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01-102999 City Federal Way Community Development Services • Electrical Permit #:01 - 102999 - 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 HOSPITAL-AMBULATORY SERVICES BUILDING Project Address: 34515 9TH Z Ayes Parcel Number: 750451 0020 Project Description: ELE-Temporary service.Install 480v 30,100-amp meter,disconnect and feed to a temporary power skid. Owner Applicant Contractor ST FRANCIS MEDICAL THOMPSON ELECTRICAL CONTR INC THOMPSON ELECTRICAL CONTR INC 1717 S J ST 31212 12TH AVENUE CTE 31212 12TH AVENUE CT E TACOMA WA ROY WA 98580 ROY WA 98580 98405-4933 (253)843-0530 Electrical Fixtures I Description Quantity Description Quantity Description !Quantity Temp.Service up to 100 amps-Corn 1 PERMIT EXPIRES January 27,2002,IF NO WORK IS STARTED. Permit issued on July 31,2001 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: /i_/iAirw Date: 7,/ —0 CI;0 CONSTRUCTION PERMIT APPLICATION ten _ RECEIVED VV FEY APPLICATION NUMBER: G, - O Z 9 - 40-4=2._ 3 2OU� _ APPLICATION NUMBER:jUt, - - • APPLICATION NUMBER: - • . **The followin i 4gRipi —Please print(in ink)or type** Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. _:- • ■ PROPERTY INFORMATION SITE ADDRESS: 307r- ./ kil S • ASSESSOR'S TAX/PARCEL #: 7 ,0 4 SL - ©O Zrd LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): • - ■ PROJECT INFORMATION . TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING C1 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): P,rovida 8O 34 Mt#ex )11's Gnr�1 114.11A1 G. ie rr,ro e,^a.r p o war ivisha b y Gtrn 3 fruc.4-.04 . �l PROJECT NAME: 7 �k omits . G ii' �jL • rye+g„ T � • • , SPL► INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE: AILING ADDRE • REET• E,ZIP): CONTRACTOR: NAME: DAYTIME PHONE: • J • Ii ca.l v li'�C . (Z53 )5 -O550 AILI •DD ESR S(STRAl SS;C ',STATE,ZIP): e 1` EVENING PHONE: P 6°)C 1301 o / W Z (253) 6513 -053o CITY FEDERAL WAY BUSINESS LICENSE MBER: FAX NUMBER: - - - - - ar73)84713 X5/ 5 ••CTOR'S REGISTRATION NUMBER: ` /j� �(' EXPIRATION DATE: y� (copy ". .rd required) Ii• 6_ C D �1 iL CAO OZ lI(p /Rt�l/LI APPLICANT: NAME: DAYTIME PHONE: MAILING ADDRESS(STREET ADDRES CITY,STATE,ZIP): EVENING PHONE: ( ) RELATIONSHIP TO PROJECT: ,�� FAX NUMBER: +i Cl ARCHITECT CI TENANT L7 OTHER(DESCRIBE): ~/�� ( ) E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR • DETAILED BUILDING INFORMATION • EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) Ir iltV **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 O 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 ❑ 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 filed against the City of Federal Way, 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. NAME/TITLE: . d �` DATE: 7- 3/_ ❑ PROPERTY OWNE' APPLICANT L7 CONTRACTOR FOR OFFICE USE ONLY: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR El TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO COMMt iNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH-P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 tt • ELECTRI. L TABLE B NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES _Single Family _Service or feeder only $44.25 #of Thermostats(First-$33.50;add'n-$10.50ea) (First 1300 ft2-$67.00;Each add'n 500 ft'-521.50) _Service and feeder $72.25 _#of Low voltage fire or burglar alarms Square Feet: First 2500 It'--$38.75;Each add'n 2500 ft'-$10.50 _Each outhuildingor garage $28.00 MOBILE HOME/RV PARK Square Feet: (Inspected with service) _#of service or feeders • I'er WAC 296-46-910(5)(b)(i&ii) _Each outbuilding or garage $44.25 (First service/feeder-544.25;Add'n service/ _#of Signs(First sign-$33.50;add'n sign (Inspected separately) feeder-$28 each) $16.00 each) _Progress inspection per 1/2 hr $33.50 _Swimming pool,hot tub,spa 67.00 _Yard Pole meter loops 44.25 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 $72.25 _Up to 200 amp $72.25 $21.50 Feeder _201-600 169.00 _201-400 amp 89.75 44.25 _0 to 100 $72.25 $44.25 _601-1000 254.50 _401-600 amp 123.25 61.50 _101-200 89.75 56.25 _over 1000 282.75 _601-800 amp 158.00 84.25 _201-400 169.00 67.00 #of circuits _Ovcr 800 amp 225.25 169.00 _401-600 197.00 78.75 (1-5 circuits-$56.25;Add'n circuits,$5 ea) ALTERED SINGLE/MULTI FAMILY _601-800 254.50 107.25 (When inspected separately from the services.) _801-1000 310.75 129.75 Temporary Service Service or Feeder _Over 1000 339.00 181.00 0 to 60 $38.75 _0 to 200 amp $61.50 Over 600 volts surcharge 56.25 N7/61- 100 44.25 _201-600 amp 89.75 _Mast or meter repair 61.50 _101-200 56.25 _over 600 amp 135.25 _201 -400 67.00 -Mast or meter repair 33.50 _401-600 89.75 _ N of circuits _over 600 97.75 (1-4 circuits-544.25;Add'n circuits$5 ea) If service is greater than 200 amp,a plan review is rcq'd.Fee is 35%of permit fee+$56.25.Add'I plan review for other submissions is$67.00/hr. FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D) 000, ¢,»yO oro-r-c j Sc ict_ 4f4/d • 115- / ,V'v49. .aer TOTAL COLUMN(D): e 0j/. Col uTn D> Estimated Permit Fee: (12) L Estimated Permit Fee from line 12 Estimated Plan Review Fee: $56.25 + 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' ?'4 Bulletin #100-January 3, 2001