08-103353 cl of Federal Way • Electrical Permit• 08-103353-00'E L•-
(!ommonity evelopment Services
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: ST FRANCIS MEDICAL PAVILLION
Project Address: 34503 9TH AVE S r- - Parcel Number: 750451 0050
Project Description: Relocate low voltage sensor
Owner Applicant Contractor
ST FRANCIS MEDICAL CTR AS EMERALD AIRE INC(GENERAL) EMERALD AIRE INC(ELECTRICAL)
ST FRANCIS MEDICAL CTR ASSOC. 5108"D"ST NW EMERAA199AKG((05/07/09)
1717 S J ST AUBURN WA 98001 5108"D"ST NW
TACOMA WA 98405-4933 AUBURN WA 98001
Additional Permit Information
Service greater than 1000 Amps7 No
Electrical Fixtures
Thermostat 1
PERMIT EXPIRES Tuesday, January 6, 2009
Permit Issued on Thursday,July 10, 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 State of Washington
and the City of Federal Way.
Owner or agent: Date:
c(./L,
fir'
41/4 THIS CARD IS TO *AIN ON-SITE
CITY OF -- fommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-103353-00-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) CI 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) 0 Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
By XP� Date 7 6
CITY C
:�'ede`ral way R E C EL RM IT SF MF CO ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325AVENUE SOUTH•PO BOX 9718 0 o L I C AT I O N TU /
FEDERAL
J U L 1
WAY,WA 98063-9718 ��P
253-835.2607•FAX 253-835-2609
www.dtuofTederalwaucom
The ollowi • is`(FP• Ph S,hI RL,W AYete a••Ucatlon will not be acce•ted. Please •rInt le•ilei in in or • .
y�/��'}� •
III PROPERTY INFORMATION
SITE ADDRESS 34 C • hie SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 5_ 0_ 4_ 5 - `2- `=) ) LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
/Attach separate page for lengthy legal desaiphon)
■ 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)
jar��•+. Q.dt� th - c-Q_A`/ 45 .
PROJECT NAME(Name of Business or Owner Last Name) c . E( t A t 4 P +I
• PEOPLE INFORMATION
PROPERTY NAME
OWNER mAPirPADRESVfl `� .11 �`
'
1cam' PitICSS 1.944446.04.-
CONTRACTOR COMPANY NAME AplucrisrKNfE (0 �
6111 .,.._
MAILING ADDRESSATE.EP .PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER 77ON DA X NUER
FAMB
I +� 11 a B _L /3i / `a•►iJ)IrTu'hAtino: 4,.. 101
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) E�J PIRATION DATE
itt.4 . ea
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
nie.rexied i/ re l 11C- Shin a
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
S lob Mid -barn" !istob)
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect 0 Tenant 0 Agent /Other(Describe) vfYaC t y- (M))810) -37cri
CONTACT NA PRIMARY PHONE E-MAIL ADDRESS
( )S'"13oc ISYI'rJn 1 teenncra i
4'..4 ., .h
LENDER .'• �
°Pe NAME
MAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
cusrato USE PROPOSED USE
E I T NG ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SIPFUNEKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
'EATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SERVICE PROVIDER O LAKEHAVEN O HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
- –—
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ. FT.
s •
.$.1t.
''d-®URTH
ADDITIONAL FLOORS(DESCRIBE)
ECK(COVERED?)
GARAGE U CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EEtsraQ SP TOTAL PROPOSED Sr TOTAL Sr
**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 factures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
r DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Foist) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER$YST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 1 further agree to hold
harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance of th city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE DATE { l I C) 1 d
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 0 0 Agent 0 Contractor 0 Architect 0 Other
a NEW ❑ADDITION a ALTERATION o REPAIR ❑TENANT'IMPROVEMENT
BUILDING SHELL ONLY? p.YES. a NO BASIC PLAN? n YES ❑:NO
ZONING DESIGNATION' CHANGE•OF USE? :: a YES o NO
IEW ADDRESS REQUIRED? 3tS o NO QIP/SEPA/SU? a YES a NO
PLATTED LOT? rs XE$ NQ DEMY EIIMIT REQUIRED? '
n YES p NO
•
#100-August 19,2004 Page 2 of 4 k\Handouts\Permit Application
s°.
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$115.50;Each add'n 500 ft2-$37.00) ❑ 0 to 100 amp $125.50 $76.50
❑ Detached outbuilding or garage ❑ 101-200 amp 155.50 98.00
(Inspected with service) $48.50 ❑ 201-400 amp 291.00 115.00
❑ Detached outbuilding or garage ❑ 401-600 amp 339.50 136.00
(Inspected separately) $76.50 ❑ 601-800 amp 439.00 186.00
❑ 801 - 1000 amp 536.50 224.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 584.50 311.50
Service Feeder
❑ Up to 200 amp $125.50 $37.00 ❑ Over 600 volts surcharge $98.00
❑ 201-400 amp 155.50 76.50 0 Mast or meter repair $106.00
❑ 401-600 amp 212.50 106.00 ALTERED COMMERCIAL/INDUSTRIAL
0 601 -800 amp 272.00 145.50
❑ Over 800 amp 389.50 291.00 Service or Feeders
❑ 0 to 200 amp $125.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 291.00
❑ 601 - 1000 amp 439.00
Service or Feeder ❑ over 1000 amp 489.00
❑ 0 to 200 amp $96.00
❑ 201-600 amp 155.50 ❑ #of circuits to be added/altered
❑ over 600 amp 234.00 (1-5 circuits-$98.00;Add'n circuits,$7.50/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$76.50;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 ❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $76.50
❑ Service and feeder $125.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $67.50
❑ #of service or feeders
(First service/feeder-$76.50;each add'n-$50.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0-100 amps $76.50
❑ 101-200 amps 98.00
❑ 201-400 amps 115.00
❑ 401-600 amps 155.50
❑ over 600 amps 168.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ �#of Thermostats ❑ #of Signs
(First-$57.50;add'n-$17.50/ea) (First sign-$57.50;add'n sign$27.00/ea) •
.ow Voltage ❑ Swimming pool/hot tub $115.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $76.50
❑ Security Alarm System ❑ Additional Plan Review $115.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling U Automation Fee on all Permits .. $5.50
El
1•'2500112-$67.50;
Each add'n 2500 ft2-$17.50) •Per WAC 296-46-910(5)(b)(i&ii)
ter"
Bulletin#100-January 1,2008 Page 3 of 4 k\Handouts\Permit Application