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03-102210 r i .. City of Federal Way • Community Development Services Electrical Permit #:03 - 102210 - 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: VIRGINIA MASON Project Address: 33501 1ST Ai ways Parcel Number: 926504 0010 Project Description: Installing 2'x2'x4"communication box with locking door for phone punch down blocks w/2-2"FMT out the bottom.Altering up to 4 circuits for new receptacles&switches on 2nd floor GIM area. Owner Applicant Contractor Mason Clinic Virginia BAINBRIDGE ISLAND ELECTRIC BAINBRIDGE ISLAND ELECTRIC 1100 9TH AVE PO BOX 10066 PO BOX 10066 SEATTLE WA BAINBRIDGE ISLAND WA 98110 BAINBRIDGE ISLAND WA 98110 98101-2756 (206)842-4200 Electrical Fixtures 55 •tl �� . .. Circuits- Commercial 1"' Low Voltage-Other Commercial 1 PERMIT EXPIRES November 25,2003. Permit issued on May 29,2003 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.See or agent: Application Date: (2 c (D" ---g) '7 ( - 3 c65. (fti9 veik, ( $E S 5/4-7-04) C City of Federal Way Electrical Permit #:03 - 102210 - 00 - EL Community Development Services 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: VIRGINIA MASON `( Iv 3 F `o o 71 GS/I4 Project Address: 33501 1ST S c t Parcel Number: 926504 0010 Project Description: ELE-install a 24"x24"x4"box with locking door k fL pytvvg P&ac poW,1) 4365 (i) Owner Applicant Contractor Mason Clinic Virginia BAINBRIDGE ISLAND ELECTRIC BAINBRIDGE ISLAND ELECTRIC 1100 9TH AVE PO BOX 10066 PO BOX 10066 SEATTLE WA BAINBRIDGE ISLAND WA 98110 BAINBRIDGE ISLAND WA 98110 98101-2756 (206)842-4200 c Lt lA CAT-Z �1� p i4L—C¢7` C7,j '^ ee our 07-.,Y0 .C`©,i Electrical Fixtures �k Al 0 wzan a 0111 • �.. : D r sc 3 .,Des4 1 ‘-i-117-17L1€ 1 d ui Qua"nt Circuits- Commercial I 1 Low Voltage-Other Commercial 1 PERMIT EXPIRES November 25,2003. Permit issued on May 29,2003 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. Owner or agent: Date: 2g '03 (9 (�,o 3 ' -#411( o r w v 2K. O2 &77-`0/2— 06/24/2003 12:03 12068421466 BAINBRIDGEISLANDELEC PAGE 01 5C-' 171 pfey 4 01—435.3 r rev vD 1 )4`418°--r- _91 s 1 r c. , �� o� a� M it 7<?11)-Y40_, 1 � 12 IF 7471t11 ))-3e_Ls,cv-i 0,74 9-)Dk:J a) d ) 1'4g-iv" 6, Sa") •1111.b. ? ) 1kL&N Lt. S a n _.oe wi N.Z. 1`0 4 Cpm]•-d ",t, 0q24/21003 11:49 12068421466 BAINBRIDGEISLANDELEC PAGE 01 BAINBRIDGE ISLAND ELECTRIC P.O.BOX 10066 BAINBRIDGE ISLAND WA,. Construction Technology Date: 06124103 To: City of Federal Way Re: Additional work on Perry.it 003-102210-00 Attn: Kari, Pages: 2 Dear Kari, Following is a list of additional work we are doing at Virginia Mason. The permit which we took out doesn't cover all of these items, so we need to have it amended or whatever you require. I was hoping you could tell me the addilional amount due so we can either mail a check or have an electrican drop it by. If you have e:ny questions, or need additional information, please call me at (206) 842-4200. Thank you for your help. Sincerely, 1A/L_ • Julie Ochota If you do not recieve the number d pages indicated or experience any other problem with this transmission, please let us know. Thank you. 110..Bjune l)r; S.E. Bainbridge Island, Wa. 98110 lndu;trlai/Commercial/Residential 06/24/2003 12: 03 12068421466 BAINBRIDGEISLANDELEC PAGE 03 ' Y VW I I 4 * W T9 �'' IO El �� L -� Tins loon anom= i - ___ .. 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APPLICATION NUMBER: Q, - (_, Z J 2 -,0 16:2- FederalPhy ` APPLICATION NUMBER: - - FED ERA Or L WAY APPLICATION NUMBER: - - cm/ ';,'r DEP BVILD"'The following is required information—Please print(in ink)or type** Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. •^'PROPERTY INFORMATION SITE ADDRESS: 33 , / /s/ WA J / ASSESSOR'S TAX/PARCEL #: - LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ■ PROTECT INFORMATION - TYPE OF PROJECT(This application): o BUILDING o PLUMBING 0 MECHANICAL 0 DEMOLITION IXELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM • PROJECT DESCRIPTION(Provide ide detailed description): I �/'cZ a 2YVa�r `" /SOX W/72/ i csti '& , o'? rte, "A 'vo' / '/GcAi .Dowivl,Uci'i-j rti// `' if�i vrT 01:: — Wil/'"►•/ �-JE.