02-102160City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: ST FRANCIS HOSPITAL
Electrical Permit #:02 -102160 - 00 - EL
Inspection request line: 253.835.3050
Project Address: 34515 9TH S Parcel Number: 750451 0020
Project Description: ELE - Remove existing 2120 FACP and install, program, and terminate new 41000 system
Owner
Applicant
Contractor
ST FRANCIS MEDICAL
SIMPLEXGRINNELL LP
SIMPLEXGRINNELL LP
1717 S J ST
9520 10TH AVE S SUITE 100
9520 10TH AVE S SUITE 100
TACOMA WA
SEATTLE WA 98108
SEATTLE WA 98108
984054933
1 (206)291-1400
Electrical Fixtures
Low Voltage - Other Commercial 2500
PERMIT EXPIRES November 19, 2002, IF NO WORK IS STARTED.
Permit issued on May 23, 2002
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: Wv%az l^ SCCA kAA_ Date: 3 - - ® `y
'!�t _ s CZ c '--mat' �, �P er 6r1✓ --D ��
RECEIVED
«�►« CONSTRUCTION PERMIT APPLICATION
MAY 2 3 2002 PPUCARON NUMBER: o Z 0
PIDUCATION NUMBER: =
CITY OF FEDERAL WAY PPLICATION NUMBER:
BUILDING DEPT.
**The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORMAI •
SITE ADDRESS: '?SCIS 15 AQC- &CO 1't ASSESSOR'S TAX/PARCEL *: l ✓_ - 4 d L a
LEGAL DESCRIPTION OF SUB3ECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT INFORMATION
TYPE OF PR03ECT (This application): o BUILDING o PLUMBING ❑ MECHANICAL o DEMOLITION
0 ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PR03ECT DESCRIPTION (Provide detailed description):
PROJECT NAME: c/ f ' 1 Y ,lJ�
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME: DAYTIME PHONE:
MATING ADDRESS (STREET ADDRESS: QTY, STATE, ZIP):
NAM '
DAYiTME PHONE:
(2ao) 2q - I
MAILM ADDRESS STREET ADDRESS; QTY, STATE, ZIP):
EVENING PHONE:
5240 Ion'- OF— S # 10 L-3(
a0w zk ( -c cls
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
- -)
— — —
2q - 15-1T1�
AC
CONTRTOR'S REGISTRATION NUMBER:
E> Mt? L (_ )t I S �5 '2�
EXPIRATION DATE:
/ / C3
(g)py of ual requrea) x
01 L,
(-261) 241 - 1-151,
o ARCHITECT o TENANT OTHER ( DESCRIBE): jCM 1"A C:r I (240,0)1_,q 1 - ) *C�
CONTACT PERSON FOR THIS PR03ECT: ❑ PROPEIITY OWNER o APPLICANT o CONTRACTOR �� c r�cv(� cc►w•'t •Ct
DETAILED •R
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: �'� i oc C
•SPRINKLERED BUILDING? #YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE o TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE o PRIVATE (SEPTIC)
"NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: A
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
E
ZIM
BUILDING SHELL ONLY? o YES o NO
COMP PLAN DESIGNATION
BASIC PLAN? o YES o NO
ST
NEW ADDRESS REQUIRED? o YES o NO
PLATTED LOT? o YES o NO
CHANGE OF USE? o YES o NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BWXS) FAN(S) HOOD(S) WOOS (S)
BOILER(S) FIREPLACE INSERT($) RANGE(S)
COMPRESSOR(S) FURNACE(S)
• DUCT(S) GAS PIPEOUTLET,y((S--) HEAT SOURCE: o ELECTRIC o GAS
YPLUMBING
BATHTUBS) LAVATORY(S) URINAL(S) WATER HEATERS)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER($) o ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUM P(S)
•
I certify 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 bold 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 of
Federal Way, butAly where clahn arises out of the reliance of the city, including Its officers and employees, upon the accuracy
of the iMormatiq n 4uppHed to thh4ft as hof application.
