02-101738 1
1 C`''unity Develoeral pment Services W
ay
Community Electrical Permit #:02 — 101738 — 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
III
Project Name: ST FRANCIS HOSPITAL
Project Address: 34515 9TH S Parcel Number: 751' - . '
Project Description: ELE-Echo room first floor existing hospital; add(1)light switch,add(2)duplex re ,tacles,(1) to
opening, move(1)fire alarm speaker and (1)paging speaker.Add (1) GFI outlet
Owner Applicant Con r
ST FRANCIS MEDICAL VECA ELECTRIC CO INC VELA E CO INC
1717 SJ ST PO BOX 80467 PO BOX 80
TACOMA WA SEATTLE WA 98108 SEATTLE WA 8
98405-4933 (206)436-5200
EI• ical Fi ures II 1
Description Quantity Des 'x'1.1"; Qua y bescription Quantity
4IS
Circuits- Commercial 5 '
P' - ' L October 2, 2, NO WORK IS STARTED.
'- 't isekii4 April 25,2002
•I hereby certify that the abo ' formation is ect and that the construction on the above described property and
the occupan d the use wil in accordan ith the laws,rules and regulations of the State of Washington and
the City eral Way.
Owner e
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ED CONSTRU ON PERMIT APPLICATION
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• I:Y':PLICAT ON NUi BER.:.i: i:::: :.:: ::��....r:.::.sw.:i e:::'.w i:' �.::.:i.::•:' '::�1
CI F DERAL WAY
�(oviinctiTrequired information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
<_ C
• PROPERTY INFORMATION
SITE ADDRESS: 34 S S 94'x^4e So. -15003 ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
''__ A
PROJECT DESCRIPTION(Provide detailed description): ss
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PROJECT NAME: sr, P2 1'I c,.i S S/ i 4 o4J11 sre (-6:
• PEOPLE INFORMATION
• NAME: DAYTIME PHONE:
ROPERTY OWNER: ,-417/c.Ate-MQ 44.611-4
// , rsro (253) 591 -6,835
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): j 9.8/ 717 .50 , 3 . S7R e7' Tom, /0A
DAYTIME PHONE:
NAME:
CONTRACTOR:
`♦
Y F.c4. 6.(?(-7-r:c CD . (` `n ) -34 -bZDO
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): �/��y {� / Q, (EVENING PHONEE:2
G?p 14 WAY BUSI4UCENSE NUMBER: .R �Cr7 i l Lam IA 'S 10B ` , ) TJ(D _5 oo
CITY OF FEDERAL 1 FAX NUMBER:
( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
VE04 LCe.6,74.4 c, ex) . ( ) e6b -5Zoo
(STREETMAIUNG ADDRESS STATE,
EVENINGPHONE:
s'G/ ! �7 eS0 Ser77, ijjA 96�96/06 ( exo 434 _Su.v
RELATIONSHIP TO PROJECT: FAX NUMBER: t/
o ARCHITECT ❑TENANT pi OTHER(DESCRIBE): tC i, r, ( ) 76 3-050 5
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER APPLICANT ❑ CONTRACTOR hinoloY. WOO O e I/ ,4ri+
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
WROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
PRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION IIIr**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
• PROJECT 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
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) FURNACES)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC ❑ GAS •
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKERS) o ELECTRIC o 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: L P�.1�T YI/lc�L . DATE: 4/Z2'/ 7.0O L-
❑ PROPERTY OWNER (A PLICANT X CONTRACTOR
R FFICE USE::ONLY:<
ci NEVeiNU:'.a ADDITION ::.:> #::ALTERATIOtCM:::::::CCREPAIIIr::.:..>::::>>ci TENANT:IMPROVEMENT .
ZONING DESIGNATI N: ..... :.:&tUILDING:SHELL>ONLY? .O.Yiii.iiii i NO >:
COMP P00004 GNATION»»:.:..... ;;;;;;::::::,:BASiIC,PL•AN2::>;,>::::i#:YES NE ifigi
:>�'• .::`. ;::::;::::>ss<>TOWNSHIP . . .:.:.:RANGE.,<>:><;s: NEW.:ADDRES' :NtQQUIREDl... ll : t:YES ii ILIO „ •
PLAITED LOT.....a yE5:. ::.ci NO..:::: ...... ;;:;:;::>:::< 1Altia 11 11+ ?'>:'>: :>>?»:' G1 �':>>s>::» 1 ...... :;:s
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.citvoffederalway.com
Construction Permit Fee Calculation Sheet
*******PLEASE NOTE: ALL FEtUST BE VERIFIED BY CITY STAFF P•R TO ACCEPTANCE OF PAYMENT.
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building,mechanical,and fire prevention system fees are based on the following schedule.
