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05-102495
f w y City of Federal Way El• ectrical Permit #: 05-102495-00-EL Community Development Services PO.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-2607 Fax'(253)835-2609 Inspection Request Line: (253) 835-3050 Project Name: LIFE CARE CENTER . • Project Address: 33590 6TH AVE S Parcel Number: 926500 0030 Project Description: New 1200amp service with various low voltage work Owner Applicant Contractor FEDERAL WAY LLCA ASSOCIATES LLC ADVANTAGE CONSTRUCTION HIGH COUNTRY ELECTRIC 3570 KEITH ST NW MANAGEMENT CONSTRUCTION INC CLEVELAND TN 37312-4309 1521 15TH ST NW SUITE 3 HIGHCEC982K1(7/5/08) AUBURN WA 98001 4251 S NATCHES CT UNIT M LAA,y ENGLEWOOD CO 80110 • aTdrA./ 143G07-4 - Additional Permit Information Electrical Fixtures Low Voltage-Other Commercial..11,08! Low Voltage Burglar Alarm -Cor 11,08! Low Voltage Fire Alarm-Commel1,08: Service/Feedan over1000 amps-C 1 Thermostat 5 PERMIT EXPIRES Saturday, July 26, 2008 Permit Issued on Wednesday, August 1, 2001 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the se will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. �- 1 07Owner or agent: Date: � / b p • A THIS CARD IS TO REMAIN ON-SITE , CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 05-102495-00-EL Owner: FEDERAL WAY LLCA ASSOCIATES LLC Address: 33590 6TH AVE S . FEDERAL WAY, WA 98003-6336 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 8 "'A2/ .Q7 By Date By Date .- ❑ Temporary Power(4275) ❑ Service(4235) 0 Feeders/Sub-panels (4045) Approved Approved Approved By Date . ByCi;) Date f- 4g '6) By Date y• ❑ Rough Electrical(4225) 0 Ceiling Cover(4020) ❑ Final-Electrical(4055) Approved Approved -7 Approved By CH�/1/ Date l 2• 3-a7 By Date .7 'Q 6 By 0 )3 Date 3 -L L(_OR ❑ UFER Ground(4295) Approved 4By A!- Dates' 67 • For inspector reference only__ __ 0 Rough Electrical 0 FINAL-Electrical Approved Approved By Date By Date - o � a \1 U' G _ p f ' it"� to M J 'j I C � y 1 I � � LBuilding givision 4416, CITY OF • 33325 Eighth Avenue South �- FederaIWay PO Box 9718 Federal Way,WA 98063-9718 Phone 253-835-2607 Fax 253-835-2609 CORRECTION NOTICE ADDRESS: 3S 6 `"A-1/Z- 5. PERMIT#: D5' /'Z �` - aC-�L 2-SC.`j Z 4- PP//c2" IF YOU HAVE ANY QUESTIONS CALL X''6A/ (253) 835- 2-6 3 WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE-INSPECTION. SEE BACK OF CARD FOR DETAILS. 2- -1/1- )6* DATE INSPECTOR DO NOT REMOVE THIS NOTICE Page of Division , in • lk CITY OF 333d25 gghth Avenue South v.A ..,, Federal Way • PO Box 9718 Federal Way 98063-9718 Phone 253-835-2607 Fax 253-835-2609 INSPECTION NOTICE ADDRESS: 33 0 1/L A/�S . #: os/oz4-9S=—EL _Z, /14--4 Z_s--o . Coco ..7-;_sz‘ .// .01 'r-0X,' e-c- • ?-r-ocisiDt)q e `e G4 a cle G&i i G.7�Av/r— 4 c A.:4-e1(--- .S-e_re, C-G 1 Z • G ?..6i 0 -46.B - 7..33 0 - / 3 Rrov•'o�•-e- 6- F P 71---c-es-74... 7j-K + 000 ABPs wt 4)6 s-e.:44- 1�� -0-f.,-1___ .s-e c- ov�r-c (.gr,e.-rf Pro -ce-(--,'w%. -Aevec- - ©V t. IF YOU HAVE ANY QUESTIONS CAL ( os-el& S •C (253) 835-7-4-Ze Call for reinspection before cover WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE-INSPECTION. SEE BACK OF CARD FOR DETAILS. - Z - s —vg DATE INSPE TOR DO NOT REMOVE THIS NOTIC Page of f AETADVANCED ELECTRICAL SYSTEM GROUND FAULT -T `: TESTING 0 TEST REPORT c PROVIDING ELECTRICAL SOLUTIONS WORLDWIDE CUENT TEST EQUIPMENT -TEST EQUIPMENT CAUBRATION JOB NUMBER High Country Electric 60-0106 1128108 CUSTOMER _ LOCATION ENGINEER DATE • • Life Care Federal WayWA Kevin Omits 2/7/08 SWITCHBOARD MFGR. CATALOGAIIODEL NUMBER UL NUMBER VOLTAGE/CURRENT RATING SYSTEM VOLTAGE SIEMENS 19-23449-A00010.01 F-390303 1200 