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03-103343
of City unity ity Development Services eveWay CommunityConElectrical Permit #:03 - 103343 - 00 - EL 33530 1st Way S Federal Way,WA 98003-6210 Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: ST FRANCIS ELEVATOR ROOM Project Address: 34515 9TH‘S vL Parcel Number: 750451 0020 Project Description: Add(1)20-amp circuit for(2)fan coil units; add(1)40-amp circuit for(1)condenser unit. Owner Applicant Contractor Hospital Bsp StFrancis THOMPSON ELECTRICAL CONTR INC THOMPSON ELECTRICAL CONTR INC 2002 ADV DEP PD 5282869 31212 12TH AVENUE CT E 31212 12TH AVENUE CT E ROY WA 98580 ROY WA 98580 (253)843-0530 Electrical Fixtures Description Quantity Description Quantity Description Quantity Circuits- Commercial 2 PERMIT EXPIRES February 11,2004. Permit issued on August 15,2003 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 Way. - V 1 Owner or agent: �_ trA Date: G �( - I Q, - ch • S'hc ,S 1D 601/. /c 40,7, �... T`` �•�c , 44. I / v RECEIVED 1` , C5 2003 CONSTRUCTION PERMIT APPLICATION CITY of A�G 1 APPLICATION NUMBER: Q 3 - L 0 3 3J 3 Federal Way U - - C�T BAY APPLICATION NUMBER: - - APPLICATION NUMBER: **The following ILD NG DEPT.is required information—Please print(in ink)or type** Please note: Electrical,Fire Prevention Systems and Engineering pennib may require a separate application. J� • PROPERTY INFORMATION SITE ADDRESS: 3 y S"0 3 q ' Ak S • ASSESSOR'S TAX/PARCEL#: - LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY); • PROJECT INFORMATION TYPE OF PROTECT(This application): o BUILDING o PLUMBING o MECHANICAL o DEMOLITION pILECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM PROD{ RIPTION(Provide detailed description): A CrJ ,03 a' r 't 1`a✓ C O ( (u J" r' ( Zo f r\.,-t - Por. 1 rD.)(Tel,/ L/AAT r4 Al PROTECT NAME: S T. �� e.4 S M T3 C. in tG1".-o-„4 h w( i/i P.razlC S is PROJECT INFORMATION PROPERTY OWNER: rr /� c DAYTIME E: r aoc, c deo, J6 ( )S1 " (bis' MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): 1?1') S o:xl.. s it T4co ., CONTRACTOR: NAME: DAYTIME PHONE: 7l/ • o soh Oecirric 4/ �6/1s/is�c_�ars, //YC_ (253)5;39 ' 0999' MAILING (STREET ADDRESS;CITY, ATE,ZIP): EVENING PHONE: OO FFA 9.5-24 LICE NSE NUMBER:a 0 (;) 10 2 9 ce / ©o L'a L (X.'3): '249 Z� CITY WAY FAX NUMBER: 2 Q - O .L — — — — - — — (26-13) .5-3q- c,o/ CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (cony a and required) d O ei Fei co Os- W 12. ' 3 I 0 3 APPLICANT: DAYTIME PHONE: N - tan om7sorr (2-s3) S37 ' or9S MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: r0 /aoi( S S. a o. Y4/V (zc& Yeth STP TO PROJECT: FAX NUMBER: o ARCHITECT o TENANT o OTHER(DESCRIBE): (2.5j,S3 5 -0101 E-MAIL ADDRESS: • CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT o CONTRACTOR • PROJECT INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES o NO WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHUNE o PRIVATE(SEPTIC) Construction Permit Fee Calculation Sheet *******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT. CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!******* Building,mechanical,and fire prevention system fees are based on the following schedule. TABLE A TOTAL VALUATION FEE FACTOR (1)$1.00 to$500.00 (1)$30.00 (2)$501.00 to$2,000.00 (2)$30.00 for the that$500.00 plus$400 for each ark ona!$100.0pa fraction thereof,to and including $2,000.00 (3)$2,001.00 to$25,000.00 $4't 51/pO (3)$90.00 for the first$2,000.00 plus$18.00 kr each addRonal SL000.00or fraction thereof,to and including$25,000.00 (4)$25,001.00 to$50,000.00 (4)$504.00 for the first$25,000.00 plus$13.00 for each additional$1,0010.00or fraction thereof,to and including$50,000.00 (5)$50,001.00 to$100,000.00 (5)$829.00 for the first$50,000.00 plus 59.00 for each addtiaaah S1.100.00or fraction thereof,to and indudig$100,000.00 (6)$100,001.00 to$500,000.00 (6)$1,279.00 for the first$100,000.00 plus SZOO for each editions/S1.000.00 or fraction thereof,to and including$500,000.00 (7)$500,001.00 to$1,000,000.00 (7)$4,079.00 for the fist$500,000.00 plus 16.00 for each addNonal$1,000,00 or fraction thereof,to and including$1,000,000.00 (8)$1,000,001.00 and up (8)$7,079.00 for the fist$1,000,000.00 plus$4.50 far each adorthoa/SL000.00or fraction thereof. Bold number is the base fee for the specified Yaaement PLUS: Add 65 percent of the base bolding permit fee for plan review fee. Add 25 percent of the base mechanical permit fee for mechanical plan review fee. Add 15 percent of the base building permit fee for Fire