07-104291city of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
�.. g1getrical Permit #: 07-104291-00-5L
Inspection Request Line: (253) 835-3050
Project Name: PACIFIC MEDICAL CENTERS PRIMARY CARE CENTER
Project Address: 33501 1ST WAY S Parcel Number: 926504 0010
Project Description: Installation of 60 amp & a 100 amp panel. Voice, Data and Fire alarm wiring also included
with this permit.
Owner
Applicant
Contractor
VIRGINIA MASON MEDICAL CENTER
KEN BOBKO ELECTRIC CO INC
KEN BOBKO ELECTRIC CO INC
1100 9TH AVE
PO BOX 7009
KENBOECO66BA 1/1/08
SEATTLE WA 98101-2756
TACOMA WA 98406-0009
PO BOX 7009
TACOMA WA 98406-0009
PERMIT EXPIRES Sunday, August 3, 2008
Permit Issued on Thursday, August 9, 2007
I hereby certify that the above information is corr nd a construction on the above described property and
the occupancy and the use will ccord a w' a laws, rules and regulations of the State of Washington
d t ity of Federal Way. C ^
Owner or agent: � Date: 1,
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -104291 -00 -EL
Owner: VIRGINIA MASON MEDICAL CENTER
Address: 33501 1 ST WAY S
FEDERAL WAY, WA 98003-6208
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.
❑ Slab/Concrete Floor (4255)
❑ Ditch cover (4030)
❑ Pool Bonding (4195)
Approved to place concrete
Approved
Approved
By Date
By Date
By Date
❑ Temporary Power (4275)
❑ Service (4235)
❑ Feeders/Sub-panels (4045)
Approved
Approved
Approved
By Date
By Date
By Date
❑ Rough Electrical (4225) ❑ Ceiling Cover (4020) ❑ Final - Electrical (4055)
Approved Approved Approved
B Date Q— l %B Dat _ Z� By Date
❑ UFER Ground (4295)
Approved
By Date
For inspector reference o
O Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By DateO
. . A
RECEIVED
Federal Way - 2 2007 01 12 - -j- � 2
�aUG 0 PERMIT
COMMSF MF CO ME ® PL DE EN FP
11N17YDEVElAPMENT SERVICES
33325 DER4LWJESOUIil ® FEDERAL Wg�ppLI CATI ON
Ff:DF,RAL WAY, WA 9
253-535-2607•FAX253-835-.IM(LDING DEPT.
www.c9uoffederahtm.ro
Thefoilowing is required igformation - an incomplete application will not be accepted. P ase print legibly (in ink) or type.
PROPERTY INFORMATION
SITE ADDRESS _ 1 �, S i (�.� �iy �� lA� 1 1 SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # �% �� T - Q LOT SIZE (sfl
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach wparare Page for IvWft legal descrfpt oN
PROJECT
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION XELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work inckLded on this permit on
3oc� 4 1 r�ec�%c.� �Te ��,Y•��e�
i'_1 i -- - __ ___ - i I_ _ �. L
PROJECT NAME (Name of Business or Owner Last Namel
PROPERTY
OWNER
NAME ` •� , y.
`
1p' NN �.% yy\ez) L-
PRIMARY PHONE
( ) -
OFFICE PHONE
)
MATLING ADDRESS
CITY, STATE, ZIP
E-MAILADDRESS
FAX NUMBER
STATE, ZIP
%�
-(;Z!53
CELL PHONE
( 3)
-�
CONTRACTOR
COPY of
With ach
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
COMPANY NAME
Ken `etAcic
APPLICANT NAME
APPLICANT NAME
Do,,Q !r
OFFICE PHONE
)
_ 03
IIICLi.RNG AD.
G.
RESS
7
FAX NUMBER
STATE, ZIP
%�
-(;Z!53
CELL PHONE
( 3)
-�
CnY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
c' Z
(Z 3 ( -o -7
) 7
-
CONTRACTOR'S
REn�GIS(TRRA;TION /NUUM/B/ER
}1EXPIRAT11ON DATE
E-MAIL AD/ -D{ RESS q
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
W,- 1CR14LI
MAILING ADDRESS
0 - WX / `� v l
Q=,
)(k W l.TATE. ZIP
ELL PHONE
CV.3J
RELATIONSHIP TO PROJECT�`
❑ Architect ElTenant ❑ Agent ❑ Other w� r'
FAX NUMBER
NAME PRIMARY PHONE E-MAIL ADDRESS
NAMEPer
RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED/APPRAISED VALUE $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑
PROPOSED USE
VALUE 9F -PROPOSED, WORK $
PROPOSED/REQUIRED? ❑ YES ❑ NO
❑ TACO ❑ PRIVATE (WELL)
❑ PRIVATE (S IC)
M
1e-�
PROJECT •••
AREAS
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
BUILDING SHELL ONLY? o YES ❑ NO
BASIC PLAN?
❑ YES
FIRST
ZONING DESIGNATION
CHANGE OF USE?
SECOND
o NO
j
UP/SEPA/SU?
THIRD
o NO
PLATTED LOT? o YES o NO
DEMO PERMIT REgUII2ED?
