07-103270 •
4
• City
ityDeFederal
pmentWay Electrical Permit #: 07-103270-00-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: TEAM HEALTH
Project Address: 505 S 336TH ST Parcel Number: 926480 0270
Project Description: InstaWrelocate(2)thermostats.
Owner Applicant Contractor
TEAM HEALTH PACIFIC AIR CONTROL INC PACIFIC AIR CONTROL INC
3455 S 344TH WAY SUITE 210 11812 NORTH CREEK PKWY N PACIFAC230P8(10/01/07)
FEDERAL WAY WA 98001 BOTHELL WA 98011 11812 NORTH CREEK PKWY N
BOTHELL WA 98011
Additional Permit Information
Electrical Fixtures
Thermostat 1,
„IfoRMIT EXPIRES Monday, June 9, 200#
Permit Issued friday June 15,2007
I herebycertify that a above formes is act and tt tt�e construction above escrit t rop;rty nd
the occupancy and the use will be in�r anco ce +ththe. ws r and ula sof the bate Wash'
and the City of Federal Way.
Owner or agent Date:
6 Z � ,97
•
.
41k, THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 8353050
PERMIT#: 07-103270-00-EL
Owner: TEAM HEALTH
Address: 505 S 336TH ST
FEDERAL WAY, WA 98003-6328
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.
❑ Slab/Concrete Floor(4255) ❑ Ditch cover(4030) •❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
— 0 Temporary Power(4275) ❑ Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
'❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) '❑ Final -Electrical(4055)
Approved Approved Approved
By 0 bill . Date 1 (o�.p-Z , By Date By __ Date '1 ._p`1. i
ry UFER Ground (4295)
Approved
Date
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
1' 1
C,� . RECEIVE® 0 / o3 7 0
Federal Way PERMIT
COMMUNITY DEVELOPMENT SERVICES UN 1 5 2007 SF MF CO M . PL DE EN FP
33325 D AVENUE SWATH•PO 9977 pApLI CATI ON
FEDERAL WAY.WA 98063-9718
253-835-2604o7•FAX 253-835-21`�Y OF F E R
www.cit (federalwatl.co
BUILDING DEPT.
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
/'j • PROPERTY. INFORMATION ) }Q
SITE ADDRESS ! 05 SO t tkA 33'3&) t A 14
�� F ate (t) SUITE/UNIT# p
ASSESSOR'S TAX/PARCEL# 9 2 Co y r v- 0 Z `l a LOT SIZE(sf) °8-J o )
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) Pl e-g e s e C .6;t " `tGl ..
(Attach separate page for lengthy legal description)
MI PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL
❑DEMOLITION NrgLECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTI N(Provide detailed de cription of work included on this permit oniti)
PROJECT NAME(Name of Business or Owner Last Name) CetMt p vg C tem (0-41A F I.-1(Te4t4.4t+-ti4 'l
is PEOPLE INFORMATION "
PROPERTY NAME rW f�(J, RIMARY PHONE
OWNER MAILING ADDRESS ` Co STATE,ZIP ( MAIL ADDRESS
i o j e ec - Pig .-re 2c)O Wak ,,c-i et4 ) iM 61ggO
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
foci c'-i c M c Co-vl cai ti ik Lc (2-tX ) CAI.- (0393
MAILING ADDRESS •s CITY,STATE,ZIP CELL PHONE
li$)2 Matti Creek- Pfd n)4 AN B,',Ue(ii wit` gbi t (2C) .* - w
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATIONDATE FAX NUMBER
LC 00'6 i 2 g 000 Be:__ 1.2/3//6 7 ( fib) 3'/O -2276
corn of<.rd regairoa CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DTE E-MAIL ADDRESS
.Ith.s.ppliutlan PA c i F A-C 2 3 z)Pg /O IJ i/ t k C_Li‘t<<-ch"hrol.
