09-104058" City of Federal Way Electrical
Q
Community Development'Services Permit #. 09 -104058 -00 -EL
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
RImE
Project Name: GARDEN TERRACE ALZHEIMERS CENTER
Project Address: 491 S 338TH ST Parcel Number: 926480 0220
Project Description: Replacement fo fire alarm panel
Owner
Agmlicant
Contractor
LIFE CARE CENTER OF FEDERAL WAY
FIRE SYSTEMS WEST INC (ELECTRICAL)
FIRE SYSTEMS WEST INC (ELECTRICAL)
PO BOX 3480
206 FRONTAGE RD N
FIRESWI055LW (6/19/11)
CLEVELAND TN 37320-3480
PACIFIC WA 98047-1023
206 FRONTAGE RD N
PACIFIC WA 98047-1023
Is Use Educational or Institutional?.......................No Service greater than 1000 Amps? ........................... No
;El�ctrr;l� jai: a g� ;r -S
Low Voltage -Fire Alarm (Com-pac
.T EXPIRES Friday, October 15, 2C`"
hereby°cer
the occupa
Owner or agent:
use vvw-tein
the/Ciiy of Federal Way.
Date: D J
1/0
THIS CARD IS T � MAIN ON-SITE
C,Tv OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 09 -104058 -00 -EL Address: 491 S 338TH ST
Owner: LIFE CARE CENTER OF FEDERAL FEDERAL WAY, WA 98003-6352
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.
11 Final - Electrical (4055)
Approved
By Date
UFER Ground (4295)El
Ditch cover (4030)
Temporary Power (4275)13
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date
Pool Bonding (4195)
E:]
Temporary Power (4275)13
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
E:]
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
I A0 _ / o�v_6T
TT
Federal VC.1� ERMIT S F CO ME L L DE EN FP
COMMUN17Y DEVELOPMENT SERVIC
253-835-2607• FAX 253-8352609C T 1 5
www.citya((ederalwau.comn APPLICATION
SITE ADDRESS
q91 5
ST vq/po' V4 -P,
SUITE/UNIT #
ZONING
ASSESSOR'S AX/PARCEL #
NAME OF PROJECT
Homeowner Name)
p�
(Tenant or
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION�ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
Vim L_A Q_,
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
N"
AME"
PRIMARY PHONE
PROPERTY OWNER
C:7RJQK4__-Q
MAILING ADDRESS, CITY, STATE, ZIP �.�
E-MAIL
`-1 1 "S 33 e {, ST VnoETq\_- wA
OWNER IS ALSO:
❑ CONTRACTOR ❑ APPLICANT PROJECT CONTACT
NAME
PRIMARY PHONE
�1(Z.sr S "rte S T
(` ) 33 - RAS
yCONTRACTOR
MAILING ADDRESS, CITY, STATE, ZIP
20 F Rai- �% h7AG� ►` WA ��o
FAX
(253 )�3S- - o �I
WA STATE CONTRACTOR LICENSE # 1
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
T-���
(� )� 3 3 - 1'Z)4 �9
APPLICANT
MAILING ADD SS, CITY, STATE, ZIP
FAX
zo�- ,� . �A �l ��� wn ��
(29) ) -)W - d,l
PROJECT CONTACT
NAME
PRIMARY PHONE
(The individual to receive and
1i:iRaK0
(1ZI) g33 - )ZL} s
respond to all correspondence
MAILING ADDRESS, CITY, STATE, ZIP
FAX
concerning this application)
�^
'2—Z"0�2a l LS-, i� rJ , PA U 7 l
ALTERNATE CONTACT NAME:
PRIMARY PHONE
E•MAH,
PROJECT FINANCING
NAME
OWNER -FINANCED
Required for projects with
value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PRIMARY PHONE
(RCW 19.27.095)
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 irlformation 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 co plane with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harm! a City ojFederal Way as to any cl m (including costs, expenses, and attorneys' fees incurred
in the investigation and defers
ch claim), hich may be made by y person, including the undersigned, and,jiled against the
city, but only where such c
a . es out of a reliance of the city ncluding its officers and employees, upon the accuracy of the
irtformation supplied t e city
a part of is app ' ation.
