02-100714 tt
City of Federal Way
Community Development Services Electrical Permit #:02 - 100714 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253 661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: ST FRANCIS HOSPITAL-AMBULATORY SERVICES BUILDING
Project Address: 34515 9TH S Parcel Number: 750451 0020
Project Description: ELE-Install low voltage work for direct digital controls in new addition of hospital.Revised 11/26 to
include low voltage controls for 14 VAV boxes and 1 T Stat for AC-1.
Owner Applicant Contractor
ST FRANCIS MEDICAL MAJOR ELECTRIC INC. MAJOR ELECTRIC INC.
1717 S J ST MAJOR ELECTRIC INC. MAJOR ELECTRIC INC.
TACOMA WA 18612 142ND AVE.NE. 18612 142ND AVE.NE.
98405-4933 WOODINVILLE WA 98072 (425)483-2677
Electrical Fixtures
Descti tion ;'-1Quaot4ty - -Description Quantity _ {-: Description Quantity
Low Voltage-Other Commercial 62478 Thermostat I 1
PERMITPIRES August 14,2002,IF NO WORK IS STARTED.
Permit issued on February 15,2002
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: . _ , �fjt 1 Date: //—�G7c
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City Federal Way
Community Development Services Electrical Permit #:02 - 100714 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax 253 661.4129 Inspection request line: 253.835.3050
Project Name: ST FRANCIS HOSPITAL-AMBULATORY SERVICES BUILDING •
Project Address: 34515 9TH S Parcel Number: 750451 0020
Project Description: ELE-Install low voltage work for direct digital controls in new addition of hospital.
Owner Applicant - Contractor
ST FRANCIS MEDICAL MAJOR ELECTRIC INC. MAJOR ELECTRIC INC.
1717 S J ST MAJOR ELECTRIC INC. MAJOR ELECTRIC INC.
TACOMA WA 18612 142ND AVE.NE. 18612 142ND AVE.NE.
98405-4933 WOODINVILLE WA 98072 (425)483-2677
Electrical Fixtures
Description Quantity . Description Quantity Description , _Quantity
Low Voltage-Other Commercial 55000
PERMIT EXPIRES August 14,2002,IF NO WORK IS STARTED.
Permit issued on February 15,2002
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: 1.
) -�I Date: 2-/L5/C)
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Community
Development services ctrical Permit#:02 - 100714 - 00 - EL
iny
33530 1st Way S
Federal Way,WA 98003-6210
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Ph:253.661.4000 Fax:253.661.4129 CO
Inspection request line: 253.835.3050'
Project Name: ST FRANCIS HOSPITAL-AMBULATORY SERVICES BUILDING '
Project Address: 34515 9TH S Parcel Number: 750451 0020
Project Description: ELE-Install low voltage work for direct digital controls in new addition of hospital.
Owner Applicant Contractor
ST FRANCIS MEDICAL MAJOR ELECTRIC INC. MAJOR ELECTRIC INC.
1717 S J ST MAJOR ELECTRIC INC. MAJOR ELECTRIC INC.
TACOMA WA 18612 142ND AVE.NE. 18612 142ND AVE.NE.
98405-4933 WOODINVILLE WA 98072 (425)483-2677
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C k.°
Electrical Fixtures
Low Voltage-Other Commercial 55000
PERMIT EXPIRES August 14,2002,IF NO WORK IS STARTED.
Permit issued on February 15,2002
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: Date:
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' r. RECD_ RECEIVED CONSTRUCTION PERMIT APPLICATION
uV AY L_ APPLICATION NUMBER: OZ- -/Oa 7/-(-c' —r
FEB 1 5 2002 APPLICATION NUMBER: -- - -
CITY OF FEDERAL WAY APPLICATION NUMBER: - - .__=4,t - : -
**The foil jh IhIQ RF.information-Please print(in ink)or type**
,.Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
' • PROPERTY INFORMATION
;,• " 3�/5/ 5 /Pre- S.
E ADDRESS: ASSESSOR'S TAX/PARCEL#: I .5 G 4I.5- J - Q O 2 O
•
AL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): 5« olert"C-ti-t-r) S Nt-GJT
M--
:Y' •
N PRO3ECT INFORMATION
4
E OF PROJECT(This application): ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
CZYfECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
JECT DESCRIPTION(Provide detailed descriptaon) D D C [o/L oLs PoY NQ..,kl a t T fbh
4 (6/42-e&-c- 1DtG—y Iry cyto e.)
.Lr,i
',A - OJECT NAME: S (• (-r-c td-d S A✓A.bJ k.G-+C)'r i l3L-0 G .
- ■ PEOPLE INFORMATION
• 'OPERTY OWNER: NAME: _ DAYTIME PHONE:
_;, a-✓15 (. ( c 1,4Ct_T (- 5 v( $r -w (Z53)5 7/ -(e-835"
'3,t4, MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
11 1 1 .Sou J. bT+Cc..1- Tti4t.43w►k cr.JA. 8 tiers—
,4,.;
'i'CONTRACTOR: NAME: DAYTIME PHONE:
M► -o e aeca 2 I c (NC, (42-J )4$3 -242-77
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
la,/2- (4 Are. I\ (mood)nvilk, 9r0-72_ ( ) -
:4r--.
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER:
- - ( ) -
,--, CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
' (ropy of card required) / /
iFfiAPPLICANT: NAME: �- DAYTIME PHONE:
;r,4 c)CO % ,UrcAAr ( ) -
,I, MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
i RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT 0 OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
`-CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER 0 APPLICANT )21 CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ -
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** •
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
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)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) - RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and
rther,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
-
•=• direr agree to hold harmless the City of Federal Way as to any daim(induding costs,expenses,and attorneys'fees incurred in the
vestigation and defense of such daim),which maybe made byanyperson,induding the undersigned,and filed against the Cityof
9 9
eral Way,but only where such daim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
•f the information supplied to the dty as a part of this application.
NAME/TITLE: a7; J"7 DATE: 2///5/6 2--
❑ PROPERTY OWNER ❑ APPLICANT to CONTRACTOR 11
MFOROFFICE USE ONLY: 1
NEVV ❑'ADDITION ❑ALTERATION -TENANTIMPROVEMENT: '
_CENSUS CODE: `- • - `LOTSIZE:c: =: -s
•
ZONING_pESIGNATION __ - BUILDING SHELL ONLY? -11 YES _❑ NO
OMJ 1k►N DESIGNATION = BASIC PLAN?; ❑ YES'` -❑ NO'
$E1 - TOWNSHIP .'RANGE • •• NEW ADDRESS REQUIRED? `..0 YES •• ❑:NO
PLATTED`LOT?`._'<❑YES -❑NO CHANGEOF,,USE?. ❑YES ,- 0 NO ,
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718.253-661-4000•FAX:253-661-4129