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04-105095
ato City of Federal Way Electrical Permit #: 04 v 105095 - 00 - EL Community Development Services P.O.Box 9718 a Federal Way,WA 98063-9718 Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305C Project Name: GROUP HEALTH FEDERAL WAY MEDICAL CENTER Project Address: 301 S 320TH$t Parcel Number: 152104 9055 Project Description: Add 3 circuits and alter 3 circuits to serve recepticle boxes at nurses stations. Owner Applicant Contractor GROUP HEALTH-FW MEDICAL CENTER PRIME ELECTRIC INC PRIME ELECTRIC INC GROUP HEALTH-FW MEDICAL CENTER 13301 SE 26TH ST 13301 SE 26TH ST 301 S 320TH ST BELLEVUE WA 98005 BELLEVUE WA 98005 FEDERAL WAY WA 98003 (425)747-5200 Electrical Fixtures Description Quantity Description Quantity Description Quantity Alt.Serv./Feeder up to 200 amps-Co{ 6 PERMIT EXPIRES June 14,2005. Permit issued on December 16,2004 I hereby certify that,the above information is correct and that the construction on the above described property and the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and the City of Federal Wa Owner or agent: w Date: I Z - 1 "0-1 ° \9-\ THIS CARD IS TO REMAIN ON-SITE CITY OF ,A Community Development Inssction Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 04-105095-00-EL Owner: GROUP HEALTH - FW MEDICAL CENT • Address: 301 S 320TH ST 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. O 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) . ❑ Feeders/Sub-panels(4045) Approved Approved Approved By Date By Date By Date ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) gi Final-Electrical(4055) Approved Approved Approved I By Date By Date Bye. I Date ' ' ` ❑ Under-slab groundwork(4295) Approved By Date .r,, 9, RECEIVED A. .cp - o_. 0 5 Federal Way DEC 1 6 2004 PERMIT COMMUNITY DEVELOPMENT SERVICES SF MF CO MEO'L DE EN FP 3353EDERAL AY,WA •roOFFED ERt� tPLICATION T° FEDERAL WAY,SOUTH 9•FO BeB 718 N I 1 / / 253-661-4115•FAX 253-661-4129 BUILDING D - www.cituofederalwau.com The ollowin• is re•aired in ormation-an inco •Tete a• •lication will not be acce•ted. Please •rint le•ibl in ink or •e. PROPERTY INFORMATION SITE ADDRESS 301 S• 770 SUITE/UNIT# ASSESSOR'S TAX/PARCEL# - LOT SIZE (sf) LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal description) PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION XELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this p it onlu) (o - c. (keted f.“4"/ ci rw; . Skalt ext..) .V-toor boxer Oki- i►tAIse, $ athe"s PROJECT NAME(Name of Business or Owner Last Name) & tovr Q 0.14 eaeao WAt� �L�tGl. A e✓1'�C�/ PEOPLE INFORMATION J PROPERTY NAME / PRIMARY PHONE OWNER COOiioca' _ O ( - 2 ,� SCITYSTATE,ZIP t50E I9MI Via) S v w;`a1 LQ 9 g 1 2 A CONTRACTOR C PANY NAME APPLICANT NAME OFFICE PHONE rci��. E`ec\i . /kf.2• 16trl (425 )�`? l -C�?,� MAILING ADDRESS CITY,STATE,ZIP J CELL PHONE t33d se 2.444%51- '51- (ttv14.) wA 9 8o05 ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER 2 0_-t2 Q-1 O \_ "3 t Z-B L 12 / 30 / by (142)1H7 -5S62- CONTRACTOR'S 5S62CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE Qg1JEE. li3YgT' ' / 3o / o$ APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE ?r%.A.N2 E le.c r c. Amt. Ger9 (L(25)1H7 -cAve tMAILING�33Dt ADDRESS 6 S4- w( `/T` 9$oS A ZIP CELL PHONE - RELATIONSHIP TO PROJECT `J //'' FAX NUMBER 0 Architect 0 Tenant 0 Agent Other(Describe)(..D 1 Wlit (% 141 -6562 CONTACT NAME r itc f7 _ _ PRIMARY PHONE_q1 - S E-MAIL ADDRESS 2-00 LENDER 1 I5 NAME ,(� Per RG3F 19,27©96:`Lender tr{/armation is . required> 'protect value exceed*$5,000 MAILING ADDRESS CITY,STATE,ZIP DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 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? TOTAL rxIrnsaTOTAL PROPOSED TOTAL EXISTING AND PROPOSED **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. 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/Shower Combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom slob) 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 officers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE DATE I 2.-- 1 -oil (Signature) (Title) RELATIONSHIP TO OJECT 0 Owner 0 Agent Contractor 0 Architect 0 Other t;OFFICE US ONL C ❑NEW o ADDITION o ALTERATION o REPAIR ❑.TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? o YES o NO ZONING DESIGNATION CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? n YES o NO UP/SEPA/SU? o YES o NO PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? ❑YES o NO Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application O ' ELECTRICAL PERMIT INFORMATION 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 U 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(s)tat 2500 ft2-$51.00; Each add'n 2500 ft2-13.50) •Per WAC 296-46-910(5)(b)(i&ii) t Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Permit Application