08-106005 ' "" �' Electr ci al
� City of Federal Way C!
CommunityDevelopmentServices �� Permit #: 0�-106005�oO�GL
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: EVERGREEN LODGE
Project Address: 31002 14TH AVE S Parcel Number: 082104 9088
Project Description: Replacing&installing nurse call pull stations.Adding/altering(5)circuits
wn r Aualicant Contractor
HEALTH CARE REIT INC B B ELECTRIC INC B B ELECTRIC INC
PO BOX 1475 2721 S ASH ST BBELEBE950P1(10/21/09)
TOLEDO OH 43603-1475 TACOMA WA 98409 2721 S ASH ST
TACOMA WA 98409
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Service greater than 1000 Amps?...........................No
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Circuits-Commercial.................... 5
PERMIT EXPIRES Saturday, December 19, 2009
Permit Issued on Friday, December 19,,200$
I hereby certify that#he above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordancewith the laws, rules and regulations of the State of Washington
and the City of Federal Way.
owner or agent: ,/�``t� � Date: `��/� y '
FINALED ` Z'` �
'`' 1 THIS CARD IS TO MAIN ON-SITE
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��n oF ���� �ommuni Develo m nt Ins ection Recor�
�Y p p
F�(��r"+a' W�y IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-106005-00-EL
Owner: HEALTH CARE REIT INC
Address: 31002 14TH AVE S �
FEDERAL WAY, WA 98003-4712
This card is part of your required inspection documents. Scheduled inspections may be failed if this cazd is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read lett 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.
� UFER Ground (4295) � Ditch cover(4030) � Slab/Concrete Floor(4255)
Approved Approved Approved to piace concrete
By Date By Date By Date
� Pool Bonding(4195) � Temporary Power(4275) � Service(4235)
Approved Approved Approved
By Date By � Date By Date
� Feeders/Sub-panels(4045) � Rough Electrical(4225) � Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date ;
� Final-Electrical(4055)
Approved ,
By Date � •��•6 �
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For inspector reference only �
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- O Rough Electrical ❑ FINAL-Electrical '
APP�'� Approved
By �� By Date
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� . �ERIVIIT
roveA»x�rrnsysco�e�rrssevrcas SF MF CO ME�L DE EN FP
33945driAVEMlSSOU7!{.��971�Ec �.q 2�p�LI CATI O N
FBDBRAL WAY,WA 98063•971B
� 453-B3S�607•FAX 45J-B35-?609 / /
� The foitowil�g��d���/!�s-a�l�lr�nplete appiicat�ton wili not be accepbed. Piease prin.t te9�HJ/���S)or�JPe•
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ASSES30R'S TAX/PARCEL# � S 2-� O �- _L� __ LOT 8IZE(s�
LF�(3AL DESCRIPTION(e.g.Acme Estates,Lot 1 J
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TYPE OF PER11�T ❑BUbDII'�Qr ❑ PLII��Q ❑ �CBAMCAL
O DEMOLITION p��LECTRICAL � FIPQIIYEERII�iQ� O FIRE PREVELiTION BYSTEM
� PRO.i$CT DESCRIPTIOl�i(Provide detafled descriptiore of work ved�ded o►t dus nesmit onhii . .
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� PROJECT AA�(Name of Bu�s'v.�s or Oumer Lost Namel ��'���C�V C��1>C��� .
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f MARdNl3 ADDRESS CITY.3TATE.Z1P B-MAO.ADDR69.9
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' CONTRACTOR co p�t�n ru�s er�.[Gxt
' �'i3 (i�c c�✓�C� S'�"�[�t'i ��a��'S G� o�cs�axs
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� C!t'Y OF FBDSRAL WAY BUSII�1&9S LICSN3B NUSIBER TION DATB FAX NUl�BR
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' APPLIceBT c�e�i�rir� �r�uc�xr ru�[s
� oFP[CB PItON6
' MAIt�NO ADDRB33 CBY,STATB.Z� CELL PHONS
' RELATiON3H1P TO PROJHCC FAX N[J�lBSR
' ❑ Architect o Tenaat ❑Agent o Other ( � _
�J�'i' � �ux�r e[tor�a e-uNr.enuasss
CONTACT _
LENDER H� P�rRCW 19.Z7.o9�
' I.�ndK ir{t6rmaeion Is nsqr�ind�(fProJ����ds#3,000
MAILIIVO ADDRS33 (�'t'1f.9TATB.Z� pgpHg
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�Q�E PROPOSED II$E
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�ffiST�Q ASSESSED/APPRAIBED VALUE� VALIIE OF PROP08SD WORS I�
SPRIIYKF�ERSD BIIbD�GP O Yffi a RO FII2E.8IIPPRESSIOA SYSTE�[PROPOSED/REQIIIRED? O YE8 o AO
WATER SERVIC$PROVIDER o LAKEHAVEN a HIQ�IIYE o TACOMA o PRNATE(WELL)
SEWER 8ERVICE PROVIDER O r-sunsus� O ffiQHLINE O PRIVATE SEPTIC •
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AREA DESCR�TIOA �7II3TING PROPOSED � TQTAL
.FT. ,p"r; g .P"�'.