ADDITIONAL FLOORS (DESCRIBE)
o NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
EX18=4o
MOPOSso
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project Do not include existing_ fwtures to remain.
MECHANICAL
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
BATI'MBS (orTLb/Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
G1 OF BID OR ESTIMATE MUST INCLUDED Vv=APPLICATION)
EVAPO E COOLERS GAS PIPE OUTLETS WOODSTOVES
FANS GAS WATER HEATERS MSC (Describe)
FIREPLACE IN RTS HOODS (Commensary
FURNACES RANGES
GAS LOG SETS REFRIG. SYSTEMS
LAV Bathroom Sinks) URINALS MISC (Describe)
ATER SYST VACUUM BREAKERS
SHOWERS WATER CLOSETS rroiieU
SINKS WASHING MACHINES
SUMPS
I cert€fy 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. I further agree to hold
harmless the City 1 Way as to any claim (i7ludlWAmsts, expenses, and attorneys' fees incurred in the investigation and defense of
such claim), which may b by any person, i undersigned, and filed against the City of Federal Way, but only where such claim
arises out of the reliance of tand employees, upon the accuracy of the information supplied to the city as a part of
this application. OZ
NAME/TITLE DATE
( (Tale)
RELATIONSHIP TOP ❑ Owner ❑ Agent .contractor ❑ Architect ❑ Other
Bulletin #100 — April 2, 2007 Page 2 of 4 k\Handouts\Pennit Application
❑ NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑ NO
BASIC PLAN?
❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REgUIRED? ❑ YES ONO
UP/SEPA/SU?
❑ YES
o NO
PLATTED LOT? o YES o NO
DEMO PERMIT REgUII2ED?
o YES
o NO
Bulletin #100 — April 2, 2007 Page 2 of 4 k\Handouts\Pennit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIAL/11MUSTRIAL SERVICE
❑ Single Family Square Feet
(First 1300 ft2- $111.00; Each add'n 500 ftz - $35.50)to
Service or Feeder Each Add'n
100 amp $120.50 $ 74.00
ElDetached outbuilding or garage
101 - 200 amp 149.50 94.50
(Inspected with service) $47.00
❑ 201 - 400 amp 280.00 111.00
❑ Detached outbuilding or garage
(Inspected separately) $74.00
❑ 401 - 600 amp 327.00 131.00
❑ 601 - 800 amp 423.00 179.00
❑ 801 - 1000 amp 516.50 216.00
NEW MULTI -FAMILY (three units or more)
❑ Over 1000 amp 563.00 300.00
Service Feeder
❑ Up to 200 amp $120.50 $ 35.50
❑ Over 600 volts surcharge $94.50
❑ 201 - 400 amp 149.50 74.00
❑ Mast or meter repair $102.00
❑ 401 - 600 amp 205.00 102.00
❑ 601 - 800 amp 262.00 140.50
ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 375.50 280.50
Service or Feeders
oZ �0 to 200 amp $120.50,
ALTERED SINGLE/MULTI FAMELY
Service or Feeder
❑ 0 to 200 amp $ 92.50
❑ 201 - 600 amp 280.50 (�
❑ 601 - 1000 amp 423.00
❑over 1000 amp 471.00
❑ 201 - 600 amp 149.50
❑ over 600 amp 225.50
❑ # of circuits to be added/altered
(1-5 circuits - $94.50; Add'n circuits, $7.00/ea)
❑ # of circuits to be added/altered
(1-4 circuits -$74.00; Add'n circuits $7.00/ea)
COMMERCIAL/INDUSTRIAL PLAN REVIEW �" 0-6-
$94.50 plus 35% of Permit Fee
❑ Mast or meter repair $55.00
❑ Service - 1,000 amps or greater (P
Medical/Educational/Institutional Facility a
MANUFACTURED HOMES
❑ Service or feeder only $74.00
❑ Service and feeder $120.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK
Residential/Multi-Family $65.00
❑ # of service or feeders
(First service/feeder-$74.00; each add'n -$48.00)
Commercial/Pndustrial Seruice or Feeder Ampacity
❑ 0 - 100 amps $ 74.00
❑ 101 - 200 amps 94.50
❑ 201 - 400 amps 111.00
❑ 401 - 600 amps 149.50
❑ over 600 amps 162.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats
❑ # of Signs
Affilrst -$55.00; add'n-$17.00/ea)
(First sign -$55.00; add'n sign $26.00/ea)
Low Voltage
Square Feet to be served by system(s) �b�
Fire Alarm system
❑ ecurity Alarm System
❑ Swimming pool/hot tub ................ $111.00
(Includes additional circuit, if required)
❑ Yard Pole meter loops ..................... $74.00
❑ Additional Plan Review $111.00/hour
oice Cabling
Data Cabling Z
(for modified submittals)
❑ Automation Fee on all Permits ..$5.00
lst 2500 ft2-$65.00;
Each add'n 2500 ft2-17.00) • Per WAC 296-46-910(51(b)(i & ip
Bulletin #100- April 2, 2007 Page 3 of 4 k\Handouts\Permit Application