08-102526..A - - #
FetalWa —- - - -- --
PERMIT �P SF MF CO ME � PL DE EN FP
COA(MUMTYDBVBLOPMBNT sBRVICBS MAY 2
33322 4 S- F� ��09718 ft)P CATION
FBDSRAG WAY, WA 98063 -97]8
wwrw.dluo%kdem CITY OF FEDERAL W
The following required In j'rr"9n. -an incomplete application will not be accepted. Please print legibly (in in)q or type.
PROPERTY IN• •
SITE ADDRESS 1 Q) () S SUITE /UNIT •
ASSESSOR'S TAX /PARCEL !1 — _ _ _ _ - _ — — _ LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot I)
(6ftaA -pa-te Pwla &Vn9 IsaW d— roff*N
PROJECT •• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ALECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT )DESCRIPTIO Provide detailed description of work included on this Dernut o
N
�y r
� � r
PROJECT NAME (Name of Business or Owner Last Name)(01 I I eA
PEOPLE •• •
PROPERTY
ME
PRIMARY PHONE
OWNER
OFFICE PRONE
( ) _
t,
Y
LINO A RESS
ocos
CITY, STATE, ZIP
E -MAIL ADDRESS
CONTRACTOR
611,11
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
COMPANY NAME
s
OFFICE PHONE -
APPLICANT NAME
OFFICE PRONE
E nll�ymknsl
t,
Y
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
LINO D
CITY, STATE, ZIP
CELL PHONE
V WRshLQM
i i -
CITY OFFEDERAL WAY BUSINESS
LICENSE NUMBER
EXPI TI0 DATE
FAX NUMBER
( ) -
NT 'S RZOurrNSTION
R
TION ATE
E-MAIL ADDRESS
_ �O
f
COMPANY NAME
APPLICANT NAME
OFFICE PHONE -
MAMM ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( ) -
NAME /1� 4 PRIMARY PHONE - E- MAILADDRESS Itir Jr
NAME
Per RCW 19.37.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
(
PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVIC)& PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑
AREA DESCRIPTION
EXISTING
8 . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
FIRST
COMPRESSORS
FURNACES
RANGES
SECOND
GAS LOG SETS
REFRIG. SYSTEMS
a NO
THIRD
a YES a NO
UP /SEPA /SU?
ADDITIONAL FLOORS (DESCRIBE)
a NO
PLATTED LOT?
a YES a NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
DEMO PERMIT REQUIRED?
o YES
a NO
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
sataeda
raerossD
TOTAL
M AL ZZOID7d1
tutu. rsarmsD ar
raaALOr
"NEWHOMES 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 ESTIMATE MUST BE INCLUDED WITHAPPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
OAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS Icommrd,q
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS (or rub /she combq
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
LAVS (s.rbroom SbJn)
URINALS MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
SHOWERS
WATER CLOSETS (ro&q
SINKS
WASHING MACHINES .
SUMPS
a NO
I cart{ fg under penalty of perjury that I am the property owner or authorised agent q/ the property owner. ! car ft that to the best of my
knowledge, the information submitted in support of this permit application is true and correct. I cerft that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorised by the issuance q f a permit. I understand that the issuance of this permit
does not remove the owner's rosponsibility for compliance with local, state, or federal laws regulating construction or environmental laws.
!further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorns s' fees incurred in the
investigation and dgfense of such claim), which may be made by any person, including the undersigned, and filed ainst the city, but only
where such claim arises out the city as a part ��- app the lianee /r the cl ,including its o jjiesrs and employees, upon the accuracy of Inf; l -tlon supplied to
SIGNATURE:
Owner and /or Authorized
o NEW o ADDITION
a ALTERATION
o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY?
a YES a NO
BASIC PLAN?
a. YES
a NO
ZONING DESIGNATION
CHANGE OF USE?
a YES
a NO
NEW ADDRESS REQUIRED?
a YES a NO
UP /SEPA /SU?
o YES
a NO
PLATTED LOT?
a YES a NO
DEMO PERMIT REQUIRED?
