06-100383 •
ts.
City of Federal Way Electrical Permit #: 06-100383-00-EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: ST FRANCIS CATH LAB REMODEL
Project Address: 34515 9TH AVE S Parcel Number: 750451 0020
Project Description: Install(3)low-voltage data drops in tenant area.
Owner Applicant Contractor
FRANCISCAN HEALTH SYSTEM INTRACOMMUNICATION NTWK SYS INC INTRACOMMUNICATION NTWK SYS INC
1717 S J ST 4922 N PEARL ST INTRANS994JL (4/10/07)
TACOMA WA 98405-4933 TACOMA WA 98407 4922 N PEARL ST
TACOMA WA 98407
Additional Permit Information
Electrical Fixtures
Low Voltage-Other Commercial.. 900
CONDITIONS:
PERMIT EXPIRES Monday, July 24, 2006
Permit Issued on Wednesday, January 25, 2006
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 accord- ce with the laws, rules and regulations of the.State of Washington _
d the City of Federal Way.
Owner or agent: - . � Date:
,I
f
(„O
V�
It
THIS CARD IS TO REMAIN ON-SITE
.,..A,
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-100383-00-EL
Owner:
Address: 34515 9TH AVE S
FEDERAL WAY, WA 98003-6761
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. 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.
O Slab/Concrete Floor(4255) 0 Ditch cover(4030) ❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date - By Date By Date
❑ Temporary Power(4275) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) 0 Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved Approved
By Date By _. . _ . . Date By Date .
❑ Under-slab groundwork(4295)
Approved i
By . Date
I
ur� IIPIFF
A RECEIVED 0 _ L • • 3 g
Federa�Way PERMIT
• COMMUNITY
MMUNI7YDEVRLOPMEW JAN 2 5 2p06 SF MF CO M:e L DE EN FP
33925 D AVENUE SOUTH 9•PO BOX 9714 L I C AT I O N
FEDERAL WAY,WA 94063-9714
269-835-2.607•FAX Z53d35
wawdtuolhdendriwa.comGUY OF Feoef&R,.
BUILDING DEPT.
The olio • is , bred orrnation-an{rico •lets • • ,licat{on will not be acre•ted. Please •rint le•Ibly n in or p .
IN PROPERTY INFORMATION /
SITE ADDRESS 3t�/S / S 94S' SUITE/UNIT$ eft- 2.i 6
ASSESSOR'S TAX/PARCEL$ - — —•— LOT SIZE(s•fl
4'14 � s.c.
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) it/012.1/ e -/ esti/X,11 jn/Yih /45/0i/0.1 - /-body-
(Attach mixing*Palle fir bgdW Wed ds.a aU '
■ PROJECT INFORMATION
TYPE.OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION j'ELECT WC
dedAIy 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work incluo this permit only)
,1ric-/,a1 _ d/a?A?- 4/1/1-,0 _. R .Lo['_.4a e'yr
1
)--..-'6
PROJECT NAME(Name of Business or Owner Last Name) C ,"
IN PEOPLE INFORMATION
PROPERTY NAME ` PRIMARY PHONE
OWNER .c/L/91-A/C el C/a,t/ /i3O/-/Z Si b S�e4s., ( )
MAILING ADDRESS ! CITY,STATE,ZIP
/7/7 S r sf 7/xo t/a, cg,* 9- Vas- Y43 3
CONTRACTOR COMPANY NAME APPLICANT NAME '/ OFFICE PHONE
i�ArnCo�.�C4 PI cn Oh ,y�v/c I. f� {/c (as3) 7G/ - Dy/F
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
V f zz ,v "?0,r--/ c-/ .. ',tzC®t4.ilr+, w/s 9f$407 (zsj ) 73 2 - S3VS—
CRY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
t - - -B L ' / / ( )
I CONTRACTOR'S REGISTRATION NUMBER(eop1 of card required with each application) EXPIRATION DATE
1 L-" e O 6 6 A Z A/ 2 A3 N5 9/yj , ' y / /o /Zoo 7
I APPLICANT COMPANY NAME APPLICANT,.
