05-103236 a
City of Federal Way Electrical Permit #: 05 - 103236 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax (253)835-2609 Inspection request line: (253) 835-3050
Project Name: FEDERAL WAY AMBULATORY SURGERY CENTER
Project Address: 34612 6TH4S Suite100 Parcel Number: 926480 0010
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Project Description: Install low-voltage thermostat for HVAC.
Owner Applicant Contractor
FWASC,LLC MAJOR ELECTRIC INC. MAJOR ELECTRIC INC.
FWASC,LLC 18538 142ND AVE NE 18538 142ND AVE NE
PO BOX 890 WOODINVILLE WA 98072 WOODINVILLE WA 98072
BLACK DIAMOND WA 98010 (425)483-2677
Electrical Fixtures
D_escription Quantity Description 'iQuantityi Description Quantity]
Thermostat 1
PERMIT EXPIRES January 2,2006.
Permit issued'.on July 6,2005
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 the,laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: /-. Date:
04
Ivo
\\
... THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-103236-00-EL
Owner: FWASC, LLC
Address: 34612 6TH AVE S Suite 100
FEDERAL WAY, WA 98003
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.
0 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) .LI Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date ' By Date
❑ Rough Electrical(4225) W Ceiling Cover(4020) VIFinal-Electrical(4055)
Approved Approved Approved
By Date By ,Ais Date C K By :IN Date `0 'zkV
❑ Under-slab groundwork(4295)
Approved
By Date
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CITY OF �-
0 5 ( 01- 2- 3 (---
Federal Way PERMIT REcEIKED
COMMUNIY DEVELOPMENT SERVICES co M E •L D E E N FP
333258*"AVENUE SOUTH•PBOX 9718 APPLICATIONIU
FEDERAL WAY,WA 980633 971
-9718 L, 0 T/.pOO5 /
253-835-2607•FAX 253-835-2609 `4'
Immo.cil tlofjederalwnq.corn CITY OF F(r l]ER
The oilowin. is re.uired in ormation-an income lete a.•lication wiiiB(J D• 4,, i AAI_ �Yease .rint le.ibi (in in or .•.
• PROPER ` 0 . -er•r• • s
t n 41,
SITE ADD• ' I � -ASV ArrM SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)�
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(.Attach separate page for lengthy legal descnpnoo)
IN PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION f ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PRO T DESCRIPTION (Provide detailed description of work included on this aermit onl))
PROJECT NAME(Name of Business or Owner Last Name) akAillit _ K4Sfir-
U PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER ( ) -
MAILING ADDRESS CITY,STATE,ZIP
CONTRACTOR CO E I NT NAM OFFICE PHONE
MAILING ADDD ESS CITY,STATE,ZIP CELL PHONE
Xel /.45' �7.' f-, �%ii�/i/, Q 1 )
CITY az FED Y BUSINESS/ � LI
NSS .EUU�MMBER EXPIRATION 6ATE� FAX NUMBER
/g�
L g--g l i / 50 J- B L i& / 3/ l �i7.i�`� -��2/7e7c/
CONTRACTOR'S REGISTRATION NUMBER(copy of card required 'tit each application) EXPIRATIO.WDATF
O��/r1} 7' l6
APPLICANT COMP NAME APPLICANT NAME OFFICE PHONE
_ 0' .6/- (
MAAACIl* *ADDRESS CITY,STATE,ZIP - CELL PI TONE
ELATIONSHIPT ROJ ECT FAX NUMBER
❑ Architect ❑ Tenant ❑Agent 0 Other (Describe) ( ) -
CONTACT �� PRIMARY PHONE E-MAIL ADDRESS
1✓;)r2�/�r ,,I 7 i9762:5r.5 - 074/6
LENDERPerRCW19.27.095::Lenderinformationis NAME
required if project value exceeds$5,000
MAILING ADDRESS 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 ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
•
DECK(COVERED?)
GARAGE ❑ CARPORT❑
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
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.
MECILANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commerdat) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(orTub/ShoaerCombo) SHOWERS WATER CLOSETS(Todet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom lois) 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 ci including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLEAith/6Zorf DATE 4 5/5re) (Title) /RELATIONSHIP TO PRO ❑ Owner o Agent ❑ Contractor ❑ Architect �ther r!'�llyte.�
FOR OFFICEVSE ONLY-
o NEW o ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? o YES ❑NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? a YES_ a NO UP/SEPA/SU? o YES a NO
PLATTED LOT? ❑YES a NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#100—January 7,2005 Page 2 of 4 k\I landouts\Pcrmit Application
FORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
CI Family Square Feet Service or Feeder Each Add'n
(First 1300 ft,-$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
LI Detached outbuilding or garage ❑ 401 -600 amp 308.00 123.50
(Inspected separately) $69.50 ❑ 601 -800 amp 398.50 168.50
LI 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) LI 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
LI 601 -800 amp 247.00 132.00
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ 0to200amp $113.50
ALTERED SINGLE/MULTI FAMILY LI 201 -600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder
LI over 1000 amp 443.50
Li 0 to 200 amp $87.00
LI 201 - 600 amp 141.00 LI # 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
LI Service- 1,000 amps or greater
❑ Mast or meter repair $52.00 LI 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
❑ # 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
LI 101 -200 amps 89.00
❑ 201 -400 amps 104.50
❑ 401 -600 amps 141.00
LI over 600 amps 152.50
MISCELLANEOUS SERVICE/EQUIPMENT
Al j #of Thermostats ❑ # of Signs
� irst-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea)
'A Low o .ge U Swimming pool/hot tub $87.00
Square Fe> to be served by system(s (Includes additional circuit,if required)
❑ Fire Ala. System LI Yard Pole meter loops $104.50
El Sec •'y Alarm System LI Additional Plan Review $104.50/hour
El V.ce Cabling (for modified submittals)
El t ata �� LI Automation Fee on all Permits $5.00
(Per System(s) 1.,2500 ft2-$61.00;
Each add'n 2500 ft2-16.00) •her WAG 296-4�O)(14(i&ii)
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application
•
This is art overview of possible fees associated with the issuance of permits and is not intended to be inclusive.
PERMIT FEES
Building,mechanical,and fire prevention system fees are based on the following schedule.
**Electrical and plumbing fees are calculated separately**
1
TOTAL PROJECT VALUATION INCREMENTAL FEE FACTOR
(1)$1.00 to$500.00 (1)$31.00
(2)$501.00 to$2,000.00 (2)$31.00 for the first$500.00 plus$4.00 for each additional$100.00 or fraction thereof,to and
including $2,000.00
•
(3)$2,001.00 to$25,000.00 (3)$91.00 for the first$2,000.00 plus$18.50 for each additional$1,000.00 or fraction thereof,to and
including$25,000.00
(4)$25,001.00 to$50,000.00 (4)$516.50 for the first$25,000.00 plus$13.50 for each additional$1,000.00 or fraction thereof,to
and including$50,000.00
(5)$50,001.00 to$100,000.00 (5)$854.00 for the first$50,000.00 plus$9.00for each additional$1,000.00 or fraction thereof,to
and including$100,000.00
(6)$100,001.00 to$500,000.00 (6)$1,304.00 for the first$100,000.00 plus$7.50 for each additional$1,000.00 or fraction thereof,
to and including$500,000.00
(7)$500,001.00 to$1,000,000.00 (7)$4,304.00 for the fist$500,000.00 plus$6.00 for each additional$1,000.00 or fraction thereof,to
and including$1,000,000.00
(8)$1,000,001.00 and up (8)$7,304.00 for the first$1,000,000.00 plus$5.00 for each additional$1,000.00 or fraction thereof.
Table A
PLAN REVIEW FEES
• Building Permit 65% of Building Permit Fees
• Mechanical Permit • 25% of Mechanical Permit Fees
• Plumbing Permit 65% of Plumbing Permit Fees
• Additional Building Division Review $63.50/hour
PLUMBING PERMIT FEES
• $26.50 Permit Fee plus $9.00 per fixture
OTHER FEES (Vary according to project type and scope)
• WA State Building Code Council (SBCC) Surcharge $4.50/issued permit
• Fire District #39 review fees (commercial only) 15% of building permit fees
• Public Works review fees Hourly/varies by project
• School District impact Fees (new residential only) $3,011.50/single-family residence
$950.50/multi-family unit
• Automation fee on all permits $5.00
• Demolition permit fees
• Required bond(s)/deposits
If you need assistance completing the permit application form, or have questions
concerning the application process, please contact:
Community Development Customer Service Counter at (253) 835-2607
8:00 am to 5:00 pm, Monday through Friday
Bulletin#100-January 7,2005 Page 4 of 4 k\l landouts\Permit Application