NAME/TITLE: �MA. � ler 1 a �..�..� tS.rK:� :��Y DATE: 15-Zl -e Z
o PROPERTY OWNER o APPLICANT o CONTRACTOR
FOR OFFICE USE ONLY:
o NEW o ADDITION o ALTERATION
o REPAIR o TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? o YES o NO
COMP PLAN DESIGNATION
BASIC PLAN? o YES o NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? o YES o NO
PLATTED LOT? o YES o NO
CHANGE OF USE? o YES o NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.253-fi61-4000 • FAX: 253-661-4129
4 -
TABLE B
NEW RESIDENTIAL SERVICES
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
Single Famil i
Service or feeder only .........................
$50.00
# of Thermostats (First -$37.50; add'n-$l1.50ea)
(First 1300 W475.00; Each add'n 500 ft'
-$24.00)
_ Service and feeder ............................... $81.00
j # of Low voltage fire or burglar alarms
Square Feet:
First 2500 ft2-$43.50; Each ad 'n 2500 ft2-$11.50 `
Each outbuilding or garage ...........................
$31.00
MOBILE HOME/RV PARK
Square Feet:
_
(Inspected with service)
# of service or feeders
` Per WAC 29646-910(5)(b)(i & ii)
_ Each outbuildingor garage ...........................
$50.00
_
(First service/feeder-$50.00; Add'n service/
_ # of Signs (First sign -$37.50; add'n sign
(Inspected separately)
feeder -$32 each)
$17.50 each)
Swimming pool, hot tub, spa ...............575.00
_ Yard Pole meter loops .........................$50.00
NEW MULTI -FAMILY
COMMERCIAL/INDUSTRIAL
COMMERCIAL/INDUSTRIAL
(includes three units or more)
Altered Service or Feeders
Service
Feeder
Amps Service or
Add'n
_ 0 to 200 ..............................................$ 81.00
Up to 200 amp .............. $ 81.00................
$ 24.00
Feeder_
201-600 .............................................. 189.00
_
201 - 400 amp ................ 101.00....................
50.00
_ 0 to 100.........................$ 81.00.......
$ 50.00
_ 601-1000 ............................................ 284.50
_
_ 401- 600 amp ................ 138.00....................
68.50
101-200 ........................ 101.00 ...........
63.50
-over 1000 ............................................. 317.00
601- 800 amp ................ 176.50....................
94.50
_
201-400 ........................ 189.00 ...........
75.00
_ # of circuits
_
Over 800 amp ................. 252.50..................
189.00
_
_ 401-600 ........................ 220.50 ...........
88.50
(1-5 circuits -$63.50; Add'n circuits, $5 ea)
_
ALTERED SINGLE/MULTI FAMILY
601-800 ........................284.50.........
120.50
(When inspected separately from the services.)
_ 801-1000 ...................... 348.00.........
145.50
TEMPORARY SERVICE
Service or Feeder
-Over 1000 ...................... 379.00.........
202.50
Residential/Multi-Family/Commercial/Industrial
_ 0 to 200 amp ...............................................
$ 68.50
_ Over 600 volts surcharge ......................
63.50
_ 0-100 ................................................ $ 50.00
_ 201 -600 amp ..............................................
101.00
_ Mast or meter repair.................. ...........
68.50
_ 101-200 ...............................................63.50
over 600 amp ................................................
151.50
_ 201-400 ................................................ 75.00
_
_ Mast or meter repair .......................................
37.50
_ 401-600 .............................................. 101.00
# of circuits
_ over 600 ...............................................109.00
_
(1-4 circuits -$50.00; Add'n circuits S5 ea)
it a new or altered commercial service is zuv amps or greater, or a new or altered residential service is greater man 4uu amps, a plan review is required. Pee is sx /o of
permit fee +$63.50. Add'1 plan review for other submissions is S75.00/hr.
Estimated Permit Fee: (12)
Total Column (D)
Estimated Permit Fee from One 12
Estimated Plan Review Fee: $63.50 + ( X.35) = (13)
I ■ DEMOLITION
Estimated Permit Fee:
Bond Amount: (15)
Estimated Permit Fee: (16)
Bond Amount: (17)
OTHER
t�
Mitigation Fee: (18) (20) (22)
SBOC Surcharge: (19)
(2
(23) 9
Total (Pa9es0ne&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100 - February 19, 2002