03-104881 .
City Federal Way
Community Development Services Electrical Permit #:03 - 104881 - 00 - EL
Community
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: RAINIER MEDICAL ASSOCIATES
Project Address: 34709 9TH S ITA200 Parcel Number: 926480 0015
Project Description: Install circuit for receptacles and switch for tenant improvements.
Owner Applicant Contractor
RAINIER MEDICAL ASSOCIATES KIRBY ELECTRIC INC KIRBY ELECTRIC INC
32114 1ST AVE S#101 4826 B ST NW SUITE 101 4826 B ST NW SUITE 101
FEDERAL WAY,WA AUBURN WA 98001 AUBURN WA 98001
98003 (253)859-2000
Electrical Fixtures
Description Quantity Description Quanti Description JQuantity
Circuits- Commercial 1
PERMIT EXPIRES April 25,2004.
Permit issued on October 28,2003
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: 4///' , Date: *C13
to — 0'3 N0 - CPG .
62
L
_ 1\ � �C.-
._„.....4% ....._ CONSTRUCTION PERMIT APPLICATION
CITY OF �..� 8 2003 APPLICATION NUMBER: 0 3- O
Federal Way i 'I
WAY
rr1TY OF APPLICATION NUMBER: - —� ((SS I_ �
FEDERAL - -
$UILDINU DEPT (APPLICATION NUMBER:
"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: 34oci Cil 4\(E S. DurrActOASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
1'
■ PRO]ECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING a MECHANICAL a DEMOLITION
' 1 ELECTRICAL—T�❑1�EEeNGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): .1�.�LJIPC-C, S-- L(_,
i
PROJECT NAME:
TAIMEQ oleo' scc.ipn^1ES
:`:_• PEOPLE INFORMATION. .
PROPERTY OWNER: NAME: ; DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
1
CONTRACTOR: NAME: DAYTIME PHONE:
• MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): i. EVENING PHONE:
14g3acp b Sr i r lo 1 I c )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
i g - 9 0 IC)? &7 -oO6Li ( )
i CONTRACTOR'S REGISTRATION NUMBER: �f+'j�'Q�^,� .� ^�'7 Q I EXPIRATION DATE:
(copy of card required) K.L11-A3V�..L�o ( / IJi�/ j / /
APPLICANT: I NAME: DAYTIME PHONE:
MAILING ADDRESS( 'EET ADDRESS;CITY,STATE,ZIP: EVENING PHONE:
� I ( )
RELATIONSHIP TO PROJECT: j FAX NUMBER:
❑ ARCHITECT o TENANT o OTHER(DESCRIBE): ; ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER XAPPLICANT 0 CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ ,
I s PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:a YES o NO
WATER SERVICE PROVIDER: a LAKEHAVEN o HIGHLINE ❑ TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER: a LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
,. ■ PRO)ECT 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 Value of Mechanical Work: $
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) ❑ 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,Including the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the Information supplied to the ci as a part of this application.
NAME/TITLE: DATE: / 4CIS
❑ PROPERTY OWNER ❑APPLICANT 0 CONTRACTOR
.FOROFFICE,USE ONLY: .,`
p ADDITION ❑ALTERATION�� o REPAIR TENANT IMPROVE
3NEW-, �.� ,� `mss '� � ' MENTA .�_.
-'.CENSUS`CODE -4 0 a .A*s LOT SIZE:V' ' X -•..s - ;7 f _ 4C44 .
'ZONING DESIGNATION;I. INKIA; 'A BUILDING SHELLONLY? a YES`' ❑ NO
COMP PLAN DESIGNATION .° 4:BASIC PLAN? ❑YES ❑ NO;r
SECTION -r.1., . TOWNSHIP GRANGE-4' .NEW ADDRESS REQUIRED? ❑YES a NO •.
PLATTED LOT? - YES' _a NO ; CHANGE OF USE?; ,=:a YES'FP-i]NO ,
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtvolfederalway.com
. ■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 ft of Thermostats(First-$43.00;add'n-$13 00ea)
(First 1300 ft'-585.50.Each add'n 500 11 -527.50) _Service and feeder $93.00 f+of Low voltage fire or burglar alarms
Square Feet. _ First 2500 ft'-$50.00;Each add'n 2500 ft`-$13 00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _ft 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/ _ft of Signs(First sign-543.00;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
(Includes three units kir more) Altered Service or Feeders
Service Feeder amps Service or Add'r _0 to 200 3 93.00
_Up to200 amp $ 93.00 $ 27.50 Feeder _201 -600 216.50
-201 -400 amn 115.50 57.00 =0 to 100 $ 93.00 $ 57.00 _601 -1000 226.50
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 i ft 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
#of circuits over 600 125.00-
(I-4 circuits-$57.00;Add'n circuits$6 ea)
i I
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+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)
� I i
TOTAL COLUMN(D): i !
Total Column(0)
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
Mitigation Fee:(18) (20) (22)
SBCC Surcharge: (19) (21) (23)
1
Total (pages one&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24) 1
Bulletin #100-December 23,2002