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03-101132 City of Federal Way Community Development Services Electrical Permit #:03 - 101132 - 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 MEDICAL OFFICE BUILDING Project Address: 34509 9TH 9.Ave 5 Parcel Number: 750451 0010 Project Description: Install 8 low-voltage thermostats in connection with HVAC retrofit. Owner Applicant Contractor Hospital Bsp StFrancis AIR SYSTEMS ENGINEERING INC. AIR SYSTEMS ENGINEERING INC. 2002 ADV DEP PD#5282869 909 S 28TH ST 909 S 28TH ST TACOMA WA 98409 TACOMA WA 98409 (253)572-9484 Electrical Fixtures eo tin Low Voltage-Other Commercial 8 PERMIT EXPIRES October 4,2003. Permit issued on April 7,2003 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: c1) ()1lDate: 4 /7 /O3 `r ( S.-' 0 Call, tv el'- to lei) 4„N.....„, . ' RE('F_-{VLD CONSTRUC I ION PERMIT APPLICATION CITY OF Federal Way MAR 2 5 L n3 APPLICATION NUMBER:( _ 10 1l ( EC., APPLICATION NUMBER: CITY OF FEDERAL WAY 'APPLICATION NUMBER: - - BUILDING DEPT **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. . Q ■'.PROPERTY INFORMATION SITE ADDRESS: 345 CR / ! ` v - S • ASSESSOR'S TAX/PARCEL #: '7 ,0 LI S I - 0 0 1 O LEGAL DES RIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): c �,( — 1� c�� •• �d 2rt'' s • . v �, in..." ;_ re •., 4'7. boo • -- ■ PROJECT INFORMATION ' TYPE OF PROJECT(This application): 0 BUILDING o PLUMBING o MECHANICAL 0 DEMOLITION I LECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM AL PROJECT DESCRIPTION(Provide detailed description): InSAT-3. '..\--- �� r E� t— m 1 --- E-1cc� re C, - PROJECT NAME: 2 - f)C''.LS M2_30, • IC \\' CQ,.. - . :U PEOPLE INFORMATION PROPERTY OWNER: NAME: , I DAYTIME PHONE: r1ClSQc� f -``' _W S 5 -FnS i f233) 4(2.5' -84 1 1 MAILING A RESS(STREET ADDRESS;CITY,STATE,ZIP): 1� 1�- • - * : ca • 9840 I CONTRACTOR: NAME: , DAYTIME PHONE: ' {- m 4 (253}57 Qi t ns , - i MAILING ADDRESS(STRE CDRESS;CITY,STATE.ZIP): /`�' -- - - ,�-}'I{-,Q�'.EVENINF,PMONEc ^ ,,cyin 3LOa < ' . C): 19.._ ( I W 1- i (AX NUMBER: S� I CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: 3 - CD 0 cp0 © (Q - oo i (2s3) 3%3 -(0337 CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE: (copy of cam required) Al Q S j E 1448, A) 3 j / / APPLICANT: NA • ierns w� rS DAYTIME PHONE: (253) 57a -`)4�4- MAILING ADDRESS(STRE ADDRESS;CITY,STATE,ZIP): EVENING PHONE: I360� S P;rt . ecu , W ,A 4$Li-CY, ( ) s s_- I RELATIONSHIP TO PROJECT: j FAX NUMBER: a ARCHITECT 0 TENANT ,OTHER( DESCRIBE): G�-c 1j (z3) 3a-3 - 6337 E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT XCONTRACTOR j be..0 QS€l,kt - `` ■ DETAILED BUILDING INFORMATION EXISTING USE: XQOL Q EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ 314- i 8-, 10°` °O- PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? ,YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES o NO WATER SERVICE PROVIDER: 0 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 001 I 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: ❑ ELECTRIC ❑ GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC 0 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 daim(induding costs,expenses,and attorneys'fees incurred in the Investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of Federal Way,but only where such daim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy of the Information supplied to the dty as a part of this application. 3 l NAME/TITLE: DATE: /� /O ❑ PROPERTY OWNER ❑APPLICANT XCONTRACTOR -FOR OFFICE.USE,ONLY: I NEW':= :ADDITION ;�❑.ALTERATION REPAIR STEN.ANT=IMPROVEMENT >•:; CENSUS.iCODE ..• 0 , ..::;-Wrtia* SLOT SIZE �� r ` . " .a- ZONING DESIGNATION., Q (BUILDING SHELL'ONLY? o YES= ;❑ NO r ° ' COMP PI N DESIGNATION _ k R BASIC PLAN? ❑AYES 0 NO SECTION S TOWNSHIP_A °RANGE NEW ADDRESS REQUIRED?, ,, .'❑'YES_ ❑ NO PLATTED`LOT? 3❑YES:= o NO ,'iriA; ' -ate 'CHANGE OF USE?;; ,,, .❑YES a'NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.cftyofederalway.com , • ■ ELECTRICAL TABLE B NEW RESIDENTIAL SERVICES MOBILE HOMESEQUIPMENT/TEMP SERVICES _Single Family _Service or feeder only $57.00 ?Cl#of Thermostats(First-$43.00;add'n-$I3.00ca) (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 f11-$50.00:Each add'n 2500 ft`-S13 00 _Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet: (Inspected with service) _#of service or feeders * Per WAC 296-46-9I0(5)(b)(i&ii) _Each outbuilding or garage $57.00 (First service/feeder-$57.00;Add'n service/ _4 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 COMMERCIAL/INDUSTRIAL Altered Service or Feeders (Includes three units ur more) Service Fredet Amps Service or Add'o 0 to 200 z 93.00 _Up to 200 amp $ 93.00 $ 27.50 Feeder 201 -600 216.50 _201 -400 amp 115.50 57.00 0 to 100 5 93.00 $ 57.00 601 -1000 326.50 -401 -600 amp 158.50 78.50 =101 -2(X1 1 15.50 72.50 =over 1000 363.00 601-800 amp 202.50 108.50 201 -400 216.50 85.50 #of circuits _Over 800 amp 289.50 216.50 401 -600 252.50 101.00 (1-5 circuits-$72.50:Add'n circuits,S6 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/Commerciai/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 85.50 _Mast or meter repair 43.00 _401 -600 115.50 _a of circuits I _over 600 125.00 (1-4 circuits-557.00;Add'n circuits$6 ea) it 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+$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) 1 I I TOTAL COLUMN(D): Total Column(D) E ti aced 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 - 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