08-104075 •
Community Developmentpment Services
CityofFedy Electrical Perm #: 08-104075-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 'ins
Inspection Request Line: (253) 835-3050
'7.4E a.. ...,
Project Name: ST FRANCIS MEDICAL PAVILION-IT DESKTOP
Project Address: 34503 9TH AVE S Parcel Number: 750451 0050
Project Description: Installation of CCTV camera security system
Owner Applicant Contractor
ST FRANCIS MEDICAL CTR ASSOC. A D T SECURITY SERVICES INC A D T SECURITY SERVICES INC
1717 S J ST 11824 N CREEK PKWY N SUITE 105 ADTSESI032O5 (9/25/09)
TACOMA WA 98405-4933 BOTHELL WA 98011 11824 N CREEK PKWY N SUITE 105
BOTHELL WA 98011
Additional Permit Information
Service greater than 1000 Amps9 No
Electrical Fixtures
Low Voltage-Other(Commercial 1
PERMIT EXPIRES Saturday, August 29, 2009
Permit Issued on Friday,August 29, 2008
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 tate of Washington
and the City of Federal Way.
Owner or agent: 14. :���1' Date:
°414
+� THIS CARD IS TO MAIN ON-SITE
CITY OF `� tommunit3Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-104075-00-EL
Owner: ST FRANCIS MEDICAL CTR ASSOC.
Address: 34503 9TH AVE S
FEDERAL WAY, WA 98003-6761
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) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
- ❑ Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
,
By ':,)&‘.. Date / 2i t?
•
•
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
REQ V ED //
rnros ld �� l "' �
Federal Way AUG 2 9 2008 PERMIT
•
COMMuxtrrneve[nrxl;NTBERVICEs SF MF CO M EL L DE EN FP
39995 8 AVENUE SO e l
253-835-2607. G.j fr FE�DCE6 , CATION �'
spwun.rUmargesol w atm
CDS
The following is reg!uwed information-an incomplete application mill not be accepted. Please print legibly(in ink)or type.
PROPERTY INFORMATION
SITE ADDRESS2.J14 l\ SUITE/YJNIT#_ _ -
ASSESSOR'S TAX/Pk/team# '7 .5 T 0 - o 0 LOT SIZE
LEGAL DESCRIPTIOII(e.g.Acme Estates,Lot I)111111.1.11
,
cn eepumoe Page/be lengthy legal amalgam/
�II PROJECT INORMATION
TY O PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL
❑DEMOLITION\ �1L ❑ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCkIPI'[iIN(Provide detailed deserrption of work Included on this Derma OnLV)
-11\73C-13%.1` L)')__ X \) C curyve ra_
rym /C(-S, A r'°I! / f
PROJECT NAME(Nana'of,Susiness or Owner Last Name) keXUNN ,X\ tt"
•
PROPERTY
PEOPLE INFORMATION
INANE PRIMARY PHONE
OWNER ' S ��VGIs.. itaio ^ ( ) -
HALLk J CITY,.,STATE.ZIP oval E-MAIL ADDRESS
re%
CONTRACTOR COMMP ZANY NAME APPLICANT NAME
E V 01 T 10E Pf[ONE
$ i �e� z��J 4 20 5g��
MA1LlNG ADDRESS CRY,STATE,ZIP CELL PHONE
_„ 11�2y N f �l So l 1� � Q►� (`7[ J ZZZ -31
-CITY OF FEDERAL WAY BUSINESSGENS&N egR RATION DATE FAX NUMBER
2 3� )
^'r,;o1VTRAGTOR•SREGISTRA B rroNiiTC1r5 E-MAILADDRESS
,A�sE ' 2-o5 /2 /0
APPLICANT
�COMPANr NAME APPLICAPn NAME OFFICE PHONE
L'. - e✓ o •' ) )
MAILING ADDRESS Cr1Y.STATE.ZIP -E� PHONE
( J
RELATIONSHIP TO PROJECT
FAX NUMBER
:1 Architect 0 Tenant 0 Agent 0 Other J -
PROJECT �� S PRIMARY PHONE E�MML ADDRESS
CONTACT ) 402.0-
Per
P 2.0- a GI I a LENDER :AMEND
P4erRRCW 19.27'.095:
Lender information is required J pr�gfeer value exceeds$5,000
ADDRESS CrrY,S'TATIV,ZITz PHONE
)
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/i4WkIa1SED VALUE$ VALUE OP PROPOSED WORK $
SPRINSLERED BUILDING? C,YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PRO'i�IDER 0 LAKEHAVEN 0 HIGBLIIVE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER O LAKEHAVEN ❑ HIGHLENE ❑ PRIVATE(SEPTIC) -
T00 HSHM QOOM�HVI I(I 06650Z9C2Z XVd Til:OT 800Z/8Z/80
II • PROJECT FLOOR AREAS
AREA DESCRIPTION EX/STING PROPOSED TOTAL
BASEMENT SQ.FT. Sg.FT, _ SQ.FT.
FIRST
SECOND
THIRD
ADDITIONAL FLOORR i(DESC121BE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT ❑ -
NUMBER OF FLOOREi�moeraa n a.e.® toxo sm4caavraros. rorecrxwaamar Bruer
•'1vEWHOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
111 FIXTURES
Indicate number qfeach type of fbeture to be installed or relocated as part of this pnject. Do not Include existing fixtures to rentoin.
