05-101078 City of Federal day Electrical Permit #:, 051- 101078 - 00 - EI
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)83522609 Inspection request line: (253) 835-305C
Project Name: ST FRANCIS MOBILE PET SCAN
Project Address: 34515 9TH a.AVE,S Parcel Number: 750451 0020
Project Description: Adding 150amp feeder to mobile pet scan.Located in south parking lot.
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM VECA ELECTRIC CO INC VECA ELECTRIC CO INC
1717 S J ST PO BOX 80467 PO BOX 80467
TACOMA WA 98405-4933 SEATTLE WA 98108 SEATTLE WA 98108
(206)436-5200
Electrical Fixtures
Description Quantity Description lguantity , Description Quantity
Alt.Serv./Feeder up to 200 amps-Co' 1
PERMIT EXPIRES September 26,2005.
Permit issued on March 30,2005
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the u •a •- in cordan, with the laws,ru' and regulations of the State of Washington and
the City of Federa ay. (32
Owner or agent: Date:
d{ -
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection, Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-101078-00-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.
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) �❑ Service(4235) 0 iii,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
By Date By Date B '1 Date 47 IA-\ -
0
Under-slab groundwork(4295)
Approved
By Date
RECEIVED _$j\/
X EDn
_MMUN/TYDEVELOP L S
33530 FIRST WAY SOUTH•PO BOX 9718
CRY
FEDERAL WAY,WA 98063-9718
IIi.••deral Way- MAR O 9 2ooPERMIT APPLICATION ', n 9 2005 253-661-4115*FAX:253-661-4129
www.cityoffederalway.com
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The ollowi • is '•aired i ormation-an Inco •tete • • •lication will not be acce•ted. Please •tint le• •1 in in or p
c n (� S • PROPERTY INFORMATION
SITE ADDRESS: -Ilk CS S C 1r_� A , _ Ste. l( p i�C� La+ 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): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
`'ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DRSCRIPTION(Provide detailed description of work included on this permit only):
\\‘h R6c2. t(C-717V(T
( 41011 �.Sc 'eece-kr
PROJECT NAME(Name of Business/Owner Last Name): SI f"fz vv j S MD 10<<e Se/w c�
• PEOPLE INFORMATION
PROPERTY ac � PRIMARY PH E:
OWNER G, W\1
4-1/''
MAILING ADDRESS(STREET ADDRESS;(: CITY, 51ATE,ZIP
1'1 Z S. ` .1 3\-j I ' core 1,..)ft 1114
CONTRACTOR NAME CVOANY OFFICE PHONE:
vEtA
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LING D RES CITY,STATE ZIPOd-k (k 163 C (' )S1rl
Li
CITY OF FEDERALOWAY BUSINESSVtA S• V_LICENSE NUMBER: itEXPIRATIONDA/E�� FAX �r z.3 _W+O
OL.
NNTTRACTORSSRREGISTRATIONNUMBER: � EXPIRATION DATE:
(copy of card required with each application( C. C `V / 31 /W
LENDER NAME: DAYTIME PHONE:
(If Proposed Value>$5,000) ( ) -
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME: COMPANY OFFICE PHONE:
MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 Architect ❑ Tenant 0 Other(Describe): ( ) -
•CONTACT PERSON FOR TFIIS PROJECT: ❑Property 0alhar D Coatractar ❑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 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
4 • PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL swsma, TOTAL PROPOSED TOTALEXiSTTQ AND PRuP°SED
**NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ FIXTURES
Indicate number of each type of fixture that is 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(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/ShoaerCombo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sink VACUUM BREAKERS ELECTRIC WATER HEATERS
llISCLAI\1E1 SIG\ATChi: HL(/(
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 accuracy of the ormation supplied to the city as a part of this application.
NAME/TITLE: g1-111DATE: J C 1 b J
(Signature) (Title)
RELATIONSHIP TO PROJECT: ❑ perty Owner 0 Applicant 0 Contractor 0 ArchitectWir ❑
¢ 9 8x1ez g
n ADDITIOIP ri.ALTERATIO El REPAIR• // p:TEN 1 JT
BUILDING sigma. LY? n'TICS 0 NO
ZONING DESIGNATION. .. --r CHANGE 4OF USES , ',Ia'TES in NO
NEW ADDRESSREQUIRED? x.; LINER o'NO Tom/SEPI#,'/SU?i ID TES tr NO
PLATTED T? n S :I]i 10 MEMO.PERMIT REQUIRED? a TES; rs NO
Bulletin#100—January 13,2004 Page 2 of 4 k:\Handouts—Revised\Permit Application '
' ■ ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
CI Family Square Feet: Service or Feeder Each Add'n
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage 0101-200 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
U Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ,L>I • 200 amp $ 94.50
(Inspected separately from service) 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 amp $ 72.50 ❑ over 1000 amp 369.50
U 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 "yot Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW $74.00 plus 35%of Permit Fee
❑ Service Over 400 amps
$74.00 Pius 35%of Permit Fee
MOBILE HOMES TEMPORARY SERVICE
U Service or feeder only $58.00
❑ Service and feeder $94.50 Commercial Residential
❑ 0- 100 $58.00 $51.00
MOBILE HOME/RV PARK U 101 -200 74.00 51.00
❑ #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
U over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats U #of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/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 U Yard Pole meter loops $58.00
❑ Security Alarm System U Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
0
(Per System(s): 1St 2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) *Per WAC 296-46-91 o(5)(b)(i es ii)
Bulletin#100-January 13,2004 Page 3 of 4 k:\Handouts-Revised\Permit Application '