480 MAIN OVERCURRENT DEVICE MFGR. CATALOG/MODEL NUMBER DEVICE VOLTAGE/CURRENT RATING TYPE SIEMENS NG NA 490/1200 BREAKER GROUND FAULT MFGR. CATALOG/MODEL NUMBER GROUND FAULT SYSTEM PICKUP RANGE GE MULTILIN BGFL 0 GROUND STRAP 100-1200 SETTINGS SUPPLIED BY AS FOUND SETTINGS AS LEFT SETTINGS RESIDUAL TIME DELAY RANGE • I NA PICK-UP 200 TIME .1 PICK-UP 800 TIME .1 ZERO SEQUENCE .1 -1 E ENTRANCE CONDUCTORS MAIN BONDING JUMPER GROUND ELECTRODE CONDUCTOR • 114X3 2 PERPHASE 114X3 2 I AWG ❑ KCMIL NEUTRAL GROUND LOCATION 'MONITER/TEST PANEL OPERATION CONTROL POWER TRANSFORMER CORRECT III CORRECT 500 VA • INCORRECT INCORRECT SYSTEM NEUTRAL INSULATION TO GROUND RESISTANCE CORRECTED BY CONTRACTOR CORRECTED BY CONTRACTOR )•574 M = c BREAKS ITCH REACTION TIME REDUCED VOLTAGE TEST 56% PICK-UP CURRENT , -" t ) PICK-UP CURRENT MINUS 2bli(AMPS, W .01 CORRECT SO0 CORRECT 0INCORRECT PRIMARY CURRENT ' MFGR. �' AMPERE-TURNS PERCENT PICK-UP TOTAL TIME REACTION TIME RELAY TIME TOL. ^v TIME CURRENT o CALIBRATION TESTS 600 150 .11 - .01 .1 .01 — w REMARKS 800 200 .1 .01 .09 _ .01 • PICK UP TEST AT 800 AMPS. TIME TEST AT 400 SETTING. -' w C z 0 co T w .o b cc cr, PAGE a N 335;z? co 'IL c-e( e- 1. 1( ((_ .-- Federa Wa ‘..._,,, $) 2 .• 0 c -.._, 33325 dm^A'DEVNUE LOPMSOUTH o��. PERMIT SF MF COM L L DE EN FP FEDERAL WAY WA 98063-9718 ��JJ J _ / 0,s--- 253-835-2607. FAX 253-835-2600?` A PLICATION �`/�//�www.dttroliederdway.wm �:Fep Ppb. The ollowi • is :i.,1,-R •-.• on-an{rico •tete • ••lication Will not be acce•ted Please •rint le.ibi in in or • PROPERTY INFORMATION5,334-f-4 SITE ADDRESS 4/ Co,-y),P.Irr�1Dr 6-81//P. 5. i d,33 4 f n 9; SUITE/UNIT# A ASSESSOR'S TAX/PARCEL# 9 ( , 5 0 (2 - 6 (/2 a 0 LOT SIZE(s,7 6�i 1s(7 t,GN. LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) ee n ti erf (Attach seParatcPc.for ar kg.,des.i0.) • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION i,ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this •-rmit onl _� , t f t ' i�MW��LRr�►7Lt►A- D ■ tit.,.a-...r. lr_"MIMs!AV/L27S/NLRL:16710:111 P9 k�� 1 1 I / 4 1/ - co 4 PROJECT NAME(Name of Business or Owner Last Name)i. e C wr('st.tilt,0✓5 D'� rtel•Gr1 '/Y/ry'Li west bidi)S MI PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE OWNER Fed&( a( Wald, - `.CCI- )9-5'Saciu'1Gs LLL (Y23) /f 73 -6767 MAILING ADDRESS CITY,STAT ZIP . -7O Ke f-(, Si-. NE C f evcIar j, TR 373%Z CONTRACTOR s'COM � OFFICE PHONE NAME APPLICANT NAME ,,, n ',. L MAILING TE,ZI CELL PHONE • M . / Cam ++�� 8 C - CITY OF FEDERAL WAY BUSINESS(LICENSE NUMBER I I4RATION DATE FAX NUMBER J - - _B L / / ( CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE / / APPLICANT COMPANY NAME APPLICANT NA E ] Q /� j / OFFICE PHONE �/ T 1 1��4 H f.eo rI� /7 ��C(sf W!�4 �DYI a (4/23 ) /73 -S-1/,6 MA`ILING A RESS / CITL(STATE,ZIP - CELL PHONE [j ��y RELATIONSHIP TO RW PROJECT R ©Id Paid , 37362 ( Ly23)7,5- - 76 / FAX NUMBER Architect 0 Tenant 0 Agent 0 Other(Describe) ( y23)33 3? - 9334 E-MAIL ADDRESS CONTACT N ME PRIMARY PHONE tea# I mad ( /23) 4'73 -S'f/1, , , _ ; L ' LENDER >• ;tel:' :t'.i:zrt K.):).43"; tZfXlrii lYr,l x< NAME MAILING ADDRESS CITY, ATE,ZIP • DETAILED BUILDING INFORMATION /r EXISTING USE V ettnit o f L/°J PROPOSED USE 6;4I ee B w t I'i riy EXISTING ASSESSED/APPRAISED VALUE $ y cod eCO• VALUE OF PROPOSED WORK $ // / POI 000 SPRINKLERED BUILDING? )e'YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? it YES 0 NO WATER SERVICE PROVIDER p LAKEHAVEN 0 HIGHLINE CI TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER PI LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT /`� FIRST I.. S y�,GSrj OTr'r�Ls 4.5SC'►+11) 14-D m A�4 // oss- /f, o85 