08-102807• c,iy De Federal Way
lopmentS Electrical Permit A.%8.102807-00-EL
Community Development Services
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: CHURCH OF GOOD SHEPARD y x'
Project Address: 345 S 312TH ST 082104 9161
Project Description: Adding (2) kitchen circuits in separate quad receptacles own the co r space
A THIS CARD IS TO REMAIN ON -SITE -
CITY OF *Community Develop Ant Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 08- 102807 -00 -EL
Owner: EPISCOPAL PARISH CHURCH
Address: 345 S 312TH ST
FEDERAL WAY, WA 98003 -4031
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)
0
Ditch cover (4030)
Slab /Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By Date
By
Date
By
Date
Service (4235)
Temporary Power (4275)
—
[] Pool Bonding (4195)
Approved
Approved
Approved
By Date
By
Date
By
Date
Ceiling Cover (4020)
[] Feeders /Sub - panels (4045)
Rough Electrical (4225)
Approved
Approved
Approved
By Date
By
Date
By
Date
0 Final - Electrical (4055)
Approved
By Date
For inspector reference only___
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
v1 /voizvvr 1v.-3a rt%A Z30bb14vo UILY Ur reuui4i w4y
APPwcmff NAME
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CrrT OF FEDERAL WAY BUS WE99 LICENSE NUMBER EXFPAMON DATE
eawuNlrrveveu7P mrsp."ces
333a1FMMLNUESOUrit•PO9718 6JU� PPLICATION
98083.9718
FEUER12W7
SF MF
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PL DE EN FP
359 - 8.%•7607• FAX 2$3835 -26r)9
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CO R73 REC
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TION DA
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Please
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(►9 or type.
SITE ADDRESS o! �h �� SUITEMMIT
ABSE.WOR'S TAX /PARCEL * ( j �� — 4'k-t— / LOT SUR to
LEGAL DESCRnwnQN (e.g. Acme Estates, Lot 1) V r C ►' 1 o � o D G
/ANaN� -mgm PwjbrIveybratck- =10nm0
TYPE OF PERMIT O BUILDING ❑ PLUMMG ❑ 1IEC33ANICAL
❑ DEMOLTnON JILECTRICAL ❑ ENGmEERmo O FIRE PRrvxNTxON BY9TEM
PROJECT DESC MMON a detailed description qj Mork tnd(uded on this l
o i c��
IY1 So n6Arrn l-0 fr,N ., r�
PROJECT NAME (Name of B1!VnASS or Owner Last Name]
PROPERTY •
OWNER
CONTRACTOR
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APPLICANT '
PROJECT
CONTACT
LENDER
RMTING USE
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APPwcmff NAME
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APPLICANT NAME
PRIIdARY PHONE
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COMPANY NAME
APPwcmff NAME
OFFICE PHONE
APPLICANT NAME
OFFICE PROVE
♦
RELA770NSHIP 70 PROJECT
o Architect ❑ Tenant ❑ Agent ❑ Other
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S7}17E.ZIP
CELLPHONE -
CrrT OF FEDERAL WAY BUS WE99 LICENSE NUMBER EXFPAMON DATE
FAX NUMBER
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Q5) 6q 1 0 V
CO R73 REC
ON NUMBER
TION DA
E -MATT. ADDRESS
COMPANY NAME
APPwcmff NAME
OFFICE PHONE
MAJIMG ADDRESS
CITY. ffA7E. 23P
/CEU. FHONE
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RELA770NSHIP 70 PROJECT
o Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUM73ER
PWAARY PHONE E-MAB.
am Pq P, _ lc
t0 YY�
xA>rtE Per 1tcFP 19.27.003.
Lender
PROPOSED USE
I E1aS ING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRnauzaED BUILDING? O YES 11110 FIRE SUPP8ESWON SYSTEM PROPOSED /RE9UJRZD? ❑ YES 17 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 maGH72NE ❑ TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ IAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
t+b/OrAtallori is raquii+esd U�prq(ect oaiBe CxouQs $5,000
KULINU ADDRM
C►TY, STATE. ZIP PHONR
PROPOSED USE
I E1aS ING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRnauzaED BUILDING? O YES 11110 FIRE SUPP8ESWON SYSTEM PROPOSED /RE9UJRZD? ❑ YES 17 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 maGH72NE ❑ TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ IAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
,. .. r �..... .... .,.. �,..,.....t ..� �y v i i CUCI 41 n'Qy
N PROJECT FLOOR
AREA D138CRIP1fON E=TMG
B . FT.
BASEMENT
FIRST
THIRD
DECK (❑ COVERED OR ❑
GARAGE O CARPORT ❑
NUMBER OF FLOORS
—r4EW HOMr$ ONLY" NUMBER OF BEDROOMS
F625 -052 -000 (8/97)
er
ESTIMATED SELIING PRICE $
DEPARTMENT OF LABOR AND INDUSTRIES
LICENSED AS PROVIDED BY LAW AS
ELEC CONTR GENERAL
gg
EGO . j2fl�0Q
EFFECTIVE DATE (71%0'7/1969
MERIDIAN CENTER ELECTRIC INC
11109 66TH AVE EAST
PUYALLUP WA 98373
(A 005 /OOG
I a .Lo under penalty QIPadwlI that the trlJbmadffld j rnlshad by me is &w mW correct to the best of nW keea1004 aed fwther that I
am authorised by the Dump' of the above promises to perform the roork fbr mhWh the permit MPHMUOR to made, i further a0ree to hold
karmtets the GYty of 8oderai Way as to am &aim yncludbo cosh. aooms, aril attonwee fas lrrcur- ed in the irarestipdd mw dcft a 0
such eldtmN rohWh mob be made W dW PC-am irrclud&W the unde+sW—d, an4fliled 0#01nat the C1ty of roderal WOW, but -4 -h— such eiahn
arises orrc q( the rr ow CUP. ineludlrr0 its ojjlaars d enrplay�s, ups the aacuragt of the ir{fv►�rfaatlon surPUea to the dtlr as a Part of
thls appUoatton.
