12-102594*FILE ` Electrical
City of Federal Commun & D w Services Permit : 12- 102594 -00 -E L
8th
33325 8th Ave S
Federal Way, WA 96003 Inspection Request Line: 253 835 -3050
Ph: (253) 835 -2607 Fax: (253) 835 -2609 p a
Project Name: H & R BLOCK
Project Address: 1646 SW DASH POINT RD Suite A Parcel Number: 189880 0010
Project Description: Installation of low - voltage voice & data cable.
Own
A121211can
Contractor
H & R BLOCK
VIRGIL KNEDLIK
OWNER IS CONTRACTOR
1638 SW DASH POINT RD
H & R BLOCK/KNEDLIK FAMILY LLC
FEDERAL WAY WA 98023
1638 SW DASH POINT RD
FEDERAL WAY WA 98023
Is Use Educational or Institutional ? .......................No
Low Voltage - Other (Commercial; 1
Service greater than 999 Amps? .............................No
PERMIT EXPIRES Tuesday, December 4, 2012
Permit Issued on Thursday, June 7, 2012
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us Will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: � 17 �� L
CITY OF
Federal Way
PERMIT #:
Project:
• THIS CARD IS TOOMAIN ON -SITE .
Construction Inspection Record
INSPECTION REQUESTS: (253) 835 -3050
12- 102594 -00 -EL
H & R BLOCK
Address: 1646 SW DASH POINT RD Suite A
FEDERAL WAY, WA 98023
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)
❑
Ditch cover (4030)
Final Electrical
Approved
Slab /Concrete Floor (4255)
Service (4235)
Approved
Approved
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
E]
Temporary Power (4275)
Final Electrical
Approved
Service (4235)
Right of Way
Approved
Approved
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
E]
Rough Electrical (4225)
Ceiling Cover (4020)
Feeders /Sub - panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By ,
Date
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF CEIVED
Federal ay ELECTRICAL
JUN 0 7 ARMIT APPLICATION
CITY OF FEDERAL WAY
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* *MtT f 'flectrical pennits may be obtained on -line at www.
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SITE ADDRESS: 614 Co
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SUITE /UNIT /SPACE#
ASSESS TAX/PARCEL # �(
CURRENT /PROPOSED USE
PROJECT NAME
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(Tenant or Homeowner Last Name)
a'0 Fur
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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NAME
P""RY PHONE
PROPERTY OWNER
G'I r
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NAME
PRIMARY PHONE
MAILING ADDRESS
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ELECTRICAL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
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APPLICANT
MAHAVG ADDRESS
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STATE
ZIP
FAX
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PRIMARY PHONE
PROJECT CONTACT
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I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the irtformation submitted in support 4f this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance 4f a permit. I understand that the
Issuance 4f this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
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,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
irlformation supplied to t c as part of this application.
SIGNATURE: DATE 7
�J L
PRINT NAME: V i 1� �) 4 [7h L. / 1C
33325 8" Avenue South ♦ Federal Way 1 WA 1 98003 -6325 ♦ 253- 835 -2607 ♦ fax: 253 - 835 -2609 ♦ www.cityoffederalway.com
Bulletin #160 —January 1, 2011 Page 1 of 2 k:\Handouts\Electrical Permit Application
RESIDENTIAL
COMMERCIAL
NEW SINGLE FAMILY RESIDENCE
NEW COMMERCIAL
Total Square Feet
1 st Service /Feeder Additional Feeders
(including attached garage):
0 - 100 amp x $132.50 _ x $ 80.50
FEES: First 1300 ftz - $122.00;
101 - 200 amp x $164.00 x $103.50
Each additional 500 ft2 - $39.00
201 - 400 amp x $307.00 ,`x $121.00
401 - 600 amp x $358.00 _x $143.50
NEW MULTIFAMILY (3 units or more)
IS' Service /Feeder Additional Feeders
601 - 800 amp x $463.00 x $196.00
0 - 200 amp _ x $132.50 x $ 39.00
801 - 1000 amp x $565.00 _ x $236.50
201 - 400 amp x $164.00 x $ 80.50
Over 1000 amp x $616.00 _ x, $328.50
401 - 600 amp x $224.00 x $111.50
601 - 800 amp x $287.00 x $153.50
Over 600 volts surcharge _ x $103.50
Over 800 amp x $410.50 x $307.00
ALTERED SINGLE or MULTI FAMILY
ALTERED COMMERCIAL
1 st Service /Feeder
1 st Service /Feeder Additional Feeders
0 - 200 amp x $132.50 x $103.50
0 - 200 amp x $101.00
201 - 600 amp x $164.00
201 - 600 amp x $307.00 x' $121.00
Over 600 amp x $246.50
601 - 1000 amp x $463.00 _x $196.00
Over 1000 amp x $515.50 x $328.50
Added or Altered Circuits
1 -4 circuits $80.50; each additional $8.00
Added or Altered Circuits
1 -5 circuits $103.50; each additional $8.00
Mast or meter repair $60.50
Mast or meter repair $111.50
MANUFACTURED HOMES
PLAN REVIEW FEES
Service or feeder only x $ 80.50
Plan Review required only for:
Service and feeder x $132.50
• New, or alteration to, service of 1,000 amps or greater
• Medical /Educational /Institutional Facility
$103.50 plus 35% of Permit Fee
(Permit Fee x 35% _ + $103.50 = Plan Review Fee)
Plan review for modified submittals $105.50 /hour
MISCELLANEOUS
SERVICE/EQUIPMENT
LOW VOLTAGE
TEMPORARY SERVICE
❑ Fire Alarm System
Is' Service /Feeder Additional Feeders
❑ Security Alarm System
Voice /Data Cabling
0 - 60 amp x $ 71.00 _ x $ 32.00
❑ Other
i w�>
61 - 100 amp x $ 80.50 x $ 39.00
Area to be served by system:
X $103.50 _ X $ 51.00
101 - 200 amp '
Pt 2,500 ft2- $71.00; each additional 2,500 ftz - $18.50
201 - 400 amp x $121.00 _ x $ 60.50
# of Thermostats
401 - 600 amp x $164.00 _ x $ 80.50
First $60.50; each additional $18.50
Over 600 amp x $154.50 _ x $.:92.00
FEE CALCULATIONS
Yard Pole /meter loops /pedestal x $ 80.50
• Fees are determined by the scope of work as indicated.
Portable Generator (transfer equipment) x $101.00
• A $6.00 Automation Fee will be added to all permits.
Ditch cover /inspection only x $121.00
• For assistance in calculating fees or completing the
application form, contact the Permit Center at
253 - 835 -2607
33325 8' Avenue South 1 Federal Way ♦ WA ♦ 98003 -6325 ♦ 253- 835 -2607 ♦ fax: 253- 835 -2609 ♦ www.cityoffederalway.com
Bulletin #160 -January 1, 2011 Page 2 of 2 k:\I-Iandouts\Electrical Permit Application