10-100297City of Federal Way
Community Development Services
P O. Box 9718
Federal Way, WA 98063-9716
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical
Permit #: 10 -100297 -00 -EL
Project Name: AUBURN REGIONAL MEDICAL AT WALMART
Project Address: 34520 16TH AVE S
Project Description: Installation of low voltage security system
Inspection Request Line: (253) 835-3050
Parcel Number: 212104 9010
Owner
Aonlicant
Contractor
FEDERAL WAY MARKETPLACE
PROTECTION ONE ALARM
PROTECTION ONE ALARM
INVESTORS LLC
7617 S 180TH ST
PROTEOA033BP (1/17/11)
5743 CORSA AVE SUITE 216
KENT WA 98032
7617 S 180TH ST
WEST LAKE VILLAGE CA 91362
KENT WA 98032
I Additional Permit Information V
Is Use Educational or Institutional? ....................... No Service greater than 1000 Amps? ........................... No
Electrical Fixtures
Low Voltage - Burglar Alarm (Cor 1
PERMIT EXPIRES Saturday, January 22, 2011
Permit Issued on Friday, January 22, 2010
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: Date:
CITY OF 401rW&
Federal Way
PERMIT #:
Owner:
THIS CARD IS TO R"tAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
10 -100297 -00 -EL Address: 34520 16TH AVE S
FEDERAL WAY MARKETPLACE IN FEDERAL WAY, WA 98003-6841
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.
13 Final - Electrical (4055)
Approved
By Date 5 �_
El
LIFER Ground (4295)
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
El
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
13 Final - Electrical (4055)
Approved
By Date 5 �_
El
Pool Bonding (4195)
❑
Temporary Power (4275)
El
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
E]
E]
Ceiling Cover (4020)
Rough Electrical (4225)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
13 Final - Electrical (4055)
Approved
By Date 5 �_
El
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
-FeciAE'CE"IVE
PERMIT
COMMUNITY nEVEr oPhlsNr seRvtcss
......
3325 1 111. WA SDUTN • t'U �'1 2 010
APPLICATION
FEf77:RAL WRY, WR 98463• 1
253-835-2607' FAX 253-835-2609
rcrrnr. tilt rdrmflc�l _ � � � ®r � /� L W L1
SF MF CO MEL DE EN FP
t rl
The jbM ng is requi^rT,Wormation -an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS 3 G 4 r�o I �n A v (� SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # Z v `� ' LOT SIZE (s])
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1 )
(Attach separate page for lengthy legal des-iption)
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION N ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on Lids permit only)
PROJECT NAME (Name of mess or Owner Last Name} ro"' ' " p`" c w -- ngj • `'� ��
PEOPLE•' •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAMEPRIMARY
"Mo
OFRCE PHONE
(�kaS7 �- i l-7
PHONE
MAILIHGADDR�
tt``��11
{ ,_
C � TE. ZIP
f2 bjoU
E-MAIL ADDRUBS
C ANMA
A P ICAN NA
c a � c krv' s�
OFRCE PHONE
(�kaS7 �- i l-7
LINGMADDRESS
7
C ATB, Zi
CELL PHONE
-
CITY DF FED RAL WAY BUSINESS LICENSE NUMBER EHPIRATI O DA E
7i1
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER EXPIRATIO DATE
T P-DTc L)F
E-MAIL ADDRESS
CONWAIfY NAM
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
( -
NAME PRIMARY PHONE
E-MAIL ADDRESS
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP /PHONE
EXISTING ASSESSED/APPRAISED VALUE
PROPOSED USE
VALUE OF PROPOSED WORK $
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)
PROJECT FLOOR AREAS •- r
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
Std, FT.
TOTAL
SQ. FT.
BASEMENT
FANS
GAS WATER HEATERS
MISC (Describe)
FIRST
FIREPLACE INSERTS
HOODS (commerdeq
SECOND
FURNACES
RANGES
BASIC PLAN?
TIziiir:r
GAS LOG SETS
REFRIG. SYSTEMS
CHANGE OF USE?
ADDITIONAL FLOORS (DESCRIBE)
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ONO
UP/SEPA/SU?
DECK (❑ COVERED OR ❑ UNCOVERED?)
LAVS poffroomsinko
URINALS
MISC (Describe)
GARAGE ❑ CARPORT ❑
RAINWATER SYST
VACUUM BREAKERS
NUMBER OF FLOORS
MSTWo rxoros®
TDTAL
ToT"L 10 sr
TOTAL PRDPOMD Sr
Torn& sr
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $ (A COPY OF BID OR ESTIl1IATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS
WOODSTOVES
BBQS
FANS
GAS WATER HEATERS
MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (commerdeq
COMPRESSORS
FURNACES
RANGES
BASIC PLAN?
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
CHANGE OF USE?
PLU=ING
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ONO
UP/SEPA/SU?
BATHTUBS (or Tub/Sho—r Combo)
LAVS poffroomsinko
URINALS
MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS poiieq
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
I certify under pexaity of perjury that I am the property owner or authorized agent of the property owner. I cert{ fij that to the beat of my
knowledge, the information submitted in support of this permit applicaVon is true and correct. I cert jvj that I udit comply with all applicable
City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with Iocal, state, or federal laws regulating construction or environmental taws.
