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05-101079 • tr City of Federal Way Electrical Permit #: 05 - 101079 - 00 - EL Community Development Services P.O Box 9718 Federal Way,WA 98063-9718 Pb:(253)835-7000 Fax (253)835-2609 Inspection request line: (253) 835-3050 Project Name: ST FRANCIS SATELLITE NURSE STATION Project Address: 34515 9TH!y AVE S Parcel Number: 750451 0020 Project Description: Altering service for nurse station renovation. 1st floor. 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 ` NQuantity j Description Quantity [Alt.Serv./Feeder up to 200 amps-Co[ 1 PERMIT EXPIRES October 5,2005. Permit issued on :pril 3,2005 I hereby certify that the above inform: ion is correct and that the ,$ struction on the above described property and the occupancy and the u ,,1 bef in. cord c-w th the laws,'' - and regulations of the State of Washington and the City of Federal . / x Owner or agen : ` II(/ �1 l�lArj ZeV` Date: (AA— \1Z‘0 THIS CARD IS TO REMAIN ON-SITE CITY OFA Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 05-101079-00-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) '❑ Service(4235) 0 Feeders/Sub-panels (4045) Approved Approved Approved By Date By Date By Date 'cgi Rough Electrical(4225) , �] Ceiling Cover(4020) '� Final-Electrical(4055) Approved Approved Approved Bye Date �k B �`t',�� / Date c�7 By0. Date5 IL ;, • .❑ Under-slab groundwork(4295) - Approved By Date C;FIV EDRFS[=11� Gain;DEVELOPMENT SERVICES 33530 FIRST WAY SOUTH•PO BOX 9718 •CITY aF FEDERAL WAY,WA 98063-9718 Federal Way MAR 0 9 z0PERMIT APPLICATION - 9 zoo w6w1 w.61y &IA1Ce: ralway,6ro;129 ;14.4. 11,' ,40'4112, t rp t . ,.5 .10,44.,047g- , l_.�, t• 3,' vri .ria The oilowi • is re,aired in ormation-an inco •lete • .•iication will not be acce• d. Please •rint le, • in ink)or • 1_ • PROPERTY INFORMATION SITE ADDRESS: J 5 ckk[` Pri& S . I s t-- SUITE/APT ik ASSESSOR'S TAX/PARCEL 4F: - 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 0 PLUMBING 0 MECHANICAL 0 DEMOLITION rELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM OJECT I,ESCRIPTION Provide detailed description of work included on t ' ermit onl ): vk:2s.S St ► NA PROJECT NAME(Name of Business/Owner Last Name):5t,�(1A(S SO,. t\, t f'SR St . • PEOPLE INFORMATION PROPERTY NAME: ` PRIMARY PHONE: OWNER )ciLiQMAILING ADDRESS -L1fi erIP 1-111 S (STREET r��fi C�cm,"`(k. W Qs40S� CONTRACTOR NAME • C'�O``R�NY OFFICE PHONE: Cr altti-rt L )43(0 -sQ l0 MAILING ADRESS(STREET ADDRESS;): CITY,STATE,ZIP CELL PHONE: e? ) 01. 0 'l Suraik LA &I 0% Om* )51 cc -6bcis CITY OF FEDERAL WAY BUSIN LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER: a ( -4 a-I 0 0 0 3 1-oma (a / a ( /boos. cede )yes -osoc i3 _L_ CONTRACTOR'S REGISTRATION NUMBER: �( EXPIRATION DATE: (copy of card required with each application) E C Cc Z S (�1 . IA (4 10 /31 /OJc LENDER NAME: DAYTIME PHONE: (If Proposed Value>115,000) • J ) '4191 lLln(i ADDRESS(STREET ADDRESS;): CITY,STATE,2TP APPLICANT: NAME: /111 k-Ca-Cferr COMPANY OFFICE PHONE: MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE: ( ) RELATIONSHIP TO PROJECT: FAX NUMBER: 0 Architect 0 Tenant 0 Other(Describe): ( ) - CONTACT PERSONFOR THIS PROJECT: ❑Property Owner 0 Contractor ❑ Applicant 'E-MAIL ADDRESS: • DETAILED BUILDING INFORMATION EXISTING USE: PROPOSED USE: EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $ ' SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES ,❑ NO WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) • ■ 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? T a �xgposEn TOTAL Ewsr(NG ANI} rROPOSED **NEW HOMES ONLY"" NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ IN 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. MEClIAMCAL Value of Mechanical Work $ AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(commertiat) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/shower Comm) SHOWERS WATER CLOSETS DISHWASHERS SINKS (Toilet) MISC(Describe) DRINHING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYS WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom sink VACUUM BREAKERS ELECTRIC WATER HEATERS • 1)ISCLAIM1,Rr'S1GNATLRI: I�LOCIy I cert{fy under penalty of perjury that the it 1)I S tion furnished by me is true and cornett 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 applicati.n 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,inciuding 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 inf tion supplied to the city as a part of this application. NAME/TITLE• DATE: 3/ -t- filed (Signature) (Title) RELATIONSHIP TO PROJECT: 0 erty Owner ❑ Applicant 0 Contractor ❑ Architect ❑ ❑ .,., n DITIO�T ALTERATION: ©"REPAIR-- o' f.I f NT ;` BUILDING'SMELT.ONLYT . 0 ,c3710 F 'RABIC�A'N? "-' ta:YEB '0 NO ZONING DES t�NATiON?,.,, . ,... AGE OF USE ❑YES , o NO , NEW ADDRESS REQUIRED? c±'YES a 5 UP/SEPA/EUP" ID �`NO PLATTED OT? .f.;`,' a ES a NO l DEMO PERMIT REQUIRED? a YES r�milt Bulletin#100—January 13,2004 Page 2 of 4 k:\Handouts—Revised\Permit Application 1 • 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-$87.00;Each add'n 500 ft2-$28.00) U 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 g0 to 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 ❑ 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 )1 Medical/Educational/Institutional Facility SINGLE/MULTI FAMILY PLAN REVIEW $74.00 plus 35%of Permit Fee ❑ Service Over 400 amps $74.00 plus 35%of Permit Fee MOBILE HOMES TEMPORARY SERVICE ❑ Service or feeder only $58.00 ❑ Service and feeder $94.50 Commercial Residential ❑ 0- 100 $58.00 $51.00 MOBILE HOME/RV PARK ❑ 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 ❑ over 600 127.00 n/a MISCELLANEOUS SERVICE/EQUIPMENT ❑ #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): (Includes additional circuit,if required) ❑ Fire Alarm System ❑ Yard Pole meter loops $58.00 ❑ Security Alarm System ❑ Additional Plan Review $87.00/hour ❑ Voice Cabling (for modified submittals) ❑ Data Cabling 0 (Per System(a): la 2500 ft2-$51.00; Each add'n 2500 ft2-13.50)'Per WAC 296-46-910(50)(i&ii) Bulletin#100-January 13,2004 Page 3 of 4 k:\Handouts-Revised\Permit Application