BA3EMENT
FIRS'f
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`S�1�B ,. -:
THIRD
ADDITIONAL FWORS(DESCRIBE)
DECK(O COVERED OR ❑UNCOVERED?)
GARAGE 0 CARPORT 0 _.
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- � � �oeo� sor�r.
NUMBER OF FWORS � .
+'NEWFIQb�S ONLY"` NUI�ER OF BEDROOMS ESTIMATF.D:3ELIdNG PRICE $ .
Indicate num6er of each type o�'fixture to be installed or relocated as port of this project. Do not inc:Gtde eadsting frxtunes to remain.
�� PY OF BID OR ESTIMATE M(!ST BE INCLUDED WiTfiAPPLICATlOIVJ '
Vahce of Medeanical Work$ (A�
nut xexnuxa vxcTs EvnPORn�v�coo�Rs c�s�r ocrn.�rs , wooasrovas
BgQg . FAN3 Q118 WATER HEATERS _ MI3C(Describe)
g�II,gR� ' - _ ° �,lIG�INSERT9 - H�QL1S�x�rd�1 ; , �
coec�ssoRs �xness �xa�s �
DUCP3. - (3A3 IAQ SET3 REFRI(i.SYSTEMS �
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PLU� �
BATHT[JBS(er'ItiWsho�seCao6o1 IAV3(e�msto�nl �N� M[SC(Descdbe)
DI3HWA3HER9 ItAiNWkTER 3YSf VACUUM BREAK�R3 1
DRQ�IQ FOUIVTAINS SHOWER4 WATER CLOSET3�[on.q
F�ECTRIC WAT�R HEATERS 3INKS WA9HiNCi bIACHlN&4 .
HOSE st�ss 3UMPS . j
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I eat�Jy�nder P�W P�tha!I mK the�a+sp�rlg ow�r or,anthor[ssd q4!�4/�P^�P�►'t9 o�wur.I ea'!�that ts tle�b�a!4/my
knowi�d��,t/i�4{/orntalio�t wbetltbd fi�aaPP�►�R/�P�t 4PP�ts hrts m�d oorrret I eer�that I artl�ooiwP�[/�+��+PPHoabis ;
«fy y hd��[yYa�s+sgriradtor�s perast�dns to tle.�xte ardaw�d bg s1ie.iss�ane.af s permit I undriaEm�d thae ths issuau�e g!rJds p�nnit
do�+wot ranow ths ome�r'a re�.�Or osn�Ptiartce nrtth ioeai,stc�te,or,f�as�+al i�rs�iat�mnadvdion or enotromw�ntai taws.
j f F�rther ergr�E to hofd hcv�ieu thf Cttg 4/lltdkai Wiyq a+Yo mtidl Ciafnt(ineludtn8 oost+, �+a,mtd attornsys',/�ts tnevrna iro ths
;nwst�Non and d4/snss q/srteh etai�a), whleli n�6e mads by meal Pa+o�, ��+�9�� �R��+����db 6ttt only
tnhsn atteh efaim arla�s out q/ths nHanae.4/!hs eitgi�luding its o,�csrs and anp/odfs�s.upon ths aeau�c9 o.t ths{R/ormatton auppHed!o
th�city as a part oj tMs pHoa�[on.