APPLICANT COMPANY NAME /+ t - APPLICANT NAME OFFICE PHONE
PCLG(-C c 4�r Co -I-raI V-e:/i�. Lo (2Ob) bt5Z-634`3
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(I B 1 2 Or-e-Rk Pk-LI-V. 0.6-Reil , wA ct e II ( 2 a) 9 b - 2-0 Ki
RELATIONSHIP 10 PROJECT FAX NUMBER
0 Architect o Tenant o Agent Other G k -Cdf (2) 34 0 - 2-2-76
PROJECT NAMEy i ' PRIMARY PH NE E-MAIL ADDRESS
CONTACT "1-1 V(� Y6 Vat" (2-OG ) Cog 2- - (03343`3 - t�@gats;CaIY-Cdn m1.Ca
LENDER NAME 1, Per RCW 19.27.095: is
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY.STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION (��^
EXISTING USE o i C �jjQ`k C e PROPOSED USE D"Mee c I 9/94c/r�y�-
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ a_31,V(./
SPRINKLERED BUILDING? ❑YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
WATER SERVICE PROVIDER a LAKEHAVEN o HIGHLINE ❑ TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT D
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
**NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
I cate number each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EV'•.• E COOLERS GAS PIP •. S WOODSTOVES
BBQS FANS S WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Commercial) 4 V A V ' 'C ' S
COMPRESSORS FURNAC '. ES I•
DUCTS : •G SEIb I REFRIG. ' MS a t-PC LY
7 e✓"S
PLUMBING
BATHTUBS for - ower Combo) LAYS)Bathroom Sinks) URINALS MISC(Describe)
DIS . . RS RAINWATER SYST VACUUM BREAKERS
DRIN G FOUNTAINS SHOWERS WATER CLOSETS Ironed
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 �i� 6C7t 5h ''4'12h Sv$p C t DATE tC/ //5Jo7
(Signature) tntle)
RELATIONSHIP TO PROJECT o Owner IJ Agent contractor o Architect o Other
R OFFICE USE 9 W
o NEW D ADDITION o ALTERATION D REPAIR D TENANT IMPROVEMENT
BUILDING SHELL ONLY? D YES o NO BASIC PLAN? o YES D NO
ZONING DESIGNATION CHANGE OF USE? o YES c NO
NEW ADDRESS REQUIRED? o YES D NO UP/SEPA/SU? D YES D NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES D NO
Bulletin#100—April 2,2007 Page 2 of 4 k\}landouts\Permit Application
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ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
D Single Family Square Feet
(First 1300 ft2-$111.00;Each add'n 500 ft2-$35.50) U 0 to 100 amp $120.50 $74.00
❑ Detached outbuilding or garage ❑ 101-200 amp 149.50 94.50
(Inspected with service) $47.00 ❑ 201-400 amp 280.00 111.00
❑ Detached outbuilding or garage ❑ 401-600 amp 327.00 131.00
(Inspected separately) $74.00 ❑ 601 -800 amp 423.00 179.00
O 801 - 1000 amp 516.50 216.00
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 563.00 300.00
Service Feeder
❑ Up to 200 amp $120.50 $35.50 ❑ Over 600 volts surcharge $94.50
❑ 201 -400 amp 149.50 74.00 ❑ Mast or meter repair $102.00
❑ 401 -600 amp 205.00 102.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ 601 -800 amp 262.00 140.50
❑ Over 800 amp 375.50 280.50 Service or Feeders
❑ 0 to 200 amp $120.50
ALTERED SINGLE/MULTI FAMILY U 201 -600 amp 280.50
❑ 601 - 1000 amp 423.00
Service or Feeder
❑ over 1000 amp 471.00
❑ 0 to 200 amp $92.50
❑ 201 -600 amp 149.50 ❑ #of circuits to be added/altered
❑ over 600 amp 225.50 (1-5 circuits-$94.50;Add'n circuits,$7.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$74.00;Add'n circuits$7.00/ea) $94.50 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $55.00 ❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
U Service or feeder only $74.00
❑ Service and feeder $120.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $65.00
❑ #of service or feeders
(First service/feeder-$74.00;each add'n-$48.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $74.00
❑ 101-200 amps 94.50
U 201-400 amps 111.00
❑ 401-600 amps 149.50
❑ over 600 amps 162.00
MI LANEOUS SERVICE/EQUIPMENT
#of Thermostats ❑ #of Signs
• (First-$55.00;add'n-$17.00/ea) (First sign-$55.00;add'n sign$26.00/ea)
U Low Voltage U Swimming pool/hot tub $111.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $74.00
❑ Security Alarm System U Additional Plan Review $111.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
❑ ❑ Automation Fee on all Permits .. $5.00
la 2500 ft2-$65.00;
h add'n 2500 ft2-17.00)•Per WAC 296-46-91015)(b)(i&ii)
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Bulletin#100-April 2,2007 Page 3 of 4 k\Handouts\Permit Application