o YES
a NO
Bulletin #100 — January 1, 2008 Page 2 of 4 k\HandoutslPermit Application
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet
eeder Each Addn
�5
(First 1300 ft2- $115.50; Each addh 500 ft2- $37.00)
0 to 100 amp $125 $ 76.50
W101
Detached outbuilding or garage
200 amp 98.00
0
(Inspected with service) $48.50
❑ 201- 400 amp 291.00 115.00
❑ Detached outbuilding or garage
❑ 401 - 600 amp 339.50 136.00
(Inspected separately) $76.50
❑ 601 - 800 amp 439.00 186.00
❑ 801 - 1000 amp 536.50 224.50
NEW MULTI- FAMILY (three units or more)
❑ Over 1000 amp 584.50 311.50
Service Feeder
❑ Up to 200 amp $125.50 $ 37.00
❑ 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
13 601 - 800 amp 272.00 145.50
ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 389.50 291.00
Service or Feeders
❑ 0 to 200 amp $125.50
ALTERED SINGLE /MULTI FAMILY
❑ 201 - 600 amp 291.00
❑ 601 - 1000 amp 439.00
Service or Feeder
❑ 0 to 200 amp $ 96.00
❑ over 1000 amp 489.00
❑ 201 - 600 amp 155.50
❑ # of circuits to be added /altered
❑ over 600 amp 234.00
(1 -5 circuits - $98.00; Addh circuits, $7.50 /ea)
❑ # of circuits to be added /altered
COMMERCIALJINDUSTRIAL PLAN REVIEW
(1 -4 circuits - $76.50; Addh circuits $7.50 /ea)
$98.00 plus 350/6 of Permit Fee
❑ Service - 1,000 amps or greater
❑ Mast or meter repair $57.50
❑ Medical /Educational /Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $76.50
❑ Service and feeder $125.50
TEMPORARY SERVICE
MOBILE HOME /RV PARK
Residentia 1/Muiti- Family $67.50
❑ # of service or feeders
(First service /feeder - $76.50; each add'n - $50.00)
COmmerciaWndustriai Service or Feeder Ampacity
❑ 0 - 100 amps $ 76.50
❑ 101-200 amps 98.00
❑ 201 - 400 amps 115.00
❑ 401 - 600 amps 155.50
❑ over 600 amps 168.00
MISCELLANEOUS SERVICE /EQUIPMENT
❑ # of Thermostats
❑ # of Signs
(First - $57.50; addn- $17.50 /ea)
(First sign- $57.50; add'n sign $27.00 /ea)
❑ Low Voltage
❑ Swimming pool /hot tub ................ $115.00
Square Feet to be served by system(s)
(Includes additional circuit, if required)
❑ Fire Alarm System
❑ Yard Pole meter loops ..................... $76.50
❑ Security Alarm System
❑ Voice cabling
❑ Additional Plan Review $115.00 /hour
❑ Data Cabling
(for modified submittals)
❑ Automation Fee on all Permits .. $5.50
lot 2500 ft'- $67.50;
Each add% 2500 W - $17.50) • Per WAc 296.469] 0(sNb)# & b)
Bulletin #100 -January 1, 2008 Page 3 of 4 k\Handouts\Pennit Application
1R
City of Federal Way Electrical Permit• 08- 102526 -00 E -E L
Community Development Services •
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609 a3�� Inspection Request Line: (253) 835 -3050
Project Name: QWEST
Ei
Project Address: 33715 10TH AVE SW Parcel 92104 9006
Project Description: Installation of 120/240 UG service or DSi, §!6! "'Mation of box is corner o
Campus Drive & 10TH Ave SW ** 4
Additional Pe \'InformatiX4
g P Service reater than 1000 Am s ? ...........................No Ele %WFixtues A
Owner
Applicant
CoA!KT
QWEST
KEN BOBKO ELECTRIC CO INC
BOBK C
1 005 17TH ST ROOM 1570
PO BOX 7009
KEN C066 /
DENVER CO 80202
TACOMA WA 98406 -000
O BO 09
COMA W 984 1 -0009
Additional Pe \'InformatiX4
g P Service reater than 1000 Am s ? ...........................No Ele %WFixtues A
•� THIS CARD IS TO REMAIN ON -SITE r
CITY OF 40C0mmunity Develop&nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 08- 102526 -00 -EL
Owner: QWEST
Address: 33715 10TH AVE SW
FEDERAL WAY, WA
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.
❑
UFER Ground (4295)
Approved
By
Date
❑
Pool Bonding (4195)
Approved
By
Date
❑
Feeders /Sub - panels (4045)
Approved
By
Date
❑ Final - Electrical (4055)
Approved
By Date
❑ Ditch cover (4030)
Approved
By Q Date S-2tw-Cam
❑ Temporary Power (4275)
Approved
IL By Date
0 Rough Electrical (4225)
Approved
By Date I j
❑ Slab /Concrete Floor (4255)
Approved to place concrete
By Date
❑ Service (4235)
Approved
By C_ Date
❑ Ceiling Cover (4020)
Approved
By Date
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date