MEC_&ANIC4L
Value 4f Mechanical Wi>rk$ GA COPY OF BID OR ES77MA7E MtJ$T BE ThIC,WDED W7LTi APPLICATION,
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS _ W000$ OvES
BBgS FANS GAS WATER HEATERS MISC(Desr+o-lbe)
BOILERS FIREPLACE INSERT'S HOODSlceeeee.a,t
COMPREssolt,3 FURNACES RANGES
DUCTS GAS LOG SETS REFRIG,SYSTEMS
PLUMBING
BATHTUBS(or tub/SI. Comes) LAYS Igruh,.,,,r<,ar.d..) URINALS MiSC(DeseHbo)
---
DISHWASHER RAINWATER SYST VACUUM BREAKERS
DRINKING FO'JNTANS SHOWERS WATER CLOSETS nt.a.,q
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE minis SUMPS
11111111=111111 SIGNATURE
I certify
knou+L under penalty of perjury that I am the property owner or authorised agent of the property owner.I cert> that to the best'of my
edge eh lri/brmation submitted in support of this permit application Is true And Correct.I certify that I will comply with all applicable
City of Federal Wag regulations pertaining en the work authorised by the issuance of a permit.I understand that the issuance of this permit
does not remove the ounces responsibility for compliance with local,state,or federal Laws regulating construction or environmental laws.
',further agree to hold harmless the City of Federal Way as to any claim llnatuding costs, expenses, and attorneys'fees incurred In the
inrrestigatton 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 wiser out of the reliance of the city, including its gQLcene and elRployeas, upon the accuracy of the information supplied to
the city as apart o/'thtd application.
SIGNATURE: VV, a. . .A .�\ DATE 2-16 A T
, er and/or Authorized Agent
If:r1cr , 4 �. ,,, 1. ,r,-.
pyei v r r
C� a t H t i [1 � • .fi�uS
d 'i r
•
a NEW o ADIIITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
, ., - ....,, ...,.....,,,.,....
BUILDING SHELL ONL V? a YES o NO BASIC PLAN? a YES 0 NO
ZONING DES/GNAT/orf
CHANGE OF USE? a YES a NO
NEW ADDRESS RE�UL@LEDT a YES o NO
_... UP/SEM/SU? _ o YES a NO'
PLATTED LOT? a YES ❑NO DEMO PERMIT RE9 4I,,,..,., �.....
. .,.....w. u NO
—
Bulletin#100—January 1, 2008 Page 2 of 4 k\Handouts\Pertnit Application
2002 HSHM 000AMI 11,Qv 06620Z94:5Z XV,4 Tr:OT 800Z/8Z/80
r
41111 IIII
imminin a ICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
k'RESIDENT:W.SERVICERCl/L/IprDITSTRIAL SERVICE
❑ Single Family&pare Feet Service or Feeder EacFt.4dd'n
(forst 1300114-$115.50:Each add'n 500 ftr-$37.00)' U 0 to 100 amp $125.50 $76.50
❑ Detached ouibu;:Iding or garage CI 101-200 amp 155.50 98,00
(Inspected with service) $48.50 ❑ 201-400 amp 291.00 115.00
❑ Detached outbuilding or garage 0 401-600 amp 339.50 136.00
(Inspected separately) $76.50 ❑ 601-800 amp 439.00 186.00
0 801 - 1000 amp 536.50 224.50
NEW Mi7h,TY-FAAMT(three units or more) ❑ Over 1000 amp 584.50 311.50
Service Feeder
U Up to 200 amp $125.50 $37.00 0 Over 600 volts surcharge $98.00
U 201 '400 amp 155.50 76.50 U Mast or meter repair $106.00
CI 401 -600 amp 212.50 106,00
CI 801 -800 amp 272,00 145.50 ALTERED COMMERCIAL/U DUSTRI'_AL
❑ Over 800 amp 389.50 291,00 Service or Feeders
❑ 0 to 200 amp $125.50
ALTERED BDt61;,1t/MIII.TI FAMI],Y' ❑ 201 -800 amp 291.00
Service or Fkeder 0 601 - 1000 amp 439.00
CI to 200 amp $96.00 ❑ over 1000 amp 489.00
❑ 201 600 amp 155.50
0 #of circuits to be added/altered
❑ over 600 amp 234.00 (1-6 circuits-$98.00;Add'n circuits.$7.50/ca)
U #of circuits'to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$7:.50:Add'n circuits$7.50/ea) $98.00 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $57.50 U Medical/Educational/institutional Facility
MANNUPFVREIJ HOME$
O Service or feeder or ily $76.50
❑ Service and feeder $125.50
TEMPORARY SERVICE
MOBILE HOME/IEY PARR Residential/Multi-Runny $67.50
U #of service or feeders
(First service/feaicr-$78.50:each add'n-$50.00) Corrumercial/Industrial Service or Feeder Ampacify
❑ 0-100 amps 5 76.50
❑ 101-200 amps 98.00
❑ 201-400 amps 115.00
❑ 401-600 amps 155.50
❑ over 600 amps 168.00
MISCELLANEOUS SERVICE/EQUIPD .@NT
❑ _#of Thermcetats U #of Signe
xsci(First-$57.50;add'in-$17.50/ea) (First sign $57.60;add'nsign$27.00/ea)
Low Voltage ,C Q swimming pool/hot tub $115-00
oars Feet to be Bernd by system(s) L�J�� (Includes additional circuit,if required)
❑ Fire Alarm Spit=n ❑ Yard Pole meter loops $76.50
❑ Security Alarm 9 natem ❑ Additional Plan Review
El Voice Cabling (for modified submittals) $115,00/hour
In Data Cabling
q ❑ Automation Pee on all Permits .. 55.50
1.4 2500 R2-$87.50:
Each add'n 2500 Its,$17.50)•Per WAC 208-48-9100)(10 4(o
Bulletin#100-January 1,2008 Page 3 of 4 k.Handouts\Permit Application
COO 2] HSHM 000M IIVel JAY 06650Z919Z XVd TI:OT 800Z/8Z/80