�7T'Z 4,>/t/ ,o____2__—./47\/4 /vi dwe- (/) O -4 T• PROJECT NAME: 2"4- FeAeaf2- 6_ -,fes I PEOPLE INFORMATION PROPERTY OWNER: Nr151 DAYTIME PHONE V 1lZGi J/4 /7/4S-°/11 „;44 (X ) '7V/ - WO MAILING AD SS/ (STREET4 7 ADDRESS; STATE, fie4 teA lAi / CONTRACTOR: NA • �- (7-' i DAYTIME PHONE: M NG ADD S(STREET ADDRESS;CITY,STAT ZIP EVENINGPHONE: 2 oI all‘. /3 IA/ 7k//0 ; ( ) - CITY OF FEDERAL WAY INESS LICENSE NUMBER: FAX NUMBER: -Og-^ /dn. SCC-i7 . - ( OC) a-} Z ia' CONTRACTOR'S REGISTRATION NUMBER: /� > /�� /ter / _/J I EXPIRATION DATE• (copy of caro required) a/4 L/v d 2 5-- (,� x / / APPLICANT: I NA : - DAYTIME PHONE: 11fl(Jf'z 6fZCr6v (74) '-7Y - /X72 G ADDRESS(STREET ADDRESS;CITY,STATE,ZIP: EVENING PHONE: l32rsn 01,,,-746F /W.. Po"oi D ; ( ) s - RELATIONSHIP TO PROJECT: _ j FAX NUMBER: O ARCHITECT 0 TENANT )(OTHER( DESCRIBE):kJ/fed-Rex/ -, ( ) /'t” E-MAIL ADDRESS: I CONTACT PERSON FOR THIS PROJECT: O PROPERTY OWNER o APPLICANT CONTRACTOR ■ DETAILED BUILDING 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:❑ YES o NO WATER SERVICE PROVIDER: o LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER: O LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) • • **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) FURNACES) 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 BREAKER(S) 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(induding costs,expenses,and attorneys'fees incurred in the investigation and defense of such claim),which may be made by any person,induding the undersigned,and filed against the City of Federal Way,but only whe I such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy of the information supp'!oto the d as a part of •,,: application. NAME/TITLE: IPDATE: 6 ci r�f o PROPERTY OWNER ❑APPLICANT ❑CONTRACTOR ..FOR.OFFICE,USE,ONLY: ,I "DNEW:." �. O ADDTTION 0 ALTERATION ]REPAIR 0,TENANT IMPROVEMENT ,-•>>;; 'CENSUSiCODE: �- � »LOT.SIZE[W � '•. `r , . ZONINGxDESIGNATION _ ; � EUILDING SHELL ONLY? a YE5' 3':❑NO COMP PLAN DESIGNATION = "E ABASIC PIAN? ;;aYES SECTION - TOWNSHIP ' °RANGE . _. „�� NEW ADDRESS REQUIRED? ❑YES._ 'D NO •. 'PLATTED LOT? ''>''`❑YES;Z_U NO o YES" -fl'NO 4_;,- COMMUNITY ,COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.dtvoffederalway.com • ■ ELECTRICAL TABLE B NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES _Single Family _Service or feeder only $57.00 _if of Thermostats(First-$43.00;add'n-$13.00ca) (First 1300 ft2-585.50;Each add'n 500 ft2-$27.50) _Service and feeder $93.00 1 it of Low voltage fire or burglar alarms Square Feet: First 250011'-$50.00;Each add'n 2500 ft2-$13.00 - _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)(b)(i&ii) _Each outbuilding or garage $57.00 (First service/feeder-557.00;Add'n service/ _#of Signs(First sign-$43.00;add'n sign (Inspected separately) feeder-537 each) $20.00 each) _Swimming pool,hot tub,spa $85.50 -Yard Pole meter loops $57.00 I ; NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL (Includes three units or more) Altered Service or Feeders Service Feeder Amps Service or Add'n _0 to 200 5 93.ou _Up to 200 amp $ 93.00 $ 27.50 Feeder _201 -600 216.50 _201 -400 amn 115.50 57.00 0 w 100 1 93.00...-...$ 57.00 _601 -1000 326.50 -401 -600 amp 158.50 78.50 _I Ol -200 115.50 72.50 _over 1000 363.00 601 -800 amp 202.50 108.50 _201 -400 216.50 85.50 f M of circuits Over 800 amp 289.50 216.50 _401 -600 252.50 101.00 (1-5 circuits-$72.50;Add'n circuits,$6 ear ALTERED SINGLE/MULTI FAMILY _601 -800 326.50 138.00 (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 5 57.00 201-600 amp 115.50 _Mast or meter repair 78.50 _101 -200 72.50 _over 600 amp 174.00 _201 -400 85.50 _Mast or meter repair 43.00 _401 -600 115.50 a of circuits _over 600 125.00 (1-4 circuits-557.00;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 nermit fee+572.50.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) t f j I I II TOTAL COLUMN(D): I Total Column(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 - Estimated Permit Fee:(16) Bond Amount: (17) ■ OTHER FEES ... -,,.. t itigation Fee: (18) (20) (22) SBCC Surcharge: (19) (21) (23) Total (Pages one 8,Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24) Bulletin #100-December 23, 2002