08-103473pvy or 'll �- 1 Z
CDI (ANBITY DBVBLOPA/BNr SBR cuE I �/ 1,� PERMIT '` SF MF CO ME DL DE EN FP
93395 8m AV.dNtuUnB /f eSdemilw a• u o BOX 9718
FEDEAW90 2 1 2008
APPLICATION
2S3=2 253
mm
The.Qk 90Fe fegE A"tWAjk incomplete application will not be accepted Please print lojibly (in ink) or type.
SITE ADDRESS � ? L SA r ) SUITE/UNIT i
ASSESSOR'S TAX /PARCEL 0 _ _ _ _ _ - _ _ LOT SIZE (q)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Aea°�' •�4aQwhrrewew rgare.w�e„y
PROJECT •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIO (Provid etailed descxiptiop of work included on e LOW
r
PROJECT NAME (Name of Business or Owner Last Namel
PROPERTY
NA
PRIMARY PHONE
OWNER
W `e Sl
_
RELATIONSHIP TO PROJECT
MAILING AD RESS
T%�
CIT Y, STATE, 2[P
E -MAIL ADDRESS
r�0
�E2Vvv
V
RATION
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
MP E
r
PU N UR
OFFICE PHONE
OFFICE PHONE
O
�,
RELATIONSHIP TO PROJECT
-
O A RE33
STAY
M�T►.
r�0
CELL PHONE
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
RATION
FAX NUMBER
/ATE
CONTRACTOR'S IS ON RIIMBER
F%P
ION DATE
E-MAIL ADDRESS
A
6 a
COMP B
APPLICANT NAME
OFFICE PHONE
O D
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
PAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( _
N PRIMARY PHONE - E-MAIL ADDRESS
N
Per RCW I9. 27.096:
Lender Wormaiion is required ifprq/ect value exceeds 06,000
ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK
SPRiNKLERED BUILDING? 0 YES a NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑YES o NO
WATER SERVICP, PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
BASEMENT
EXISTING
SO. FT.
PROPOSED
$ . FT.
TOTAL
80. FT.
FIRST
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
SECOND
COMPRESSORS
FURNACES
RANGES
THIRD
OAS LOG SETS
REFRIG. SYSTEMS
a NO
ADDITIONAL FLOORS (DESCRIBE)
a YES a NO
UP /$EPA /SU?
DECK (❑ COVERED OR ❑ UNCOVERED?)
a NO
PLATTED LOT?
a YES ONO
GARAGE ❑ CARPORT ❑
DEMO PERMIT REQUIRED?
a YES
a NO
NUMBER OF FLOORS
23MIMe
'W oe °
TOTAL
rorntsssnswer
tor�raorosss ,$r
r ALar
"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 ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLINO UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS F---"Q
COMPRESSORS
FURNACES
RANGES
DUCTS.
OAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS (wTUb/shW~combq LAVS (II.O.WWO URINALS MISC (Describe(
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS fr�n.0
ELECTRIC WATER HEATERS SINKS WASHINO MACHINES .
HOSE BLBBS SUMPS
I csrtVy under penalty of perjury that I am the property owner or authorised agent of the property owner. t certVy that to the beat of my
knowledyy the Wormation submitted in support of this permit application is true and correct. I eert{J that t will comply with ail srppitca6ts
City of hdtrai Way regulations pertaining to the work authorised bg the issuance of a permit. t understand that the issuance of this permit
dos,$ not remora the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws.
I further agree to hold harm( Ct of lUderat Way to any et irn (in ding coals, expenses, and attorneys' fees incurred in the
Investigation and dofe such , be aryy sr n, the undersigned, and filed ag nst ty, but only
when such claim art s t of U of city, inclu g its employees, upon the accuracy of o n suppUed to
the city as a part o ht plies n.
