06-101013' THIS CARD IS TO R;.:MA ;N ON -SITE
CITY OF - Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT 9: 06- 101013 -00 -EL
Owner: CHRISTOPHER & KAREN REDFEARN
Address: 29416 19TH PL S
FEDERAL WAY, WA 98003 -3860
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
❑
® Temporary Power (4275)
Service (4235)
❑ Feeders /Sub - panels (4045)
Approved
Approved
Approved
By Date
By
Date
By Date
Rough Electrical (4225)
Approved
By \`/ Date
Under -slab groundwork (4295)
Approved
By Date
❑ Ceiling Cover (4020)
Approved
By Date
Final - Electrical (4055)
Approved
Byo Date
r
CITY OF \ >: W A i
Fec�e�-a! Way,,,,, OF SING D Y'i•I��I -�l��T
COMMUNITY DEVELOPMENT SERVICES ILD SF MF CO ME EL L DE EN FP
33325 8711 AVENUE SOUTH • PO BOX 9718
APPLICATION FEDERAL 1 .2607 FAX 253-835-2609
� �
wU1LP.cituo(Tederalwau. com
The ollowin is required information -an incomplete a lication will not be accepted. Please print legibly (in ink) or t pe.
SITE ADDRESS b 1 "l � � p 1 S . SUITE/UNIT #
ASSESSOR'S TAY. /PARCEL # _ - V LOT SIZE (sfi
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate pagelor I ngft legal description)
WE
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION D ELECTRICAL if ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlul
r•e, Sou rclom wcLvAes (?) (%�>v r#� — ��r�7) T (i> Pu��a l� t63)L�G�t�r
' LtJ'tf Q ig Z—
PROJECT NAME (Name of Business or Owner bast Name) h e Cj ` L? Ci r
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
]PEOPLE INFORMATION
NAME nn
R ed fcct✓' n
APPLICANT NAME
PRIMARY PHONE
( J
-
MAILING ADDRESS
CTIY, STATE, ZIP
WAX ) /�
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
( ) -
NAME //. f
PRIMARY PHONE
E .IIAIL ADDRESS
Per RCW 19.27.095: Lender inforrteation 1s
required if project .rialue exceeds $s000
N`ME
MAILING ADDRESS
COMPANY NAME
00W
APPLICANT NAME
Aone
OFFICE PHONE
MAILING ADDRESS G
223 MC
CITY, STATE, ZIP
Se t0e A c8i L
(z PHONE 3 96
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER I EXPIRATION DATE
d C o .L 131 /?_cob
FAX NUMBER
(LPL) •yy
-�SI
_Z - - �
I V 1 5 ? -
12-
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application)
EXPIRATION
DATE
! Q ►..1/ L. sL
4
C3 / CS
/
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other (Describe)
FAX NUMBER
( ) -
NAME //. f
PRIMARY PHONE
E .IIAIL ADDRESS
Per RCW 19.27.095: Lender inforrteation 1s
required if project .rialue exceeds $s000
N`ME
MAILING ADDRESS
CITY, STATE, ZIP
EXISTING ASSESSED /APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
PROPOSED USE
VALUE OF PROPOSED WORK $
FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
Value of Mechanical Work $
❑ REPAIR ❑ TENANT n%fPROVEMENT
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS REFRIG. SYSTEMS
BBQS
FANS
HOODS (cotnmvCal) WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES MISC (Describe)
COMPRESSORS
FURNACES
GAS WATER HEATERS
DUCTS
GAS PIPE OUTLETS
❑ NO
a NO
BATHTUBS (or1Lb /Shower Combo) SHOWERS WATER CLOSETS Itollct) MISC (Describe)
GAS PIPE PIPE
DISHWASHERS S SINKS DRINKING FOUNTAINS
G OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS (Bathroom Sink.) VACUUM BREAKERS ELECTRIC WATER HEATERS
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 fried against the City of Federal Way, but only where such claim
arises our of the reli of the city, incj�td' its o and employees, upon the accuracy of the information supplied to the city as a part of
this application. ,)
NAME /TITLE J /
(Signature) f ATE Q 6
(Mile)
RELATIONSHIP TO PROJECT ❑ Owner . ❑ Agent ❑ Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
❑.NEW ❑ ADDITION
BUILDING SHELL ONLY?