81(�NATUR� - DATE
propecly Oaner and/or Authorized Agent
o NEW o ADDITION ALTERATION a REPAIR o.TENANT IMPRAVEMENT
B�.D�H(��O8L1€�' 'a FES' a Bt3 BASIG PLAI�?" ' n.� a Bd
ZOA�Q DESIQBATION CBANOE OF II8S? o YE3 o AO
j ASW ADDRESS 1tEQtTIRED� , ,,o Y�8. n NO IIP/Sffi'M$� a YE8 n�i0 _
PLATTBD LOT?, _ o Y� a 80 DEMO PERmIT RE4UIIiSD? o YES o NO
Bulletin#100—January 1,2008 Page 2 of 4 k�Handouts�Permit Application
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RESIDENTIAL COMMERCIAL
NEW RE3IDENTIAL 8ERVICE N�����/�IIgTR�AL SERVICE
❑ Single Family Square Feet Seruios or Feeder Each.Add"n
(First 1300 ft�-$115.50:Each add'h 500 R�-$37.00) ❑ 0 to 100 amp $125.50 $76.50
❑ Detached outbuilding or garage : 0 lU l-200 amp 155.50 98.00
(InspecF:ed vvith§eivice)' $48.50 , ❑ 201-40(�emp 291.00 115.00
❑ Detached outbuilding or garage ❑ 401-600 amp 339.50 136.00
(Inspected separately) $76.50 0 601-SU0 amp 439.00 186.00
❑ 801-1000 amp 536.50 224.50
ItEW MULTI-FAb�Y(thrce units or more) ° ❑ Over 1000 amp 584.50 311.50
Seruice Feeder
❑ Up to 200 amp $125.50 �37.00 0 Over 600 volts surcharge $98.00
❑ 201-400 amp 155.50 76.50 ❑ Mast or meter repair $106.00
❑ 401-600 amp 212.50 106.00 ALTERED COMMERCIAL/�TDIISTI2IAI�
❑"601-800 amp 272.00 145.50 •
❑ Over 800 emp 389:50 291.00 Seruice or Feedess
0 0 to 200 amp $125.50
ALTERED 3INQLE/MULTI FAM�Y 0 201-600 amp 291.00
❑ 6Q1- 1000 amp 439.00
Seruice or Feeder ❑ ova 1000 amp 489.00
❑ 0 to 200 amp $96•00
❑ 201-600 amp 155.50 ❑ �#of circuits to be atdded/altered
❑ o v e r 6 0 0 a m p 2 3 4.0 0 (1-5 circuita-$98.00:Addh ciccuits,$7.50/ea}
❑ M of circuits to be added/altered CO�RCIAL/INDIISTRIAL PLAft RE'VIE�V
(i-4 circuitrS76.50:Add'a circuits$7.50/ea� $98.00 phls 35%of Permit Fee
❑ Servic:e- 1,000 amps or�eater
❑ Mast or meter repair $57.50 ❑ Medical/Educatioaal/Institutional Fac�7ity
' MANUFACTURED SOMES
❑ Service or feeder only $76.50
❑ Semice and feeder $125.50
TE�ORARY SERVICE
MOBII.E HOME/RV PARK Reatdmettg�/dLuiE[Fami1� $67.50
❑ #of service or fxders
(Ftrst s«vice/feedm�-�76.50;each addh-�50.00) Co i Seraice or Feeder A»tpaett►J
. ❑ a-100 amps $?6.50
❑ 101-200 empa 98.00
❑ 201-400 amps 115.00 �
0 401-600 amps 155.50
❑ over 600 amps 168.00
MISCELLANEOIIS BERVICE/EQUIPMENT
❑ #of Thermostats ❑ #f�'8igas
(FYrst-$57.50;add'a-$17.50/ea� (F�irst sig�-�t57.50;add"n sign$27.00/e�
❑ Low Voltage 0 8ovimmiag pooi/hot tnb................ $115.00
Sqnare Feet to.be served bY sYstem(� (Inctudea additionat circuit,if re4uiredl
� F�ra Alarm,System ❑ Y�tM Pole meter loops..................... $76.50
0 Security�Urrm 3yatem � Additioaal Plaa Ravieor �115.00/hour
0 voice canliag: (f�modified sut,mittats)
� Da C ling ,�� ❑ Antomatloa Fee oa ali Permits .. $5-50 }
0 � .
1�Z500 tH�-$67:5(� •
EaCh.Addh 2500 R�-$17.50)�Aer R�AC?96-06910(SN6J�[6 N/
Bulletin#t 00-January 1,2008 Page 3 of 4 '`'ktHandouts�Perndt Application