04-103251 Community
Federal l Wan Electrical Permit #:04 - 103251 -`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: MEDICAL REAL ESTATE SERVICES
Project Address: 34503 9THkSJJJ Parcel Number:
Project Description: Install battery can&tie into existing fire alarm panel.Located in "Medical Bldg" @ St.Francis
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM/CHI A D T SECURITY SERVICES,INC. A D T SECURITY SERVICES,INC.
1717"J"ST 841 POWELL AVE SE SUITE 101 841 POWELL AVE SE SUITE 101
RENTON WA 98055-2910 RENTON WA 98055-2910
\TACOMA WA 98405 (206)624-3103
Electrical Fixtures
r Description ]Quantity k Description QuantityDescription Quanti
�, ry — p tY
Low Voltage Fire Alarm-CommercialL10000
PERMIT EXPIRES February 13,2005.
Permit issued on August 17,2004
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: 41/60 ---- Date: i//. `i/
THIS CARD IS TO REMAIN ON-SITE
CITY OF4A Community Development Inspection Re rd
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103251-00-EL
Owner: FRANCISCAN HEALTH SYSTEM/CHI
Address: 34503 9TH AVE S
FEDERAL-WAY, WA 98003
This card is part of your required inspection documents 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. Wolk 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.
0 Stab/Concrete Floor(4255) ['j Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Apprcved
By •� Date By Date �J By Date
Temporary-Po-:ver Er(4273) ❑ Service(4235) Feeders/Sub-panels(4045)
i--
Appr�vr.o": Approved r
�-_�, r PP'c`'n
1
tBy Date ! By Dnte I �By Date '
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a l:o;101lie:. �.i:.t! (4,:l`) Li.,: .0ih ?: over.(.40'-7---7.7-7""7"I) L ,' i4 ,t l•-F1tricA (40`S)
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Federal Way 0_5— -� � � I__PERMIT RLL.P
COMMlJNlIYDEVELOPAIENfSERVICES �/ P'�IF CO ME EL PL DE EN FP
3353EDFIRST AWAY,WA 9•PO BOX 3-971818 APPLI CATION,,FEDERAL WAY,WA 98063-9718 p
253-6614115•FAX 2536614/29 (` r
www.cituotfederalwau.corn l7 1 7 2 04 / /
The ollowin• is re.uired in ormation-an Inco •fete a••licatio`ti41 )1,f,,j ;, •:, Please •rint le•ibl (in ink)or
PROPERTY INFORMA°n. N
•
SITE ADDRESS 3 4/57..7.3 cfs t�, vr`, ii2.z,g C, L,. ,4y i wa• Wcz3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# _- LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) gkc/ic.,i►C. Rfel4. Q Sri. F—/t7S
(Attach separate page for lengthy legal description)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit oniti)
.a; AGL 2.04,k,--y CAA) i 'TE iA f, Ex in-i; .),)- Filz A1A&.A., `pmez-
•
PROJECT NAME(Name of Business or Owner Last Name) /.1sdic.Kt /t-i9L E A,jE .4V6(4
PEOPLE INFORMATION
PROPERTY NAME
,��" PRIMARY PHONE
OWNER
inECQi'GAL ,CffL�,¢Mil- 3A-LE'- (dOte ) 9/C - k?le
MAILING ADDRESS - CITY,STATE,ZIP
/CS- et- w,ky. arc-, coda 3 A3e44i4,0.0,, �,a. 9J J
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
—ZING
�Cuie;7y k)t"3 g (q ) Yce9 -3,is/
M (LING ADDRESS CITY,STATE,ZIP CELL PHONE
//(y-,?,/ //, c44 ?RA)),Ai .*/mssJ/ Ail, f/cv/ (act, ) ?8 -33'4
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
/ / (gO ) S' . /Q3/
B L
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
/ILrl Sa,ag:4y 5c.rr..),c A 15 (gas-) yea -33 S/
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
i��a�L
, CeK .Pk,.a, .A), *)�- .0 laI. 9Jo,/ (, et..- ) 7fiv —5 344
R ATIONSHIPTO PROJECT FAX NUMBER
0 Architect 0 Tenant ❑Agent Ng Other(Describe) S44.6eznOtl-Ae400._ (:R53 ) S/-2 -/93/
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
f *o-?4 j C::/i)(0 ) -mac. - 3394
LENDER Per RCW 19:27.095: Lender information is `` NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS _ _ -
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
—SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES _ _ _ _
��� _Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing factures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES i
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
• 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 cl ..----- .lon42. DATE g/,v/0/J
nature( (Title(
RELATIONSHIP TO PROJECT 0 Owner ❑ Agent 0 Contractor ❑ Architect 17(Other ScA 6 awns
FOR OFFICE USE ONLY
o NEW o ADDITION a ALTERATION o REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES o NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? a YES a NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? a YES ❑NO
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201-400 amp 220.50 87.00
❑ Detached outbuilding or garage ❑ 401 -600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601 -800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) ❑ 801 - 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201 -400 amp 117.50 58.00 ❑ Over 600 volts surcharge $74.00
❑ 401 -600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
U Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY U 0 to 200 amp $ 94.50
❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 amp $ 72.50 ❑ over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ over 600 amp 177.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
❑ # of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58.00;Add'n circuits$6.00/ea)
$74.00 plus 35%of Permit Fee
❑ Mast or meter repair $43.50 ❑ Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
U Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES
U Service or feeder only $58.00 TEMPORARY SERVICE
U Service and feeder $94.50
Commercial Residential
MOBILE HOME/RV PARK ❑ 0- 100 $58.00 $51.00
❑ #of service or feeders ❑ 101 -200 74.00 51.00
(First service/feeder-$58.00;each add'n-$37.50) ❑ 201 -400 87.00 n/a
U 401 -600 117.50 n/a
U over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signs
J.Frrst-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
a Low Voltage U Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
' ire Alarm System U Yard Pole meter loops $58.00
❑ Security Alarm System U Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
0
(Per System(s) 1=,2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) •Per WAC 296-46-910(5)(b)(185 ii)
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Bulletin 4100-March 30,2004 Page 3 of 4 k\l-landouts-Revised\Permit Application