05-106388 r
City of Federal Way Electrical Permit #: 05-106388-00-E L
Community Development Services
P.O.Box 9718
dWay,WA 98063-9718
Ph:(25Fe3)eral 835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: ST FRANCIS HOSPITAL PARKING IMPROVEMENTS
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Adding(5) circuits to support installation of Parking Lot Lighting.
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM R.E.P.ELECTRIC INC. R.E.P.ELECTRIC INC.
1717 S J ST 1121E 26TH ST 1121E 26TH ST
TACOMA WA 98405-4933 TACOMA WA 98421 TACOMA WA 98421
•
Additional Permit Information
Electrical Fixtures
Circuits- Commercial 5
CONDITIONS:
•
PERMIT EXPIRES Wednesday, June 14, 2006 •
Permit Issued on Friday, December 16, 2005
1 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 th City of Federal Way.
Owner or agent: G� r2 /A Date: /2 — 1 6 -0
/IC/
A THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106388-00-EL
Owner:
Address: 34515 9TH AVE S
FEDERAL WAY, WA 98003-6761
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) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) 0 Ceiling Cover(4020) ' ►` Final-Electrical(4055)
Approved Approved Approved
• 1„
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By Date By Date By,�1 Date' Vo
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pi Under-slab groundwork(4295)
( Approved rr'_
B '\V. - Date�7 Cad �K� : , . .
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.. RECEIVED
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Federal Way DEC 1 6 2005 'U.)
PERMIT SF MF CO ME J.L DE EN FP
COMMUNITY DEVELOPMENT SERVICES
333258"'AVENUE SOUTH•PO BOX 9718 DERAL •;
1 FEDERAL WAY,WA 98063-9718 APPLI CA
253-835-2607•FAX 253-835-2609 N G D F PT, --- -
www cd0o(lederalwatl.com
The ollowin• is r:•uired i ormation-an incom•lete a••lication will not be acce•ted. Please •rint le•ibly(in ink)or • .
• PROPERTY INFOR/MATION
SITE ADDRESS 3 i'/ S� dV/m i Ls 41//:-.7 S OGT( SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page Jar lengthy legal descdploo)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ,RPLUMBING 0 MECHANICAL
0 DEMOLITION, G/BLECTRICAL 0 ENGINEERING El FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
Wesfe-ti fa.k..., L44 C • 4t;, .,
PROJECT NAME(Name of Business or Owner Last Name) S.A. F•-v,4..c .'s I f c:•.,,..,,44./
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER S.A. P/'c.aC.,s N05,f f4/ ( ) -
MAILING ADDRESS Cr1Y,STATE,ZIP
3 y5/S 94.4 /Qv e . s0. /Ce't e s/ (,e/9 t JJ4 9$Q 3
CONTRACTOR COMPANY NAME APPLICANT NAME // OFFICE PHONE
REP 67ec.><,..c _Tsrc /9a f Po 6.-.e /( (a53)a7a -57/7
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
PO /3byi(/8y 7a Awa 98Y(( ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER /EXPIRATION DATE FAX NUMBER
2Q 0 Q-1 Q3 3 2 Z.- B L 12 /31 /2CX5 (0253)a7a - Si 7.0
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
k E P E' L Zit 0 Y 3 4( g. / /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
s4,1-,C AS CON/-ikC:-fO,/. ( )
MAII.ING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect 0 Tenant ❑Agent ❑ Other(Describe) ( ) -
CONTACT AME PRIMARY PHONE E-MAIL ADDRESS
.,..)Lt Z'C',(.11Tt C fr-7-) ( ) -
LENDER Per RCW 19.27.095: Lender information is NAME
required(f project value exceeds$5,000 /V / +k
MAILING ADDRESS COY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION `/
EXISTING USE (4.10441,5 PROPOSED USE A 0'k.. > £ 71
3
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
4
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD /V/7,^
FOURTH f/t
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT 0
NUMBER OF FLOORS ezts+ura F"OPOIID TOTAL TOTAL=STING AR TOTAL PROPOS=$F TOTAL ST
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
'- Value of Mechanical Work $
---------------
AIR TNG UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBgS „........, FANS HOODS f;,, - WOODSTOVES
�
BOILERS -"-��_ FIREPLACE INSERTS RANGES- MISC(Describe)
COMPRESSORS FUI�CES-....„` =GAS WATER HEATERS
DUCTS GAS PIPE OUTLET---- --
PLUMBING r'/
BATHTUBS for Tib/Shower Combo) ''"6MOWERS WATER CLOS U MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS---- SUMPS RAINWATER SYST
WASHING MAtrHINES URINALS HOSE BIBBS
LAYS(Bathroom Sinks) 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 authorised 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 Fede Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim),which may ade by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the relian of the city,includ its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE c c Pre;
re; ✓.LI*” DATE /a - /6' a S
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent X.Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
o NEW n ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES 0 NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? n YES n NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
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
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$104.50;Each add'n 500 112-$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
O 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 530.50 283.00
Service Feeder
❑ 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
❑ Oto 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY U 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 J #of circuits to be added/altered
❑ over 600 amp 212.50 1 (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
U Service- 1.000 amps or greater
❑ Mast or meter repair $52.00 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $69.50
❑ Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $61.00
❑ 4 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/EQUIPMENT
❑ #of Thermostats ❑ 4 of Signs
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea)
❑ Low Voltage U Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $104.50
❑ Security Alarm System U Additional Plan Review $104.50/hour
❑ Voice Cabling
❑ Data Cabling (for modified submittals)
❑ Automation Fee on all Permits .. $5.00
(Per System(s)1^t 2500 ft2-$61.00;
Each add'n 2500 ft2-16.00)•Per WAC 296-46-910(51b)Ii hip
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application