• TOTAL VALUATION TABLE AFEE FACTOR
(1)$1.00 to$500.00 (I)$26.00 •
(2)$501.00 to$2,000.00 (2)$26.00 for the first$500.00 plus$3.50 for each additional 5100.00 or fraction thereof,to and including
$2,000.00
(3)$2,001.00 to$25,000.00
(3)$78.50 for the first$2,000.00 plus$15.50 for each additional$1,000.00 or fraction thereof,to and
including$25,000.00
(4)$25,001.00 to$50,000.00
(4)$435.00 for the first$25,000.00 plus$11.00 for each additional$1,000.00 or fraction thereof,to and
including$50,000.00.
(5)$50,001.00 to$100,000.00
(5)$710.00 for the first$50,000.00 plus$600 for each additional$1,000.00 or fraction thereof,to and
including$100,000.00.
(6)$100,001.00 to$500,000.00
(6)$1,110.00 for the first$100,000.00 plus$600 for each additional$1,000.00 or fraction there9f,to and
including$500,000.00
(7)$500,001.00 to$1,000,000.00
(7)$3,510.00 for the fist$500,000.00 plus$5.50 for each additional$1,000.00 or fraction thereof,to and
including$1,000,000.00. r
(8)$1,000,001.00 and up
(8)$6,260.00 for the first$1,000,000.00 plus$4.00 for each additional$1,000.00 or fraction thereof.
Bold number is the base fee for the specified increment
Italicized,underlined number Is the fee per additional specified increment
PLUS: Add 65 percent of the base building permit fee for plan review fee.
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add 15 percent of the base building permit fee for Fre District#39 surcharge,commercial only.
Add$4.50 for WA State Building Code Coundl,plus$2.00 per unit for duplex&above.
**Electrical,plumbing,and mechanical fees are calculated separately*'
■ BUILDING ..,. . . ..
PROPOSED VALUATION:
• FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (1)
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERCIAL ONLY)
r , ■ MECHANICAL
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5)
... . . ,... • • ,::.■ -FIRE PREVENTION SYSTEM . ..
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
,_;■ .PLUMBING .
Base Fee Number of Fixtures
4110
$22.50 + { X$8.00/fixture}= (8) Estimated Permit Fee
Estimated Permit Fee
X _65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge:(10)
Sub Total (PageOnc): Line(s)(1)±(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11) •
TABLE B
'MEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
- _Single Family _Service or feeder only $50.00 _#of Thermostats(First-$37.50;add'n-$11.50ea
(First 1300112-$75.00;Each add'n 500 ft2-$24.00) _Service and feeder $81.00 _#of Low voltage fire or burglar alarms
Square Feet: First 2500 ft2-$43.50;Each add'n 2500 ft2-$11.50
Each outbuilding or garage $31.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _#of service or feeders •Per WAC 296-46-910(5XbXi&ii)
-Each outbuilding or garage $50.00 (First service/feeder-$50.00;Add'n service/ _4 of Signs(First sign-$37.50;add'n sign
(Inspected separately) feeder-$32 each) $17.50 each)
_Swimming pool,hot tub,spa $75.00
-Yard Pole meter loops $50.00
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 $ 81.00
_Up to 200 amp $ 81.00 $ 24.00 Feeder _201-600 189.00
_201-400 amp 101.00 50.00 _0 to 100 $ 81.00 $ 50.00 _601-1000 284.50
_401-600 amp 138.00 68.50 _101-200 101.00 63.50 _over 1000 317.00
_601-800 amp 176.50 94.50 _201-400 189.00 75.00 _#of circuits
Over 800 amp 252.50 189.00 _
_ 401-600 220.50 88.50 (1-5 circuits-$63.50;Add'n circuits,$5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800 284.50 120.50
(When inspected separately from the services.) _801-1000 348.00 145.50 TEMPORARY SERVICE
Service or Feeder _Over 1000 379.00 202.50 Residential/Multi-Family/Commercial/Industrial
_0 to 200 amp $ 68.50 _Over 600 volts surcharge 63.50 _0-100 $ 50.00
_201-600 amp 101.00 _Mast or meter repair 68.50 _101-200 63.50
_over 600 amp 151.50 _201-400 75.00
_Mast or meter repair 37.50 _401-600 101.00
#of circuits _over 600 109.00
(1-4 circuits-$50.00;Add'n circuits$5 ea)
If a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps,a plan review is required.Fee is 35%of
permit fee+$63.50.Add'l plan review for other submissions is$75.00/hr.
s:WOc'#itl?Ec><ES.001# 4NtiAI:::.:<:_MIOU1VEE..#`R:Oti.:#`h .�.���.._..........�iE�i�E3rr�c::0�<;A1h�S.��..... ............ ..... IO)
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hi sem,/-�,.. r
by lrX. R t�p4Att.s
LAT n evo 61 r
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Total Column(0)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12 •
Estimated Plan Review Fee: $63.50+( 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) III
Total (Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)= (24)
Bulletin#100-February 19,2002