OFFICE PHONE
; /✓- -" .r kc3 ) Z'/ - iyi6e
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
4/ 1--2 ,�,. / Tmv/41/Ct, pe.d4- :F90? (2c-3 )73,-s3 '3
RELATIONSHIP TO PROJECT FAX NUMBER G�
0 Architect 0 Tenant ci Agent o Other(Describe) (tC3). .8'7 0/416
CONTACT NAME PRIMARY PHONE I,MAIL ADDRESS
Z.-A1 �� ( 2 S3) 731- 93 VS
f LENDER NAME
MAILING ADDRESS CITY,STATE,ZIP PHONE
•
( )
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ •
SPRINKLERED BUILDING? d YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES o NO
F WATER SERVICE PROVIDER ❑ LAKEHAVEN O HIGHLINE O TACOMA O PRIVATE(WELL)
SEWER SERVICE PROVIDER O LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
1
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND 1
THIRD
FOURTH
•
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?) •
GARAGE 0 CARPORT 0
NUMBER OF FLOORS I amtvo rsoroe O I TOTAL
**NEW HOMES ONLY*" NUMBER OF BEDROOMS TED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed o, '• •ted as part of this project. Do not include existing fixtures to remain.
MEC&AMCAL
Value of Mechanical Work $
AIR HANDLING UNITS r•APORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(c.mmaa.q WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS OAS PIPE OUTLETS
PLUMBING •
BATHTSJBS 1«Tun/Showa combo) SHOWERS WATER CLOSETS(r.s.q MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS Isom1 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 authorised 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,includin is officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE DATE /
(>4014
S (fm)
RELATIONSHIP TO PROJECT a Owner a Agent o Contractor t]Architect 0 Other •
•
f•-••••• 1 ,v6„2 ,Jr:
..-.._.._...nn •------ wnnt n___A..tI L\II .4..\13e.••.7A•••d ine.inn
i
Al"
, ,
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE.
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300(t2-$107.50;Each add'n 500 ft2-$34.50) • ❑ 0 to 100 amp $117.00 $71.50
❑ Detached outbuilding or garage 0 101.-200 amp 145.00 91.50
(Inspected with service) $45.50 0 201-400 amp 272.00 107.50
❑ Detached outbuilding or garage 0 401-600 amp 317.00 127.00
(Inspected separately) $71.50 0 601-800 amp 410.00 173.50
O 801-1000.amp 500.50 209.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp $117.00 $34.50 ❑ Over 600 volts surcharge $91.50
O 201 -400 amp 145.00 71.50 0 Mast or meter repair $99.00
❑ 401-600 amp 198.50 99.00 ALTERED COMMERCIAL/INDUSTRIAL
0 601 -800 amp 254.00 136.00
•
❑ Over 800 amp 364.00 272.00 Service or Feeders
O 0 to 200 amp $117.00
ALTERED SINGLE/MULTI FAMILY 0 201-600 amp 272.00
O 601-.1000 amp 410.00
Service or Feeder ❑ over 1000 amp 456.50
❑ 0 t 200 amp $89.50
❑ 201 -600 amp 145.00 0 #of circuits to be added/altered
0 over 600 amp 218.50 (1-5 circuits-$91.50;Addh circuits,$7.00/es)
•
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$71.50;Add'n circuits$7.00/ea) $91.50 plus 35%of Permit Fee
O Service- 1,000 amps or greater
❑ Mast or meter repair $53.50 0 Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $71.50 •
O Service and feeder $117.00
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/MultiFamily $63.00
❑ #of service or feeders
(First aervice/feeder-$71.50;each add'n-$46.50) Commerciallndustrial Service or Feeder Ampacity
❑ 0-100 amps $71.50
❑ 101-200 amps 91.50
❑ 201-400 amps 107.50
O 401-600 amps 145.00
❑ over 600 amps 157.00
•
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats • ❑ #of Signs
(First-$53.50;add'n-$16.50/ea) (First sign-$53.50;add'n sign$25.00/ea)
U Low Voltage ❑ Swimming pool/hot tub $107.50
Square Feet to be served by system(s) 9 (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $71.50
O Security Alarm System 0 Additional Plan Review $107.50/hour
D Voice Cabling (for modified submittals)
ND Data Cabling ❑ Automation Fee on all Permits .. $5.00
(Per Systeni(s)1e,2500 ft2-$63.00;
Each add'n 2500 fta-16.50)•Per WAC 296-46.910(5)(b)fi&ii)
1:11.dId:�41AA L-..--.t .fAAL - T_._1 _L`I \J11_._J___._\T_�_:!. •_._Ie__.!___