02-103351City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Electrical Permit #:02 - 103351 - 00 -
Inspection request line:
Project Name: VANDERSLICE _ tc la
Project Address: 111 S 340TH U N '` C Parcel Numbe.
Project Description: ELE - Replace existing 125amp MLO panel with a new one. Also ailing new dryer
�_ �.
Owner
Applicant
Contractor
JULIE VANDERSLICE
CITY ELECTRIC INC OF TACOMA
CITY EL IC TACOMA
11 I S 340TH ST
217 E 25TH
217 E 25TH
FEDERAL WAY WA 98023
TACOMA WA 98402
TACOMA WA 98402
(253) 55
'es
Description Quantity
,003, IF NO WORK IS STARTED.
.ugust 5, 2002
ruction on the above described property and
id regulations of the State of Washington and
Date: ? ^ S- — D
MY OF �. CONSTRUCTION PERMIT APPLICATION
�� �PPLICATION NUMBER: 2 - I Q &sL - &o
-
VOW NUMBER: - -
PPLICATION NUMBER: - -
**The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORMATION
SITE ADDRESS: /'/ / S. 3-10 7"4 CS7 ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ - _ _ _ _
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
KELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): /e/tPLA GF / EX/S 7-1,,-� /- -c' �
l�✓/ i75i fl /✓J=tn/ / � A is �� �Q f 7ts�EL (�� /die£ CtR—Ccc
PROJECT NAME:l/�►..raC,icSLlce-
••LE INFORMATION
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
CONTACT PERSON
EXISTING USE:
NAME: DAYTIME PHONE:
-1 -IA -1E \./f+MbEims'i-dCE 1 (a-,53) --27f -10.23
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
/ / / S. 340 7 -Al S77.
NAME:
DAYTIME PHONE:
MAILING ADDR SS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
-;2/7 E. ->57W cs; .
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
T (0 1 tg f)
/.2 / 31
/ OZ
(copy of card required)
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
( )
RELATIONSHIP TO PROJECT:
FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE):
( )
-
E-MAIL ADDRESS:
:OR THIS PROJECT: VPROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
■ DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/ APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS:
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
COOLER(S)
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
FAN(S)
HOOD(S)
WOODSTOVE(S)
SECOND
FIREPLACEINSERT(S)
RANGE(S)
MISC.( )
THIRD
FURNACE(S)
FOURTH
GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
OTHER FLOORS (DESCRIBE)
PLUMBING
DECK
LAVATORY(S)
URINAL(S)
WATER HEATER(S)
GARAGE
HOW MANY FLOORS?
RAIN WATER
VACUUM BREAKER(S)
❑ ELECTRIC ❑ GAS
TOTAL:
SYS.
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING
EVAPORATIVE
GAS LOG(S)
REFRIG. SYSTEM(S)
UNIT(S)
COOLER(S)
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
BBQ(S)
FAN(S)
HOOD(S)
WOODSTOVE(S)
BOILER(S)
FIREPLACEINSERT(S)
RANGE(S)
MISC.( )
COMPRESSOR(S)
FURNACE(S)
DUCT(S)
GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S)
LAVATORY(S)
URINAL(S)
WATER HEATER(S)
DISHWASHERS)
RAIN WATER
VACUUM BREAKER(S)
❑ ELECTRIC ❑ GAS
SYS.
DRINKING
SHOWER(S)
WASH MACHINE
FOUNTAINS)
OUTLET
GAS PIPE OUTLET(S)
SINK(S)
WATER CLOSET(S)
MISC. ( )
INTERCEPTOR(S)
SUMP(S)
•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: 0a4tX DATE:
❑ PROPERTY OWNER ❑ APPLICANT 'CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
Estimated Plan Review Fee: (7)
Base Fee Number of Fixtures
$22.50 + ( X $8.00/fixture} _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65 =
Miscellaneous Fixture Charge: (10)
(9) Estimated Plan Review Fee
Sub Total (Page one); Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)
TABLE B
NEW RESIDENTIAL SERVICES
NUMBER OF UNITS C TOTAL D
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
Single FamilyService
or feeder only .........................
S50.00
_ # of Thermostats (First -$37.50; add'n-$I 1.50ea)
_ 2
(First 1300 ft -$75.00; Each add'n 500 11
-$24.00)
_ Service and feeder ...............................
$81.00_
# of Low voltage fire or burglar alarms
Square Feet:
TOTAL COLUMN (D):
First 2500 ft2-$43.50; Each add'n 2500 fe-$I 1.50
_ Each outbuilding or garage ...........................
$31.00
MOBILE HOME/RV PARK
Square Feet:
(Inspected with service)
# of service or feeders
* Per WAC 29646-910(5)(b)(i & ii)
_ Each outbuilding or garage ...........................
$50.00
_
(First service/feeder-$50.00; Add' n
service/
_ # 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 separatcl\ from the services.)
_ 801 -1000 ..................... 348.00.........
145.50
TEMPORARY SERVICE
Service or Feeder_
0 to 200 amp ..............................................
$ 68.50
Over 1000 ..................... 379.00.........
_ Over 600 volts surcharge.......................
202.50
63.50
Res idential/Multi-Family/Commercial/Industrial
_ 0-100 ................................................ $ 50.00
_
_ 201 - 600 amp ...............................................
_ 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=] plan review for other submissions is $75.00/hr.
FIXTURE DESCRIPTION A FIXTURE FEE FROM TABLE B B
NUMBER OF UNITS C TOTAL D
TOTAL COLUMN (D):
6-0 ` �� Total Column (D)
Estimated Permit Fee: (12) 1 (�''T-0
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50 + ( X .35) = (13)
■ DEMOLITION
Estimated Permit Fee: (14)
Bond Amount: (15)
Estimated Permit Fee: (16)
Bond Amount: (17)