I further agree to hold harmless the City of Federal Way as to any claim linofuding costs, expenses, and attorneys' fees incurred to the
Investigation and defense of such ctaim), which may be made by any person, including the undersigned, and filed against the city, brut only
where such claim arises out of the reliance of the city Reding its officers and employees, upon the accuracy of the irk/ormation supplied to
the city as a part of this appfi n. r
SIGNATURE: 46
r DATE
Property Owner
d/or Authorized Agent
FOR OFFICE USE ONLY
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
T�
BASIC PLAN?
❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ONO
UP/SEPA/SU?
❑ YES
❑ NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
❑ NO
Bulletin #100 — January 1, 2009 Page 2 of 4 k\Handouts\Permit Application
*NOTE: an automation fee of
RESIDENTIAL
NEW RF-SMEN'TIAL SERVICE
❑ Single Family Square Feet
(First 1300 W $13 1.00; Each add'n 500 ft2 - $39.00)
❑ Detached outbuilding or garage (w/ service) ......................... $51.00
❑ Detached outbuilding or garage (inspected separately) ........ $80.00
❑ Swimming pool (w/ service) ................................................. $80.00
❑ Swimming pool (inspected separately) ............................... $120.50
❑ Hot tub/spa/sauna (w/ service) .......................................... $51.00
❑ Hot tub/spa/sauna (inspected separately) .......................... $80.00
❑ Septic pumping system (w/ service) ..................................... $51.00
❑ Septic pumping system (inspected separately) ..................... $80.00
NEW 'MULTI -FAMILY (three units or more)
$ 80.00
Service
Feeder
❑ Up to 200 amp
$131.50
$ 39.00
❑ 201 - 400 amp
163.00
80.00
❑ 401 - 600 amp
223.00
111.00
❑ 601 - 800 amp
285.50
152.50
❑ Over 800 amp
408.50
305.50
ALTERED SINGLE1MULTI FAMILY
Service or Feeder
❑ 0 to 200 amp $100.50
❑ 201 - 600 amp 163.00
❑ over 600 amp 245.50
❑ # of circuits to be added/altered
(1-4 circuits -$80.00; Add'n circuits $8.00/ea)
❑ Mast or meter repair $60.50
MANUk'ACT[> RED HOMES
❑ Service or feeder only $80.00
❑ Service and feeder $131.50
MOBILE iI011+IEI1tV PARI{
❑ # of service or feeders
(First service/feeder-$80.00; each add'n -$52.50)
will be charged for all permits.
COMMERCIAL
NEW COMMERCIALl1NDUSTRiAL SERVICE
❑ 0 to 100 amp
❑ 101 - 200 amp
❑ 201 - 400 amp
❑ 401 - 600 amp
❑ 601 - 800 amp
❑ 801 - 1000 amp
❑ Over 1000 amp
Service or Feeder Each Add'n
$131.50
$ 80.00
163.00
103.00
305.50
120.50
356.00
142.50
460.50
195.00
562.50
235.50
613.00
327.00
❑ Over 600 volts surcharge $103.00
❑ Mast or meter repair $111.00
ALTERED COMMERCIALMDUSTRiAL
(Does not include circuits.)
$ 71.00
Service or Feeders
❑ 0 to 200 amp
$131.50
❑ 201 - 600 amp
305.50
❑ 601 - 1000 amp
460.50
❑ over 1000 amp
513.00
❑ # of circuits to be added/ altered
(1-5 circuits - $103.00; Add'n circuits, $8.00/ea)
COMMERCIAL INDUSTRIAL PLAN REVIEW
$103.00 plus 35% of Permit Fee
❑ Service - 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
❑ Additional plan review for
modified submittals $115.00/per hour
TEMPORARY SERVICE
Service or Feeder Each Add'n
❑ 0 to 60 amp
$ 71.00
$32.00
❑ 61 - 100 amp
80.00
39.00
❑ 101 - 200 amp
103.50
51.00
❑ 201 - 400 amp
120.00
60.50
❑ 401 - 600 amp
163.50
80.00
❑ Over 600 amp
183.00
92.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats
(First -$60.50; add'n-$18.50/ea)
Low Voltage QD�
�/ AA Square Feet to be served by system(s)
❑ Fire Alarm System
Security Alarm System
❑ Voice Cabling
❑ Data Cabling
Pt 2500 ft2-$71.00;
Each add'n 2500 W - $18.50) "Per WAC29Cr46910(5)(b)(i & ii)
❑ # of Signs
(First sign -$60.50; add'n sign $28.50/ea)
❑ Yard Pole/meter loops/pedestal................... $80.00
❑ Portable Generator (transfer equipment)...... $100.50
❑ Ditch cover/inspection only ....................... $120.50
For fees not listed, contact the Permit Center at
253-835-2607
Bulletin #100 - January 1, 2009 Page 3 of 4 MandoutsTermit Application