17-104983 A
Electrical
City of Federal Way Permit #:17-104983-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: ST FRANCIS HOSPITAL-OUTPATIENT CENTER UPS
Project Address: 34515 9TH AVE S Parcel Number:750451 0020
Project Description: Install new service for UPS located in outpatient center
Owner Applicant Contractor
JOHN ELSWICKFRANCISCAN HEALTH CHRIS BARKERCOFFMAN ENGINEERS THOMPSON ELECTRICAL
SYSTEM-W 1601 FIFTH AVE SUITE 900 CONSTRUCTORS INC
1717 S"J"ST SEATTLE WA 98101-1620 THOMPECOO8CW(2/16/18)
TACOMA WA 98405
PO BOX 45260
TACOMA WA 98445
Additional Permit Information
Is this an Online or O.T.C.application No
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New Service:201 -400 amps 1 1
PERMIT EXPIRES Wednesday,28 November,2018
Permit Issued on Tuesday,November 28,2017
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: //2_ A / 7
THIS CARD IS TO REMAIN ON-SITE
.004Construction Inspection Record
FeCierau Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 104983 00 Address: 34515 9TH AVE S
Project: JOHN ELSWICK 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.
UFER Ground(4295) El Ditch cover(4030) 0 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) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
1t) Final-Electrical(4055)
Approved
By e ,\1/4...e.1 v Date *� ,.l.-.J1 a
0 Rough Electrical El Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
r.
RECEIVE® CELCjAL
CITY OF
Federal Way OCT 16 2017 PERMIT APPLICATION
CITY MWAY
0 ICOMUTY DEVOP( T NUMBER L
— —
SUITE/UNIT/SPACE N
SITE ADDRESS: 34515 8th Ave South - Federal Way, WA 98003
PROJECT VALUATION ASSESSOR'S TAX/PARCEL M CURRENT/PROPOSED USE
$ 15,000 750451 - 0020 - Hospital
PROJECT NAME SFH - Outpatient Center UPS
(Tenant or Homeowner Last Name)
Provide new power for new UPS in outpatient center.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PHONE
PROPERTY OWNER NAME PRIMARY
Francis Hospital (253 )94 8100
MAILING ADDRESS E-MAIL
34515 8th Ave South
CITY STATE ZIP FAX
Federal Way WA 98003 ( ) -
NAME PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
710D c ) —
' WA STATE CONTRACTOR'S LICENSE• EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE A
NAME PRIMARY PHONE
Coffman Engineers (206 )623 (1717
APPLICANT
MAILING ADDRESS E-MAIL
1601 fifth Ave. Suite 900 barker@coffman.com
CITY STATE ZIP FAX
Seattle WA 98101 ( 206624 3775
NAME PRIMARY PHONE
PROJECT CONTACT Chris Barker; Hanh Mortenson ( 206-p23-0717
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;7the city as a part of this application.
SIGNATURE: t LIP�i/ / c DATE 1 0/09/1 7
PRINT NAME: Hanh Mortenson P.E.
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609 +permitcenter@cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application