09-103234 }� -} Electrical
City of Federal Way Permit #: 09-103234-00-E L
Community Development
P.O.Box 9718 Services
Federal Way,WA 98063-9718
Ph (253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
1 1 L.
Project Name: ST FRANCIS HOSPITALr,e ,-
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Installing acces control L/V cabling only. Termination equipment install by another
contractor.
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM INTRACOMMUNICATION NTWK SYS IN INTRACOMMUNICATION NTWK SYS IN
34515 9TH AVE S (INSI) (INS!)
SEATTLE WA 98003 4922 N PEARL ST INTRANS994JL(4/10/11)
TACOMA WA 98407 4922 N PEARL ST
TACOMA WA 98407
• �v.. ° '-' A ditl* Permit'Information v
Is Use Educational or Institutional? No Service greater than 1000 Amps? No
. , ,.: ,fie ''
Low Voltage-Other(Commercial 1
PERMIT EXPIRES Friday,August 20, 2010
Permit Issued on Thursday, August 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
d the City of Federal Way.
l
Owner or age �� -� Date: 4-'—.2 2-
THIS CARD IS TO REMAIN ON-SITE
CITY OF """ Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 09-103234-00-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 UFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By C 1� Date caV ✓a 4,_6,1,4,_6,1, By Date
El Final-Electrical(4055)
Approved
By Date
O Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
,
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• CITY OF A ®PERMIT SF CO ME @ PL DE EN FP
Federal Way
COMMUNITY DEVELOPMENT SERVICES APPLICATION / /
253-835-2607•FAX 253-835-2609
www.crtuoffederalwau.com
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SITE ADDRESS
.a i` er r�. ici , f7n �-s'.5- 9,1 ..- %.5--, /. L ".. lie.e�
SUITE/UNIT# / i ZONING ASSESSOR'S TAX/PARCEL#
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n`Sst'
NAME OF PROJECT
(Tenant or Homeowner Name) 4
❑BUILDING 0 PLUMBING 0 MECHANICAL
TYPE OF PERMIT ❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTIOI�I1(J0p
,
1
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PROJECT DESCRIPTION
Detailed description of work to '
be included on this permit only jy/40749,,1 /
NAME Y PHONE
PROPERTY OWNER (-5-;0',...4"/"C'r 5 CAA./ /41,44/i-)7'47:14-1. (2 j 3 ) '7P 77- 7S -5-V
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
/2/2 S , s- �. ,w , ,.,A; `�� s...
OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT
NAME PRIMARY PHONE "---__-
.,yi 4,0 Ce'ii/,�r�i/c/ c /11�i/ie.va.4/L f,c*s. C 273 - ' - G tom/‘r
CONTRACTOR
MAILING ADDRESS,CITY,STATE, FAX
W?2 ,c%2/% ,4%,-44/ &' ,A: ate. 1-.yam 2 s 3 7-.- e:'/I'
WA STATE CONTRACTOR'SR' LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
-
47r-
A/ it.S 9 - ..7-"Z- G- / -,' /,-e. //
NAME PRIMARY PHONE
APPLICANT -.d✓l.'Z /1,e_ii L if3 70 _ ��V/S'
MAILING ADDRESS,CITY,STAT5 ZIP FAX
, E=5 /f/o,A//•/ 1,,74/ Of- 7, d " 7 4,./.0,-- s3 , a5 - el/eG
PROJECT CONTACT NAME PRIMARY PHONE G
(The individual to receive and ". 7,/'m; /g�y, 25 3 %/ - L,i%/D
respond to all correspondence MAILING ADD"1 ; CITY,STATE,ZIP g4,I-75:14:1444E.
E 444
concerning this application) / , 2L /QCs3.C/ S� t- �,,,i9 Cff/O 2 -
S r-� 5
ALTERNATE CONTACT NAME: PRIMARY PHONE •
A///4^ -i.. - ') mss �/ t: /2,24.41173/ /I1$I / .ee
PROJECT FINANCING NAME
Ei OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
(
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses,and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises o of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to tithe•ty as ap•- of this application.
