04-101679 City of Federal Way
Conunumty Development Services Electrical Permit #:04 - 101679 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ply 253.661 4000 Fax:253.661 4129 Inspection request line: 253.835.3050
Project Name: MULTICARE MEDICAL CENTER
Project Address: 34716 1ST S AtiLS Parcel Number: 202104 9013
Project Description: Low voltage voice and data wiring
Owner Applicant Contractor
A N I INC COMMUNICATION SPECIALISTS COMMUNICATION SPECIALISTS
720 S 320TH ST#C COMMUNICATION SPECIALISTS COMMUNICATION SPECIALISTS
FEDERAL WAY WA 17280 WOODINVILLE REDMOND RD NE 17280 WOODINVILLE REDMOND RD NE
98003-5254 WOODINVILLE WA 98296 (800)877-8013
Electrical Fixtures
Description ]Quantity _ Description ;Quantity Description Quantity
Low Voltage-Other Commercial 600
PERMIT EXPIRES November 1,2004.
Permit issued on May 5,2004
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use wil be ' accord ce th the laws,rules and regulations of the State of Washington and
the City of Federal Way. C�
Owner or agent: Date: S " a /
511 (04 Ki0
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FINALED
FedPERMIT eral WayEIFCEIVED —!-
CDMMUM7YDEVELOPMEN'SERVICES
SF MF COMalp DE EN FP
33530SJ 667��1A•FAX253-661-4129
AY SOUTH•PO BOX 7/d A P P L I C AT13 2004
FEDERAL WAY, 61d / /
an„w.dtuorederalwaiLcom CITY OF FEDERAL WAY
BILJILDING DEPT.
The oliowin• is -•uired in ormation-an inco •fete a••iica on will not be acce•ted. Please •rint le•ibl in ink)or .
`� PROPERTY INFORMATION
SITE ADDRESS 317 16? �'l �� A,id /S+ Aye S, SUITE/UNIT It
ASSESSOR'S TAX/PARCEL# - _ LOT SIZE(sf
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach sepa•atepage for logthy legal description)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING o PLUMBING 0 MECHANICAL
0 DEMOLITION • ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
1- ' VOi-t VO r'Cc. ct bA+A 10 rR 165
PROJECT NAME(Name of Business or Owner Last Name) 114 it 4/6-.1 r G Inca. ,ca.( l.e t-
PEOPLE INFORMATION
PROPERTY NAME A PRIMARY PHONE
OWNER k) L LC- ( ) -
MAILIN DD CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
COr4ritUn,i Cwfib1-, S i'(')ts TrAa l .G 0 ije' (?" ) x'77-PD/7
MAILING ADDRESS CITY,STATE,ZIP , Wok CELL PHONE
17?e'c7 k'c't /n v 11� Ii 1,1A q y4 ,(dor.? ) 37? - 0357
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - -B L / / (i'.�) yes- - 32-lo
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application( EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
C.j� 73i.,0e,( -De . ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(aS3) 377 - P351
RELATIONSHIP TO PROJECTFAX NUMBER
0 Architect 0 Tenant 0 Agent dk Other(Describe) ( ) -
CONTACT NAM PRIMARY PHONE E M
AIL ADDRESS
5 t>p' beck GS3) 377- 03.S`9
LENDER Per RCW 19.27.095: Lender information is NAME
required If project value exceeds$5,000
MAILING ADDRF_SS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
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 ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
1 SEWER SERVICE PROVIDER ❑LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
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PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BAS�MENT
�a' X 30
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL.EXISTING TOTAL PROPOSED TOTAL r OSTt1NO AND PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS I/(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(cos merci,X) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(rode) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Smks)
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 of cers and employees,upon the accuracy of the information supplied to the city as a part of
this application. �/� _ n
NAME/TITLE A7!j/rJJ//// 7 DATE 437/C2
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent I(Contractor ❑ Architect 0 Other
FOR OFFICE USE ONLY
o NEW a ADDITION a ALTERATION ❑REPAIR )11'TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? ❑YES o NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? a YES ❑NO
Bulletin 11100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application
ELECTRICAL PERMIT IN..4:17 :.TATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201-400 amp 220.50 87.00
❑ Detached outbuilding or garage ❑ 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 ❑ Over 600 volts surcharge $74.00
❑ 401 -600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
❑ 201 -600 amp 220.50
Service or Feeder ❑ 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)
$74.00 plus 35%of Permit Fee
❑ Mast or meter repair $43.50 ❑ Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES
❑ Service or feeder only $58.00 TEMPORARY SERVICE
❑ Service and feeder $94.50
Commercial Residential
MOBILE HOME/RV PARK ❑ 0-100 $58.00 $51.00
❑ #of service or feeders ❑ 101 -200 74.00 51.00
(First service/feeder-$58.00;each add'n-$37.50) ❑ 201 -400 87.00 n/a
❑ 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
U #of Thermostats ❑ #of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) 0 (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $58.00
O Security Alarm System ❑ Additional Plan Review $87.00/hour
Voice Cabling (for modified submittals)
Data Cabling
(Per System(s) 1•,2500 ft2-$51.00,
Each add'n 2500 ft2-13.50) 'Per WAC 296-46-910(501(136 u)
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Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Permit Application