11-103112 X
. • III Electrical
City of Federal Way r
Community Development Services Permit #: 11 -1 031 1 2-00-E L
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p a
Project Name: KING COUNTY HEALTH CENTER
Project Address: 33431 13TH PL S Parcel Number: 768190 0070
Project Description: Installing 34 EMCS controls for new AHU and VAV's.
Owner Applicant Contractor
:ING COUNTY AUTOMATION CONTROLS INC. AUTOMATION CONTROLS INC.
500 4TH AVE 20611 BOTHELL/EVERETT HWY SUITE E-11 AUTOMCI038QQ 4/7/12
SEALE WA 98104-2337 EVERETT WA 98012 20611 BOTHELL/EVERETT HWY SUITE E-1
EVERETT WA 98012
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Is Use Educational or Institutional? No Service greater than 999 Amps? No
Thermostat 34
PERMIT EXPIRES Thursday, August 2, 2012
Permit Issued on Wednesday, August 3, 2011
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
nd the City of Federal Way.
Owner or agent: l�ii'1 Date: 5-3-"i/
40C4
- ,
• THIS CARD IS TO MAIN ON-SITE
CITY OF - Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 11-103112-00-EL Address: 33431 13TH PL S
Project: KING COUNTY FEDERAL WAY, WA 98003-6357
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 Slab/Concrete Floor(4255) El Pool Bonding(4195) ❑ Service(4235)
Approved to place concrete Apprened Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) ❑ Rough Electrical (4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
fl Final-Electrical(4055)
Approved
i . Date 5— e' i /
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF -3•��
FeitetttIVED ELECTRICAL
Aug o PERMIT APPLICATION
,T-T-v relatEMicAdical permits may be obtained on-line at www.cityoffederalway com**
40viifi X y' .$ 9 $ ffiq -. '$L S. # r A PQl\
SITE ADDRESS: 3 ! j��� J� t�l
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE geak
41/10 eui
PROJECT NAME `f
(Tenant or Homeowner Last Name) .1f1/121 i &J 16 Al-6d /174//13 -• 40/2,arc
571-47/161:71-/e ra o0/04-0/5 //e
PROJECT DESCRIPTION A-MI Vrtv S c
Detailed description of work to
be included on this permit only
art7;111triONV,,.;:k4,44:kikii,i,Ar: PEON- lating011110046011, 14i
NAME • PRIMARY PHONE
PROPERTY OWNER
/1::/' c;c; �(j�///f i //4,_ /�j '41//' ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
ne/te,n?d747071 ionfro/- 1 - (4'2 774-
MAILING ADDRESS " E-MAIL
ELECTRICAL , CCG, getilt/=Ue'r�i/ gUy
F-1l2_ 461 Van#�'R�L,cc���
CONTRACTOR CITY STATE ZIP FAX
—41* -A 0--i11- 7 a/ (e/,`T 77C- ,7 7 5"7
WASTATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
//V 7 ) C C%'3 U�(Ls / /
NAME .erm ,� PRIMARY PHONE
APPLICANT //err/rr;'7/ (.2(26)57 C- - ,6 4-V/
MAILING ADDRESS E-MAIL
a//t.•'
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT .9q ��/T/1914A ( )S-IO- (g /
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 city, including its officers and employees, upon the accuracy of the
information supplied to the cit as a part of this ppplication.
SIGNATURE: �Jt ✓! DATE [�`- c7 ~//
PRINT NAME: 1/4'/1 /4 I"Y'//71 a in
33325 8th Avenue South•Federal Way♦WA♦98003-6325♦253-835-2607♦fax:253-835-2609 •www.cityoffederalway.com
Bulletin#160—January 1,2011 Page 1 of 2 k:\Handouts\Electrical Permit Application
RESIDENT t MERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 1st Service/Feeder Additional Feeders
(including attached garage): 0- 100 amp x$132.50 x$ 80.50
FEES: First 1300 ft2-$122.00; 101- 200 amp x$164.00 x$103.50
Each additional 500 ft2-$39.00 201- 400 amp x$307.00 x$121.00
NEW MULTIFAMILY (3 units or more) 401- 600 amp x$358.00 x$143.50
1st Service/Feeder Additional Feeders 601- 800 amp x$463.00 x$196.00
0 200 amp x $132.50 ' x $ 39.00 801-1000 amp x$565.00 x$236.50
201 -400 amp x $164.00 x $ 80.50
Over 1000p x$616.00 x$328.50
401 -600 amp x $224.00 x $111.50
601-800 amp x $287.00 x $153.50 Over 600 volts surcharge x$103.50
Over 800 amp x.$410.50 x $307-00
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
1st Service/Feeder 1st Service/Feeder Additional Feeders
0- 200 amp x $101.00 0- 200 amp x.$132.50 x'$103;50
201 600 amp x $164.00 201- 600'amp x$307.00 x$121.00
601-1000-amp x$463.00 x$196.00
Over 6001amp' /4 j
Over 1000 amp x$515.50 x$328.50 r /
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 $ 80.50 Plan Review required only for:
Service and feeder ,.4 ,„ ,C,, ,,'„ ,,� 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 1S1 Service/Feeder Additional Feeders
❑ Security Alarm System
❑ Voice/Data Cabling 0 60 amp x $ 71.00 x $ 32.00
Other - 100 amp x $ 80.50 x $ 39.00
Area to be served by system: ,Al.vr7 ---
1st 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50 1QI-20Q'amp x $103.50 X':$ 5I♦00
201-400 amp x $121.00 x $ 60.50
J # of Thermostats
401,-600 amp x'$164.00 x $ 80.50
yirst$60.50;each additional$18.50
Over 600 amp x $184.50 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 8''Avenue South•Federal Way•WA•98003-6325•253-835-2607♦fax:253-835-2609•www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 2 of 2 k:\Handouts\Electrical Permit Application