12-105415Project Name: GROUP HEALTH CLINIC
Project Address: 301 S 320TH ST
Electrical
Pe> mit #: 12 -105415=a0 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 172104 9105
Project Description: Re -circuit existing outlet circuits from (4) isolation panels to a 100 -amp subpanel.
Owner
Applicant
.a.
GROUP HEALTH COOP
City of federal Way
PRIME ELECTRIC INC
Community & Econ. Dev. Services
13301 SE 26TH ST
33325 8th Ave S
Federal Way, WA 98003
TUKWILA WA 98168
Ph: (253) 835-2607 fax: (253) 835-2609
13301 SE 26TH ST
Project Name: GROUP HEALTH CLINIC
Project Address: 301 S 320TH ST
Electrical
Pe> mit #: 12 -105415=a0 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 172104 9105
Project Description: Re -circuit existing outlet circuits from (4) isolation panels to a 100 -amp subpanel.
Owner
Applicant
Contractor
GROUP HEALTH COOP
PRIME ELECTRIC INC
PRIME ELECTRIC INC
12501 E MARGINAL WAY S
13301 SE 26TH ST
PRIMEEI134BT (1/30/13)
TUKWILA WA 98168
BELLEVUE WA 98005
13301 SE 26TH ST
BELLEVUE WA 98005
Is Use Educational or Institutional?.......................No
Service greater than 999 Amps? .............................No
New Service: 0 - 100 amps (Comm 1 New Service: 201- 400 amps (Con 1
PERMIT EXPIRES Wednesday, May 29, 2013
Permit Issued on Monday, December 17, 2012
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 a cordance with the laws, rules and regulations of the State of Washington
nd the City of Federal Way.
Owner or agent:4& Date:
I /I 4P /( 03
CITY OF p ,
Federal Way
PERMIT #:
. THIS CARD IS TO MAIN ON-SITE < '
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
12 -105415 -00 -EL
Address: 301 S 320TH ST
Project: GROUP HEALTH COOP FEDERAL WAY, WA 98003-5200
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.
Final - Electrical (4055)
Approved
By Date ,)
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
E]
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date ,)
Pool Bonding (4195)
Temporary Power (4275)
E]
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
❑
❑
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date ,)
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY of ( 2-- l a
±� Fq*Mlle/ ELECTRICAL
Nov 30 2012 PERMIT APPLICATION
CITY OF FEDERA1M19i Ylectrical permits maybe obtained on-line at www.cityoffederalway.com**
ft
SITE ADDRESS: 301 5. '324 T45T -Fb_Dt 1 L "I VA '78
SUITE/UNIT/SPACE #
ASSESSOR'S TAX/PARCEL # CURRENT/PROPOSED USE
MEDICAL.
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PROJECT NAMEr
G VLO UP E4) L� V'i FA C—D T
or HomeowneLast Name)
lel
PROJECT DESCRIPTION
_ Tj1 1Q*,Q 1pmmFi l\, ` N
Detailed description of work to
4 NIL
be included on this permit only
PROPERTY OWNER
NAME
GAO v 1� T 1 CT1 Y
PHONE
c z66) 44 %Y 5 600
MAILING ADDRESS
E -MAD,
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no �VZ AVE N, ST 1CQ
CITY
FAX
IMSTATE
gZIPR A
NAME
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PRD&4RY PHONE
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MAILING ADDRESS`V
1 ��0` S C CJe� ST
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ELECTRICAL
CONTRACTOR
CITY
STATEZIP
FAX
P Et1_�'0 U �
WA
9% -MS
-
( ) 555
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
VVII MZ:al 13`1 ?)T 01 /20 1013
10-0D- M770zMzEL
NAME
PRIMARY PHONE
P911h1p, E-wT k
Of ) - 11100
APPLICANT
MAILING ADDRESS
E MAH.
CITY
STATE
ZIP4
FAX
PROJECT CONTACT
NAME
Z31VI-
PRIMARY PHONE
) Ru -
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 plication. %)
4
SIGNATURE: - ` / DATE V
PRINT NAME: ✓ V �V U LL—t— l,'
33325 8" Avenue South ♦ Federal Way ♦ WA 198003-6325 1253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin #160 - January 1, 2011 Page 1 of 2 011andoutsTlectrical Permit Application
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a
Ah
RESIDENTIAL
CTMMERCIAL
NEW SINGLE FAMILY RESIDENCE
NEW COMMERCIAL
Total Square Feet
(including attached garage):
111 Service/Feeder A tonal Feeders
0 - j 100 amp J x $132.6Qj,- x $ 80.50
FEES: First 1300 ft2 - $122.00;
,
-'' 200 amp x $164.00 x $103.50
Each additional 500 ft2 - $39.00
201 -', 40 x $3 .00{�i�i x $121.00
(
NEW MULTIFAMILY (3 units or more)
401- 600 amp 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 1000 x $616.00 x $328.50
401 - 600 amp _ x $224.00 x !, $111.50
601 - 800 amp x $287.00 x $153.50
Ove 00 volts surcharge x $103.50
Over 800 amp x $410.50 x $307.00
ALTERED SINGLE or MULTI FAMILY
ALTERED COMMERCIAL
1st Service/FeederCx
ice/Feeder Additional Feeders
)$132
0 - 200 amp x $101.00
0 _ 200 amp .50 x $103.50
201 - 600, amp x $164.00
201 -'- 600 amp , $307.00 x $121.00
Over 600 amp x $246.50
601 -'1000 amp x $463.00 x $196.00
Over 1000 amp x $515.50 x $328.50
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 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
❑ Security Alarm System
1s1 Service/Feeder Additional Feeders
❑ Voice/Data Cabling
0 - 60 amp x $ 71.00 x $ 32.00
❑ Other
Area to be served by system:
61 - 100 amp '' x $ 80.50 x $ 39.00
1st 2,500 ft2-$71.00; each additional 2,500 ft2- $18.50
101 - 200 amp x $103.50 x $ 51.00
201 - 400 amp x $121.00 x $ 60.50
# of Thermostats
401 - 600 amp x $164.00 x $ 80.50
First $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 1253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin #160 -January 1, 2011 Page 2 of 2 k:\liandouts\Electrical Permit Application