19-105227 `Electrical
City of Federal Way Permit #:19-105227-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: ST FRANCIS HOSPITAL-RADIOLOGY '
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Electrical to include changing out existing Fluoro X-ray machine with a GE Precision 600 XP
Scope.
Owner Applicant Contractor
JOHN ELSWICKFRANC1SCAN HEALTH STAN THOMPSONTHOMPSON THOMPSON ELECTRICAL
SYSTEM-W ELECTRICAL CONTR INC CONSTRUCTORS INC
1717 S"J"ST PO BOX 45260 THOMPECOO8CW(2/16/20)
TACOMA WA 98405 TACOMA WA 98445 PO BOX 45260
TACOMA WA 98445
Additional Permit Information
Is this an Online or O.T.C.application9 No
' ¢ `"` ! ' ,�.,., 4r '172n1'0a,' ..:..... n 1._ �,F+at,"f
Alt. Srvc/Feeder 0 to 200 am] 1
PERMIT EXPIRES Wednesday,4 November,2020
Permit Issued on Tuesday,November 5,2019
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
ashington and e City of Federal Way.
Owner or agent "' Date: �����(0 / 9
4 ./i/1/ 1/ l
THIS CARD IS TO REMAIN ON-SITE
Federal ' Construction Inspection Record . '
Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 105227 00 Address: 34515 9TH AVE S
Project: JOHN ELSWICK FEDERAL WAY WA 98003-6761
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.
® UFER Ground(4295) 2❑ Ditch cover(4030) 3❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date `By Date
® Pool Bonding(4195) ® Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date j By Date Date
El Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved p 1 Approved
,By Date ° By ,/eDate ��j 7-/ I jBy Date
•
ID Final-Electrical(4055)
By €,pproDateved
'-/62!/
Z., all Pael- et1441
ep by
Ge, , k7 `z-ii-19 ` e
le/loye v,iv-sed 1- V 4()"'er�
f
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED ELECTRICAL
CITY OF ^..i OCT 3 0 2019
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT ]
PERMIT NUMBER C - 1 0 5 2 a ( _
SUITE/UNIT/SPACE#
SITE ADDRESS: ` 6— n�/OAveOt �`����/"�(
J��/
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# 1 CURRENT/PROPOSED USE
$ iz � r . s' -7 5 O ti 5 1 - p o 2 D
PROJECT NAME
(Tenant or Homeowner Last Name) 3pi P"✓g/1'lc"`S / f
f1 , RtLet;a 1Q,C)y
PROJECT DESCRIPTION C hr 4. c a- FI0YT,1 h ro L1 ,rt) t'v /f (.1 h i ?-
Detailed description of work to
be included on this permit only
NAME ? .t-� PRIMARY PHONE
PROPERTY OWNER C 1*1 ! c rot Cc M US3 )4e26 -d q
MAILING ADDRESS E-MAIL
1717 S. J S d„tLit-
CITY STATE ZIP FAX
c�.Ccs,wti Wt- 9lfifo`l ( ) -
NAME PRIMARY PHONE
s v17 )=1e-c4v'+'Ce.A c(1,.I cdvc,cfc,,rs (.253 )539- ogg9
MAILING ADS)RESS E-MAIL
ELECTRICAL /5-0 S. t ok-50% S+. 5++4/46-14.1Ars.%c.ins ued.res
CONTRACTOR CITY STATE ZIP FAX .COM
Ti, (-0) - 0114/4 c ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
vOl (OZ OH o5-6 / / -20-61- 1e2fb/-00-81.
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP ( FAX
)
NAME PRIMARY PHONE
PROJECT CONTACT S -TL o ida,cr►l (253) Yas'- 574/3
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
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,
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.
SIGNATURE: ��," .�J DATE /6-30 -2019
PRINT NAME: /c7/144 //LawfoSen
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application