SECOND (i THIRD FOURTH . ADDITIONAL FLOORS(DESCRIBE) • DECK(COVERED?) GARAGE 0 CARPORT 0 !OUSTING PROPOSED TOTAL �,..,,bx PROPOSED S s,a• AL r:•T"` NUMBER OF FLOORS :. **NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ • AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS ' FANS HOODS(commereia) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING / BATHTUBS(or Tub/Shower Combo) SHOWERS (O WATER CLOSETS(roue) I MISC(Describe) DISHWASHERS / SINKS Z DRINKING FOUNTAINS `11.O/ s/k k- GAS PIPE OUTLETS SUMPS 1 RAINWATER SYST WASHING MACHINES 3 URINALS 3 HOSE BIBBS LAVS(BathroomSioks) VACUUM BREAKERS / ELECTRIC WATER HEATERS 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 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 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,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. /f NAME/TITLE ci'`i6.6a_ Z DATE 5 S L� ( i6nature) (Title) RELATIONSHIP TO PROJECT ❑ Owner #Agent ACContractor 0 Architect ❑ Other m •::avft_," `l "t (.94 • � 7: '.7„1a v!s7 :4,C.'!f P.s'.�. ' • " L,)I 3,(E) = '� yjtt � }.�y , 1:0 .,it�t1S[?) (e)4+,k1 '•`• s L. ;E )� r ?,1f--) ��•_ • OT;iDoaii 76i _'l ' �1 SO) R �� .;. Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application ELECTRICAL PERMIT INFORMATION RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE Service or Feeder Each Add'n ❑ Single Family Square Feet (First 1300 ft2-$104.50;Each add'n 500 ft2-$33.50) ❑ 0 to 100 amp $113.50 $69.50 ❑ Detached outbuilding or garage ❑ 101-200 amp 141.00 89.00 (Inspected with service) $44.00 ❑ 201-400 amp 264.50 104.00 ❑ Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50 (Inspected separately) $69.50 ❑ 601-800 amp 398.50 168.50 ❑ 801 - 1000 amp 486.50 203.50 NEW MULTI-FAMILY(three units or more) T Over 1000 amp 530.5Q , 283.00 Service Feeder _ 7 D.5--c_ ❑ Up to 200 amp $113.50 $33.50 ❑ Over 600 volts surcharge $89.00 ❑ 201 -400 amp 141.00 69.50 ❑ Mast or meter repair $96.00 ❑ 401 -600 amp 193.00 96.00 ALTERED COMMERCIAL/INDUSTRIAL 0 601 -800 amp 247.00 132.00 ❑ Over 800 amp 353.50 264.50 Service or Feeders ❑ 0 to 200 amp $113.50 ALTERED SINGLE/MULTI FAMILY 0 201 -600 amp 264.50 ❑ 601 - 1000 amp 398.50 Service or Feeder ❑ over 1000 amp 443.50 ❑ Oto 200 amp $87.00 ❑ 201 -600 amp 141.00 ❑ #of circuits to be added/altered ❑ over 600 amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea) ❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW (1-4 circuits-$69.50;Add'n circuits$7.00/ea) $89.00 plus 35%of Permit Fee 7 b-, Service- 1,000 amps or greater ❑ Mast or meter repair $52.00 ❑ Medical/Educational/Institutional Facility MOBILE HOMES ❑ Service or feeder only $69.50 i ❑ Service and feeder $113.50 8 9 ,00 TEMPORARY SERVICE 1 MOBILE HOME/RV PARK Residential/Multi-Family $61.00 ❑ #of service or feeders (First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Ampacity ❑ 0-100 amps _ $69.50 $ 101-200 amps 89.00 ❑ 201-400 amps 104.50 ❑ 401-600 amps 141.00 ❑ over 600 amps 152.50 MISCELLANEOUS SERVICE/ UIPMENT ea Jt #of Thermostats I ) 6. 0 v Yfr #of Signs (First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea) ja Low Voltage ❑ Swimming pool/hot tub $87.00 Square Feet to be served by system(s) 1/1 d 6S (Includes additional circuit,if required) 0 Fire Alarm System J ❑ Yard Pole meter loops $104.50 ii Sec tyy Alarm System �25 0 ❑ Additional Plan Review $104.50/hour 1 Di Voice Cabling (for modified submittals) Al Data Cabling ❑ Automation Fee on all Permits $5.00 0 (Per System(s) 1.2500 ft2-$61.00; Each add'n 2500 ft2-16.00) •Per WAC 29646-910(5)(b)#&5) Bulletin#100-January 7,2005 Page 3 of 4 1 ( -) ,..1 k\Handouts\Permit Application