SIGNATURE•ns -' homy.- DATE
PRINT NAME: /.0 i /46
44-2-+'tom
Bulletin#100-4/17/2009 Page 1 of 4 k:\Handouts\Permit Application
MECHANICAL FIXTUR
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDRI))
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(cos)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
4-
Indica'
ndicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑ Yes ❑ No
J
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
BASEMENT _._..._
FIRST FLOOR(or Mobile Home)
SECOND FLOOR _...__.
COVERED ENTRY
DECK
GARAGE I] CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
zo3ezw, ,c4L- NEW/ADDITION
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
NEW BUILDING
ADDITION
COMMERCIAL- REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY z .
Bulletin#100—4/17/2009 Page 2 of 4 k:\Handouts\Permit Application
• ELECTRICAL41)
RESIDENTIAL COMMERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 1st Service/Feeder Additional Feeders
(including attached garage): 0- 100 amp x$131.50 x$ 80.00
FEES: First 1300 ft2-$121.00; 101- 200 amp x$I63.00 x$103.00
Each additional 500 ft2 $39.00 201- 400 amp x$305.50 x$120.50
NEW MULTIFAMILY (3 units or more) 401- 600 amp x$356.00 x$142.50
1st Service/Feeder Additional Feeders 601 800 amp x$460.50 x$195.00
0- 200 amp x $131.50 x $ 39.00 801- 1000 amp x$562.50 x$235.50
201 400 amp x $163.00 x $ 80.00 Over 1000 amp x$613.00 x$327.00
401 -600 amp x $223.00 x $111.00
601 800 amp x $285.50 x $152.50 Over 600 volts,surcharge x$103.00
Over 800 amp x $408.50 x $305.50
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
1st Service/Feeder Additional Feeders 1st Service/Feeder Additional Feeders
0- 200 amp x $100.50 x $ 39.00 0-'200 amp x$131.50 x$103.00
201 -600 amp x $163.00 x $ 80.00 201- 600 amp x$305.50 x$142.50
Over 600 amp x $245.50 x $111.00 601-1000 amp x$460.50 x$235.50
Over 1000 amp x$513.00- x$327.00
Added or Altered Circuits
1-4 circuits$80.00;each additional$8.00 Added or Altered Circuits
1-5 circuits$103.00;each additional$8.00
Mast or meter repair $60.50
Mast or meter repair $111.00
MANUFACTURED HOMES PLAN REVIEW FEES
Service or feeder only x $ 80.00
$103.00 plus 35%of Permit Fee;Plan Review required for:
Service and feeder x $131.50
❑ New,or alteration to, service of 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
Plan review for modified submittals $120.50/hour
MISCELLANEOUS SERVICE/EQUIPMENT
LOW VOLTAGE TEMPORARY SERVICE
❑ Fire Alarm System 1st Service/Feeder Additional Feeders
❑ Security Alarm System
0 Voice/Data Cabling 0- 60 amp x $ 71.00 x $ 32.00
❑ Other 5 61- 100 amp x $ 80.00 x $ 39.00
Area to be served by system:
1st 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50
101-200 amp x $103.50 x $ 51.00
201-400 amp x $120.00, x $ 60.50
#of Thermostats 401 -600 amp x $163.50 x $ 80.00
First$60.50;each additional$18.50
Over 600 amp x $183.00 x $ 92.00
#of Signs **NOTE: an automation fee of$6.00 will be charged
First$60.50;each additional$28.50 on all permits**
Yard Pole/meter loops/pedestal x$ 80.00
Portable Generator (transfer equipment) x$100.50 For fixtures or fees not listed contact the Permit Center at
Ditch cover/inspection only x$120.50 253-835-2607
Bulletin#100-4/21/2009 Page 3 of 4 k:\Handouts\Permit Application