04-100775 City of Federal Way
Community Development Services Electrical Permit #:04 - 100775 - 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: THE MEDICAL PAVILION
Project Address: 34505 9TH S fYY. .S Parcel Number: 750451 0050
Project Description: Pulling power from existing pole,running a trench,adding a circuit for new freestanding sign
Owner Applicant Contractor
MEDICAL REAL ESTATE SVCS NORTH STAR ELECTRIC NORTH STAR ELECTRIC
1501 4TH AVE 1905 S JACKSON ST 1905 S JACKSON ST
SEATTLE WA SEATTLE WA 98144 SEATTLE WA 98144
98101-3225 (206)329-159
Electrical Fixtures
Description 'Quantity Description Quantity Description ,Quantity
Sign 1
PERMIT EXPIRES August 31,2004.
Permit issued on March 4,2004
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: oe" Date: j 'V /�,/
l`? l O4 - rhos,
CITY of RECEIVED E C E I t E "..-410.
� C530 FIRST
DEVELOPMENT SERVICES
!� v 33530 FIRST WAY SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718
Federal Way P PLICATION 253-661-4115.FAX.253 661-4129
mmuw ntgn(frderniumq rom
SAAR 0 4 2004 �j
For Office Use Only �ll i1e umber: _ , - ' 0 — / - 0-6
(i' T.::-•
)YY OF FEuti�L
BUILDING.D 7-
The ollowin• is re.utre in T ormation-art incom•lete a.•lication will not be acce•ted. Please •rint le.ibl (in ink)or .
N PROPERTY INFORMATION
SITE ADDRESS: .3 4C01 cr t" VS 4, SUITE/APT#
ASSESSOR'S TAX/PARCEL#: - SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT(This application): 0 BUILDING 0 PLUMBING 0 MECHANICAL ❑ DEMOLITION
'ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only): ?1e0 U i .E ?ow e it
To ,Ai C/ZOa sde j ,
PROJECT NAME(Name of Business/Owner Last Name):
IN PEOPLE INFORMATION
PROPERTY NAME: PRIMARY PHONE:
OWNER: s k 0 N Recou rco .Z1•1 t. ( ) -
MAILING ADDRESS(STREET ADDRESS,): .;►a(53 CITY,STATE,ZIP
1 6 5- Cent e k a L wckY 12. kistoJt trick 9 acs's-3
CONTRACTOR NAME Larry Frot P C I COMPANY OFFICE PHONE:
)jO2T h Slf4 R ELt C Nort6W Spit Cter (06 ) 3e2g - X 94
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP CELL PHONE:
X405 S = -50,.c*s o,‘ SEA-Pi f k W A ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER:
go -4e - 1 0 1 $ IS_ / / ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(coPy of card required with each application) /
LENDER NAME:
(IProposed Value $5,000( DAYTIME PHONE:
( ) -
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME: COMPANY
OFFICE PHONE-
(
HONE( ) -
MAILING ADDRESS(STREET ADDRESS)• CITY,STATE,ZIP EVENING PHONE:
( • )
RELATIONSHIP TO PROJECT: FAX NUMBER'
❑ Architect ❑ Tenant ❑ Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner 0 Contractor ❑ Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: 0 YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
• ELECTRICAL PERMIT INFORMATION
i ,n
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
CI Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft=-$37 00, Each add'n 500(t=-$28 00) LI 0 to 100 amp $ 94 50 $ 58 00
❑ Detached outbuilding or garage ❑ 101 -200 amp 117.50 74 00
(Inspected with service) S 36 50 ❑ 201 -400 amp 220.50 87.00
❑ Detached outbuilding or gar age ❑ 401 -600 amp 256 50 103 00
(Inspected separately) $58 00 ❑ 601 -800 amp 332 00 140 50
NEW MULTI-FAMILY(three units or more) ❑ 801 1000 amp 405.50 169 50
Service Feeder ❑ Over 1000 amp 442 00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201 - 400 amp 117 50 58.00 CIOver 600 volts surcharge $74 00
LI 401 - 600 amp 161.00 80.00 LI Mast or meter repair $80.00
❑ 601 -800 amp 206 00 110 00 ALTERED COMMERCIAL/INDUSTRIAL
LI Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
(Inspected separately from service) ❑ 201 -600 amp 220.50
Service or Feeder LI 601 - 1000 amp 332.00
❑ 0 to 200 amp $ 72 50 ❑ over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ over 600 amp 177.00 ❑ # of circuits to be added/altered
(1-5 circuits-$74 00,Add'n circuits,$6.00/ea)
❑ # of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58 00,Add'n circuits$6 00/ea)
❑ Service over 200 amps
❑ Mast or meter repair $43.50 ❑ Medical/Educational/Institutional Facility
$74 00 plus 35%of Permit Fee
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES TEMPORARY SERVICE
U Service or feeder only $58.00
❑ Service and feeder $94.50 Commercial Residential
LI 0- 100 $58 00 $51 00
MOBILE HOME/RV PARK ❑ 101 -200 74.00 51.00
LI # of service or feeders ❑ 201 -400 87.00 n/a
(First service/feeder-$58 00,each add'n-$37.50)
❑ 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats __I__f of Signs
(First-$43 50; add'n-$13 50/ca) (First sign-$43 50, add'n sign $20 50/eal
❑ Low Voltage ❑ Swimming pool/hot tub -S87 00
Square Feet to tie ser'r'tl by systent(s( (Includes additional circuit, )(required)
❑ Fire Alarm Systcin ❑ Yard Pole meter loops... . .. ... .. .. S58 00
O Security Nairn St stent ❑ Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
1 0 Dat, Lahliri,
❑ I
(I'm r:,,'.tein('.( 1 284)0 It- `,51 4)(_,,
Each add'n 2:300 (t- 13 50) ^P, P.,.. -.,, , ,of ,,,). . ii)
1
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