District#39 surcharge,commercial only. Add$4.50 for WA State Building Code Council,plus$2.00 per unit for duplex&above. **Bectrical,plumbing,and mechanical fees are cakulated separately** • BUILDING PROPOSED VALUATION: FEE FACTOR FROM TABLE A:Number: (a)Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (1) Estimated Plan Review Fee: (2) Estimated FW Fire Department Surcharge: (3) (COMMERCIAL ONLY) • MECHANICAL. PROPOSED VALUATION: FEE FACTOR FROM TABLE A:Number: (a)Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (4) Estimated Plan Review Fee: (5) • FIRE PREVENTION SYSTEM PROPOSED VALUATION: FEE FACTOR FROM TABLE A:Number: (a)Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (6) Estimated Plan Review Fee: (7) • PLUMBING Base Fee Number of Fbdures $26.00+{ X$9.00/fixture}= (8)Estimated Permit Fee Estimated Prnnit Fee X ,65= (9)Estimated Plan Review Fee Miscellaneous Fixture Charge:(10) Sub Total(Pageone): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)=(11) **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ • PROJECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: • FIXTURES Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC o GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKERS) o ELECTRIC ❑GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) • 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 flied against the City of Federal Way,but only where such claim arises out of the reliance of the dty,including its officers and employees,upon the accuracy of the information . to the dty part of this application. NAME/TITLE: tdr?.,l� ®l 1J DATE: d 6 0. ❑PROPERTY OWNER ❑APPLICANT CONTRACTOR FOR OFFICE USE ONLY: 0 NEW ❑ADDITION ❑ALTERATION 0 REPAIR 0 TENANT IMPROVEMENT CENSUS CODE: LOT SUE: ZONING DESIGNATION: BUILDING SHELL ONLY? ❑YES o NO COMP PLAN DESIGNATION BASIC PLAN? 0 YES 0 NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? 0 YES o NO PLATTED LOT? o YES o NO CHANGE OF USE? o YES ❑NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718.253-661-4000•FAX:253-661-4129 www.citvoffederalway.com ■ ELECTRICAL TABLE B NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES _Single Family _Service or feeder only $57.00 _#of Thermostats(First-$43.00;add'n-$13.00ea) (First 1300 ft2-$85.50;Each add'n 500 ft2-$27.50) _Service and feeder $93.00 _#of Low voltage fire or burglar alarms Square Feet: First 2500&-$50.00;Each add'n 2500 ft-$l 3.00 _Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet: (Inspected with service) _#of service or feeders *Per WAC 296-46-910(5)(bXi&ii) _Each outbuilding or garage $57.00 (First service/feeder-$57.00;Add'n service/ _#of Signs(First sign-$43.00;add'n sign (Inspected separately) feeder-$37 each) $20.00 each) _Swimming pool,hot tub,spa $85.50 Yard Pole meter loops $57.00 NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL ti's{ �� 'ISO COMMERCIAL/INDUSTRIAL .�� (Includes three units or more) Altered Service or Feeders Service Feeder Amps Service or Add'n _0 to 200 $ 93.00 _Up to 200 amp $ 93.00 $ 27.50 Feeder 201-600 216.50 _201-400 amp 115.50 57.00 1 0 to 100 $ 93.00 $ 57.00 `601-1000 326.50 _401-600 amp 158.50 78.50 _101-200 115.50 72.50 _over 1000 363.00 _601-800 amp 202.50 108.50 _201-400 216.50 85.50 _Over 800 amp 289.50 216.50 _401-600 25230 101.00 1-5 circuits-$72.5 k;Add=n circuits,$6 ea) ALTERED SINGLE/MULTI FAMILY _601-800 32630 138.00 (When inspected separately from the services.) _801-1000 399.00 166.50 TEMPORARY SERVICE Service or Feeder _Over 1000 434.50 232.00 Residential/Multi-Family/Commercial/Industrial _0 to 200 amp $ 71.50 _Over 600 volts surcharge 72.50 _0-100 $ 57.00 _201-600 amp 115.50 _Mast or meter repair 78.50 _101-200 72.50 _over 600 amp 174.00 _201-400 8530 _Mast or meter repair 43.00 _401-600 11530 _#of circuits _over 600 125.00 (1-4 circuits-$57.00;Add'n circuits$6 ea) If a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps,a plan review is required.Fee is 35%of permit fee+$72.50.Add--I plan review for other submissions is$85.50/hr. FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) :NUMBER OF UNITS(C) TOTAL(D) TOTAL COLUMN(D); Rai CAlurn(D) Estimated Permit Fee: (12) Estimated Permit Fee from line 12 Estimated Plan Review Fee: $72.50+( X.35)=(13) • DEMOLITION Estimated Permit Fee: (14) Bond Amount:(15) ` • ENGINEERING s Estimated Permit Fee:(16) Bond Amount: (17) • OTHER FEES Mitigation Fee:(18) (20) (22) SBCC Surcharge:(19) (21) (23) Total(Pages one&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)=(24) Bulletin#100-December 23,2002