SIGNATURE• DATE
Owner and /or )kuthorized Agent
a NEW a ADDITION
a ALTERATION
a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY?
a YES a NO
BASIC PLAN?
a. YES
ti NO
ZONING DESIGNATION
CHANOE OF USE?
a YES
a NO
NEW ADDRESS REQUIRED?
a YES a NO
UP /$EPA /SU?
a YES
a NO
PLATTED LOT?
a YES ONO
DEMO PERMIT REQUIRED?
a YES
a NO
Bulletin #100 — January 1, 2008 Page 2 of 4 MandoutsTennit Application
r -1q
RESIDENTIAL
COMMERCIAL
NOW RESIDENTIAL SERVICE
NEW COMMERCIAL /INDUSTRIAL SERVICE
❑ Single Family Square Feet
Service or Feeder Badt Add'n
(First 1300 ft2- $115.50; Each addh 500 iii - $37.00(
0 to 100 amp $125.50 $ 76.50
❑ Detached outbuilding or garage
❑ 1- 200 amp 155.50 98.00
(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
❑ 601 - 800 amp 272.00 145.50
ALTERED COMMERCIa/1NDUSTRIAL
❑ Over 800 amp 389:50 291.00
Service or Feeders
❑ 0 to 200 amp $125.50
ALTERED SINQLELMULTI FAMILY
❑ 201 - 600 amp 291.00
Service or Feeder
❑ 601 - 1000 amp 439.00
❑ over 1000 amp 489.00
❑ 0 to 200 amp $ 96.00
❑ 201 - 600 amp 155.50
❑ over '600 amp 234.00
❑ # of circuits to be added /altered
'
(1 -5 circuits - $98.00; Addh circuits, $7.50 /ea)
❑ # of circuits to be added /altered
COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1 -4 circuits - $76.50; Addh circuits $7.50 /*
$98.00 plus 35% 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
MOBII.E HOMElRV PARK
❑
ResidenNa(/Mutti Fanti(y $67.50
# of service or feeders
(First service /feeder - $96.50; each add'n - $50.00)
CommerctaWndustriai 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; add"n- $17.50 /ea)
(First sign - $57.50; addh 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
1,* 2500 "7.50;
Each addh 2500 W - $17.50) +Per WAC 99618- 910(5#bl# & it)
Bulletin #100 - January 1, 2008 Page 3 of 4 k\HandoutslPennit Application
Community DCityofevFederalWay
elopmentServices • Electrical Permi•: 08-103473-00-EL
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: QWEST DSL SITE
: �t L.Project Address: 32420 1ST LN SW Parcel Number: 182104 9042
Project Description: Service installation at the corner of 1st Avenue S and SW 323rd Ln of Campus Landing
Apartments
Owner Applicant Contractor
HI-VALLEY DEVELOPMENT COR KEN BOBKO ELECTRIC CO INC KEN BOBKO ELECTRIC CO INC
1310 COBURG RD#1B PO BOX 7009 KENBOEC066BA(1/1/10)
EUGENE OR TACOMA WA 98406-0009 PO BOX 7009
97401-5200 - TACOMA WA 98406-0009
Additional Permit Information
Service greater than 1000 Amps? No
Electrical Fixtures
New Service/Feeder: 0- 100 amps 1
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 5)and must comply with FWCC,
Chapter 22,Article XIV"Critical Areas" and fill out a Hazardous Materials Inventory Statement,if
applicable.
PERMIT EXPIRES Tuesday, July 21, 2009
Permit Issued on Monday, July 21, 2008
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the ill be i ccordance , ith the laws, rules and regulations of the Stat if Was►'ngton
41 A,City of F eral W .
Owner or agent: Date:
2/ o8
400•1\ 11401,P)/
•
'THIS CARD IS TO MAIN ON-SITE
CITY OF A. Community Developmfflit Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-103473-00-EL
Owner: QWEST
Address: 32420 1ST LN SW
FEDERAL WAY, WA 98023-5665
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.
O UFER Ground(4295) 0 Ditch cover(4030) Ei Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
P CIA .A,.s,;.r.
By GCS Date 1, � f, By Q--\f..\..) Date ri_23._.x,5 By Date
— 0 Pool Bonding(4195) ❑ Temporary Power(4275) .❑ Service(4235)
Approved Approved Approved
By Date By Date By (Le,_„/) Date 7 70
O Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
O Final-Electrical(4055)
Approved
By <AA) Date 7 z
.
For inspector reference only
❑ Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date