08-101703 e
r City of Federal Way 1111
Community Development Services Electrical Perml . 08-101703-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspectio -•- ,,(253)835-3050
i
Project Name: LIFE CARE OF FEDERAL WAY
Project Address: 1045 S 308TH ST ' Pa * •er: 082104 9042
Project Description: Installation of low voltage security an card access to,�.
I
Owner A• •lic• 4ctor `
FEDERAL WAY CONVALESCENT CENTER MAJOR ELECT'. C. MAJOLECTRIC INC.
PO BOX 723548 18538 142ND A MAJOREI066MN 7/15/08
ATLANTA GA 31139-0548 WOODINVILLE WA 2 18538 142ND AVE NE
OODINVILLE WA 98072
0160Addition r nformalp% 14
Service greater than 1000 Amps? `
lectrtcal Fixture
Low Voltage Burglar 71
irillif
'.,H IT EXPIRESSaturday, April 4, 200
permit;bilged Wednesday, April 9, �8,: ` -
I •yn . that ,.. bove information is comet and that the construction 1( the above: cn ` rc Id z
t •' •ancyvand t• us= Mit be in accordance with°the tom, rules and antt*gd1atiens of the tate 1i 1/a "
- d the City of Federal Way. _
Owner :gent: fi' ..7' .—ArA
Date: il--9
F/Ye/A 2 C
• THIS CARD IS TW.' EMAIN ON-SITE
11116
CITY OF CommunityDevelopMent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-101703-00-EL
Owner: FEDERAL WAY CONVALESCENT CENTER
Address: 1045 S 308TH ST
FEDERAL WAY, WA 98003-4706
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.
❑ 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) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
By Date '/9
For inspector reference only _
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
a R T\�
cin of E,i V 0 - / 0 / 7-03
Federal Wj �� PERMIT
coMMUM7YDEVELOPMENT SERVICES "'"' SF MF CO M A11110 PL DE EN FP
33325 8'^t AVENUEY.WA 9•6O BOX72971At R p 9 Z00� p p LI CATI O N
FEDERAL WAY.WA 98063-9 7 7 8 t� TD / /
253-835-2607•FAX 253-835-2609
www.cittioffederolwau m
ci t? OF FEDERAL WAY
The following is required ition-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 10 T✓ S MISAY1 St- ' ' SUITE/UNIT#
C)
ASSESSOR'S TAX/PARCEL it C Z I v(l '_ yI `-I'
' - q O i 2 LOT SIZE(sfi
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) E. 6�� .1 �) 1V `/Z OF `)W ot- `\Et�y' i' co IG
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION Xi ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit oni
Ukk) \M\* , 69 U.W\ C V C uC aCc eiv\�
PROJECT NAME(Name of Business or Owner Last Name) L4?_ \U,l t O-F FPd-era 1 "a'
• PEOPLE INFORMATION
PROPERTY NAME �....ny. PRIMARY PHONE
OWNER 'Q �OY��
Yak \/\) 1 .QMAILING ADDRESSC T C` �-/',ZIP E-MAIL ADDRESS
CONTRACTOR O PANY NAME� ,yA7�pPQ ICANT AM /O ICE P �/�
l l ( \ liA`‘C I c- U QC T TE(r`� ,' ` y ) -/-�4��
�M Z fk\P2,
\\ 1Y' CELLPHONECITY OF FEDI�4.2- --
W YA BUNESS LICENSE NUMBER r�� EXPI�• DA, FAX NUMBER
iG1'-. -\057.3)\ - o0-a_ 1-21•611 6% (11--v - (4 e
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
IM '4, IMS 1 Ico 1b2kimasernalsirek*i.1
APPLICANT COMPANY NAME n `/ 4,�/�\1/'� �PrPLICANT E OFFICE PHONEH -2o17
�/-- -_/ALO D a1PC�i ti/I - (:11'YI^[''^STATE,ZIP ��y� lCrE1 L`P')HONE
IRESS /� \t V VLUkki,l f RV-a_ FAX FAX NUMB ER
RELATIONSHIP TO PROJECT ` `�1[ � �,'^� -����
❑ Architect ❑Tenant Agent ❑ Other (gib `tV
PROJECT11 )w\ PRIMARY
P�PHONENE �E-MAIL ADDRESS ,
CONTACT aY\vvud-k- rZdty) "7c �� -M 1 V V�IL�rntre lecivl C.
LENDER NAME oso Per RCW 19.27.095: �J
Lender information is required(f project value exceeds$5,000
MAILING ADD CITY,STATE,ZIP PHONE
( )
t , �� /• DETAILED BUILDING INFORMATION ,`\' 1n� (�
EXISTING USE L V TEj Y V�SC i PROPOSED USE L V i((5� ► IcU�\&Q 1
EXISTING ASSESSED/APPRAIS D VALUE$ VALUE OF PROPOSED WORK ) i MO
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. S9.FT.
BASEMENT
FIRST V Ve UO`1.1 wok,
Vh i2.21/4555_`' ✓_
SECOND y J �M 233
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS earsruro PROPOSED TOTAL rmgc TOTAL� i sr' TOTAL s"'
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type offucture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLIi1S WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSElb(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 city as a part of this appl - .n.
SIGNATURE:41. ' 1'j. `A A DATE 0
rty Owner and/or Authorized Agent
D NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? D YES o NO BASIC PLAN? D YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? D YES D NO
PLATTED LOT? D YES o NO DEMO PERMIT REQUIRED? o YES D NO
Bulletin#100—January 1,2008 Page 2 of 4 k\.Handouts\Permit Application
• • •
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(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) U 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 ❑ Mast or meter repair $106.00
❑ 401 -600 amp 212.50 106.00
U 601 800 amp 272.00 145.50 ALTERED COMMERCIAL/INDUSTRIAL
❑ 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
CI to 200 amp $96.00 ❑ over 1000 amp 489.00
❑ 201 -600 amp 155.50 ❑ #of circuits to be added/altered
U 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
U 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)
Low Voltage ❑ Swimming pool/hot tub $115.00
Square Feet to be served by system(s) 10(0'M (Includes additional circuit,if required)
❑ Fire Alarm System U Yard Pole meter loops $76.50
❑ Security Alarm System U Additional Plan Review $115.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
U Automation Fee on all Permits .. $5.50
1st 2500 ft2-$67.50;
Each add'n 2500 ft2-$17.50)•Per WAC 296-46-910(5)(b)(t&U)
Bulletin#100-January 1,2008 Page 3 of 4 k\Handouts\Permit Application