TURNER OR 97392
s c ,,,g 4 a' N. dditio ��^ /� - l
tll
Service greater than 1000 Amps? No
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Low Voltage-Other(Commercial; 1
----" PERMIT EXPIRES.Wednesday, January 20, 2010
'ermit Issued on esday, January 20, 2009
I hereby cert. that e above infirm.tion is correct and hat the/instruction on the above described property and
the occupa and'the use will se - accordance with th laws, , les and regulations of the State of Washington
and the City of ed= -1 Way.
Owner or agent: ,w., - Date: /— 7 c? 0?(
FINJ ' ED
THIS CARD IS TO MAIN ON-SITE
CITY PFACommunity Develop nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100246-00-EL
Owner: HALLMARK CARE CENTER
Address: 32300 1ST AVE S
FEDERAL WAY, WA 98003-5762
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
•El Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
,❑ Final-Electrical(4055)
Approved
By Date ' ''7
For inspector reference only
0 Rough Electrical ' 0 FINAL-Electrical
Approved Approved ,
By Date By Date
CITY OF A ) EcE.w 4 0 ' -. / o D 2_ 163,
Federal Way - .— —
PERMIT SF MF CO ME DE EN FP
COMMUNITY DEVELOPMENT SERVICES (KI (DPL
33325 8TH AVENUE SOUTH•PO BOX 9718 �,N O Pl, I CATION
FEDERAL WAY, 98063 TD /
253-835-2607•FAXX 253-835-260-260 9
wuna.dhro`1ederatwatl.com _ - Fr)E
The followtntrus required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
- PROPERTY INFORMATION
SITE ADDRESS `j i.3 c-c, ( .* A- i I
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ —_ LOT SIZE(sf
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
•' 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 onhi)t= \- .,!1""R-ti/i(/;
L L`A-` 7 e.t..-( v.-C. . ) \L I\ CLC i.C NCIS l
PROJECT NAME(Name of Business or Owner Last Name) ."--- IC _U �.. (' 1 C j...LT`t
•' PEOPLE INFORMATION
PROPERTY NAME # PRIMARY PHONE
OWNER .-•
I.--)ICI�� ket rs, c K w ( )
MAILING ADDRESS CITY,STAT§,ZIP E-MAIL ADDRESS -
-1 - 2a 5 S l+1 CSA. 3 I f.
CONTRACTOR COMPANY NAME •PLICANT NAME OFFICE PHONE
v'I cf7<<( % c r v2 K' la ,Z rc I t=._ t- c,, 1, r t-t (CTC9 S 1 - e .3 Z.
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
PL` -RCs 7 (s`- —77_,:'rr�l =GC_. 672 `173`iz. ( '03 ) S-5742 - Z S 3 Z
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBEREXPIRATION DATE FAX NUMBER
C F- 100 E r3 /il. u. -V � �y�. ) 564/- .d z 0
/, CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
Pfc.' i / , r : ` l >cL ,74 / C ; pActii, tCif bc.-tc.lre"ic
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
(
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect o Tenant o Agent 0 Other ( ) -
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 ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER o LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC)
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
=STING PROPOSED TOTAL TOTAL BASTING Sr TOTAL PROPOSED Sr TOTAL sr
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(commaei,y
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS ciao
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGIIFTUR _ _ f
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,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 o such claim), which may be made by any person, including the undersigned, and filed against the city, but only
where such claim arises ou 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 ap tion. ) i
SIGNATURE: '� ( DATE /Z d/fl
Property Owner and/or Authorized Agent
271
�
� F� ISS
a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
_
ZONING
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application
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
❑ Single Family Square Feet
Service or Feeder Each Add'n
(First 1300 ft2-$121.00;Each add'n 500 ft2-$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
0 201.-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
❑ Swimming pool(inspected ❑ 601-800 amp 460.50 195.00
separately) $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 $103.00
❑ Septic pumping system(inspected separately) $80.00 ❑ Mast or meter repair $111.00
ALTERED COMMERCIAL/INDUSTRIAL
NEW MULTI-FAMILY(three units or more) (Does not include circuits.)
Service Feeder Service or Feeders
❑ Up to 200 amp $131.50 $39.00 ❑ 0 to 200 amp $131.50
0 201 -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 ❑ over 1000 amp 513.00
❑ 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
❑ 0 to 200 amp $100.50 $103.00 plus 35%of Permit Fee
CI Service- 1,000 amps or greater
❑ 201 -600 amp 163.00
CIMedical/Educational/Institutional Facility
CI over 600 amp 245.50
❑ Additional plan review for
❑ #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
❑ Service or feeder only $80.00 ❑ 61-100 amp 80.00 39.00
❑ Service and feeder $131.50 ❑ 101-200 amp 103.50 51.00
O 201-400 amp 120.00 60.50
MOBILE HOME/RV PARK U 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
❑ #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) 1T,-7 r-r ❑ Yard Pole/meter loops/pedestal $80.00
❑ Fire Alarm System ❑ Portable Generator(transfer equipment) $100.50
❑ Security Alarm System
U Ditch cover/inspection only $120.50
❑ Voice Cabling
❑ Data Cabling
W- Arcr- <;s C t-(7K(.s e____
pa2500 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