ZONING DESIGNATION
NEW ADDRESS REQUIRED?
PLATTED LOT?
Bulletin #100 — January 7, 2005
❑ ALTERATION
❑ REPAIR ❑ TENANT n%fPROVEMENT
❑ YES o NO
BASIC PLAN?
❑ YES
❑ NO
CFIANGE OF USE?
❑ YES
❑ NO
YES ❑ NO
❑ YES o NO
UP /SEPA /SU?
DEMO PERMIT REQUIRED?
❑ YES
❑ YES
❑ NO
a NO
Page 2 of 4
Mandouts\Pennit Annlicatinn
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIAL /INDUSTRIAL SERVICE
❑ Single Family Square Feet
Service or Feeder Each Add'n
(First 1300 ft2- $104.50; Each add'n 500 ft2 - $33.50)
❑ 0 to 100 amp $113.50 $ 69.50
❑ Detached outbuilding or garage
❑ 101 - 200 amp 141.00 89.00
(Inspected with service) $44.00
❑ 201 - 400 amp 264.50 104.00
❑ Detached outbuilding or garage
❑ 401
(Inspected separately) $69.50
- 600 amp 308.00 123.50
❑
601 - 800 amp 398.50 168.50
❑ 801 - 1000 amp 486.50 203.50
NEW MULTI- FAMILY (three units or more)
❑ Over 1000 amp 530.50 283.00
Service Feeder )
❑ Up to 200 amp $113.50 $ 33.50
❑ Over 600 volts surcharge $89.00
❑ 201 - 400 amp 141.00 69.50
❑ Mast or meter repair $96.00
❑ 401 - 600 amp 193.00 96.00
❑ 601 - 800 amp 247.00 132.00
ALTERED COMMERCIAL /INDUSTRIAL
❑ Over 800 amp 353.50 264.50
Service or Feeders
❑ 0 to 200 amp $113.50
ALTERED SINGLE /MULTI FAMILY
❑ 201 - 600 amp 264.50
Service or Feeder
❑ 601 - 1000 amp 398.50
❑ 0 to 200 amp $ 87.00
❑ over 1000 amp 443.50
❑ 201 - 600 amp 141.00
❑
❑ over 600 amp 212.50
# of circuits to be added /altered
(1 -5 circuits - $89.00; Add'n circuits, $7,00 /ea)
❑ # of circuits to be added /altered
COMMERCIAL/INDUSTRIAL PLAN REVIEW
circuits- $69.50; Add'n circuits $7.00 /ea)
$89.00 plus 35% of Permit Fee
❑
❑ Service - 1,000 amps or greater
Mast or meter repair $52.00
❑ Medical /Educational /Institutional Facility
MOBILE HOMES
❑ Service or feeder only $69.50
❑ Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME /RV PARK
Residential/Multi-Family $61.00
❑ # of service or feeders
(First service /feeder - $69.50; each add'n - $45.00)
Commercial/Industrial Service or Feeder Ampacity
❑ 0 - 100 amps $ 69.50
❑ 101 - 200 amps 89.00
❑ 201 - 400 amps 104.50
❑ 401 - 600 amps 141.00
❑ over 600 amps 152.50
MISCELLANEOUS SERVICE /EQUIPMENT
❑ # of Thermostats
❑ # of Signs
(First - $52.00; add'n- $16.00 /ea)
(First sign- $52.00; add'n sign $24.50 /ea)
❑ Low Voltage
❑ Swimming pool /hot tub ................ $87.00
Square Feet to be served by system(s)
(Includes additional circuit, if required)
❑ Fire Alarm System
❑ Yard Pole meter loops.... $104.50
❑ Security Alarm System
❑ Voice Cabling
❑ Additional Plan Review $104.50 hour
/
❑ Data Cabling
(for modified submittals)
❑
❑ Automation Fee on all Permits .. $5.00
(Per System(s) 18t 2500 ft2- $61.00;
Each add'n 2500 ft2- 16.00) "Per WAC 296- 46- 910(5)(b)ti & w
.0 u1,eu11 fP1 uv - January ), 2uu0 Page 3 of 4 k\landoutslPennit Application