SIGN
/
f DATE / e;Y
PRINT NAME:
Bulletin #100 — 4/21/2009
Page 1 of 4 k:\Handouts\Permit Application
as As
Indicate number of each type c
BATHTUBS (or Tub/Shower Combo)
DISHWASHERS
_ DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
PLUMBING
MECHANICAL FIXTURESw
Value of Mechanical Work $
(A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to
be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS
FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS HOODS (commercial)
BOILERS
FURNACES HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS REFRIGERATION SYST
DUCTING
GAS PIPING WOODSTOVES
Indicate number of each type c
BATHTUBS (or Tub/Shower Combo)
DISHWASHERS
_ DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
PLUMBING
FIXTURES
to be installed or relocated as part of this project. Do not include
_ LAVS (Hand Sinks)
TOILETS _
RAINWATER SYSTEMS
URINALS _
_ SHOWERS
VACUUM BREAKERS
_ SINKS (Kitchen/Utnny)
WATER HEATERS (El -tic)
SUMPS
WASHING MACHINES
ifixtures to remain.
WATER PIPING
OTHER (Describe)
TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Stories
Additional Information
NEW BUILDING
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
ADDITION
❑ Yes ❑ No
[]Yes ❑ No
RESIDENTIAL
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
................................................................................................................................................................................................
BASEMENT
...............................................................................................................................................................................................
FIRST FLOOR (or Mobile Home)
................................................................................................................................................................................................
SECOND FLOOR
...............................................................................................................................................................................................
COVERED ENTRY
................................................................................................................................................................................................
DECK
...................................................................................................................................................
GARAGE ❑ CARPORT ❑
................................................................................................................................................................................................
OTHER (describe)
................................................................................................................................................................ ...............................
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 - 4/21/2009 Page 2 of 4 k:\Handouts\Pennit Application
• ELECTRICAL .
RESIDENTIAL
COMMERCIAL
NEW SINGLE FAMILY RESIDENCE
NEW COMMERCIAL
Total Square Feet
Is' Service/Feeder Additional Feeders
(including attached garage):
0 - 100 amp x $131.50 x $ 80.00
FEES: First 1300 ft2 - $121.00;
101 - 200 amp x $163.00 x $103.00
Each additional 500 ft2 - $39.00
201 - 400 amp x $305.50 x $120.50
401 - 600 amp x $356.00 x $142.50
NEW MULTIFAMILY (3 units or more)
111 Service/Feeder Additional Feeders
601 - 800 amp x $460.50 x $195.00
0 - 200 amp x $131.50 x $ 39.00
801 - 1000 amp x $562.50 x $235.50
201 - 400 amp x $163.00 x $ 80.00
Over 1000 amp x $613.00 x $327.00
401 - 600 amp x $223.00 x $111.00
601 - 800 amp x $285.50 x $152.50
Over 600 volts surcharge x $103.00
Over 800 amp x $408.50 x $305.50
ALTERED SINGLE or MULTI FAMILY
ALTERED COMMERCIAL
Is' Service/Feeder Additional Feeders
1-11 Service/Feeder Additional Feeders
0 - 200 amp x $100.50 x $ 39.00
0 - 200 amp x $131.50 x $103.00
201 - 600 amp x $163.00 x $ 80.00
201 - 600 amp x $305.50 x $142.50
Over 600 amp x $245.50 x $111.00
601 - 1000 amp x $460.50 x $235.50
Over 1000 amp x $513.00 x $327.00
Added or Altered Circuits
1-4 circuits $80.00; each additional $8.00
Added or Altered Circuits
1-5 circuits $103.00; each additional $8.00
Mast or meter repair $60.50
Mast or meter repair $111.00
MANUFACTURED HOMES
PLAN REVIEW FEES
Service or feeder only x $ 80.00
$103.00 plus 35% of Permit Fee; Plan Review required for:
Service and feeder x $131.50
❑ New, or alteration to, service of 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
Plan review for modified submittals $120.50/hour
MISCELLANEOUS
SERVICE/EQUIPMENT
LOW VOLTAGE
TEMPORARY SERVICE
Fire Alarm System
Is' Service/Feeder Additional Feeders
❑ Security Alarm System
❑ Voice/Data Cabling
0 - 60 amp x $ 71.00 x $ 32.00
❑ Other
61 - 100 amp x $ 80.00 x $ 39.00
Area to be served by system:
101 - 200 amp x $103.50 x $ 51.00
191 2,500 ft2-$71.00; each additional 2,500 ft2- $18.50
201 - 400 amp x $120.00 x $ 60.50
# of Thermostats
401 - 600 amp x $163.50 x $ 80.00
First $60.50; each additional $18.50
Over 600 amp x $183.00 x $ 92.00
# of signs
"NOTE: an automation fee of $6.00 will be charged
First $60.50; each additional $28.50
on all permits"
Yard Pole/meter loops/pedestal x $ 80.00
Portable Generator (transfer equipment) x $100.50
For fixtures or fees not listed contact the Permit Center at
Ditch cover/inspection only x $120.50
253-835-2607
Bulletin #100 - 4/21/2009 Page 3 of 4 k:UHandouts\Permit Application '