NADti$/IITLE DATE
(Sl�ran�re� fnue)
RELATIONS P'ROJECI' ❑ Owner o Agent contractor ❑ Architect o Other
o NEW a ADDITION
o ALTERATION
o REPAIR o TENANT I AMOVFAENT
DUE D1NO SEOUL ONLY?
o YES ONO
BASIC PLAN?
o YES
ONO
ZOMQ DESIGNATION
CRANG=E OF USE?
o YES
o NO
NEW ADDRESS RZ;9UIREA?
a YES a NO
UP /SEPA/8177
o YES
a NO
FLATTED LOT?
o YES o NO
DEKO PEnUT RMMRM?
o YES
❑ NO
Bulletin #100 —January 1, 2007 Page 2 of 4 k \Handouts\Pcrnut Application
a
ELECTRICAL PERMIT INFORMATION
RESMIDNTIAL
NEW REMDM7AL SERV1
❑ Single Family Square Feet
(First 1300 R2.- $111.00: Each add -n $00 lta - 835.50)
❑ Detached outbuilding or garage
(Inspected with service) $47.00
❑ Detached outbuilding or garage
(Inspected ecpamtely) $74.00
NEW MULTI- FAMII.g
(three units or more)
❑ 0 to 200 amp
Seruicg
Feeder
❑ Up to 200 amp
$120.50
$ 35.50
❑ 201 - 400 amp
149.50
74,00
❑ 401 - 600 amp
205.00
102.00
❑ 601 - 800 amp
262.00
140.50
❑ Over 800 amp
975.50
280.50
ALTERED SY1VG WMULTI FAMILY
❑ # of circuits to be added /altered
(i-4 cimult"74.00; Add'n clrcwi8 $7.00 /gal
❑ Mast or meter repair $55.00
MANUFACTURIta HOAa<EF3
❑ Service or feeder only $74.00
❑ Service and kedcr $120.50
COMMERCIAL
NEW CO KMERCIAL /INDUSTRIAL SERtRCE
❑ 0 to 100 amp .
❑ 101 - 200 amp
❑ 201 - 400 amp
❑ 401 - 600 amp
❑ 601 _ 800 amp
❑ 601 - 1000 amp
❑ Over 1000 amp
IPJ VV4 /VVb
Service or Reeder Each Add'n
$120.50
Service or Feeder
❑ 0 to 200 amp
$ 92 -50
❑ 201 - 600 amp
149.50
❑ over 600 amp
225.50
❑ # of circuits to be added /altered
(i-4 cimult"74.00; Add'n clrcwi8 $7.00 /gal
❑ Mast or meter repair $55.00
MANUFACTURIta HOAa<EF3
❑ Service or feeder only $74.00
❑ Service and kedcr $120.50
COMMERCIAL
NEW CO KMERCIAL /INDUSTRIAL SERtRCE
❑ 0 to 100 amp .
❑ 101 - 200 amp
❑ 201 - 400 amp
❑ 401 - 600 amp
❑ 601 _ 800 amp
❑ 601 - 1000 amp
❑ Over 1000 amp
IPJ VV4 /VVb
Service or Reeder Each Add'n
$120.50
$ 74.00
149.50
94.50
280.00
111.00
327.00
131.00
423.00
179.00
516.50
216.00
563.00
300.00
❑ Over 600 volts surcharge $94.50
❑ Mast or meter repair $102.00
ALTMED C0MXZRCIAIdIl�USTR7AL
Serutce or Feeders
❑ 0 to 200 amp $I20.50
❑ 201 - 600 amp 280.50
❑ 601 - 1000 amp 423.00
❑ over 1000 amp 471.00
Nf
-L-# of circuits to be added /altered
(1 -5 circuits - $94,50: Add'n circuits, 67.00/ea)
CQ_?AjWjWcWLM117871t1AL PLAN RLVn> W
$94.50 plus 35% of Permit Fee
❑ Service- 1.000 amps or greater
❑ Medical /Educational /Institutional Facility
TEMPORARY SERVICE
XQBME ROME/RV PARK
Residendai/lllult$- Family
$65.00
❑ # of service or feeders
(F)rst service /teeder -074.00: each add'n - $49.00)
CommereftVIndusMai Service or Feeder AmpacUy
❑ 0 - 100 amps
$ 74.00
❑ 101 - 200 amp.
94.50
❑ 201 - 400 amps
111 -00
❑ 40I - 600 amps
149.50
❑ over 600 amps
162.00
3ESCELIANMUS 8LrRV10EjEQL rM 1VT
❑ # of Thermostats
(First 455.00: add'n- $17.00 /ea)
❑ law Voltage
Square Feet to be served by systetn(s)
❑ Mre AN= System
O Security Alarm System
❑ voice Cabling
❑ Data Cabling
-❑
I- 2500 its- $9b.00:
Each add'n 2500 ftz- 17.00) • Per wAc x9846 giop(wi a W
❑ # of signs
(P -first sign- $55.00; add'n sign $26.00 /ea)
❑ 9- luualag pool/hot tub ................
(Included additional circuit, it required)
❑ Yard Pole meter loop& .....................
❑ Additional Play Review
(for modified submittals)
❑ Automation Fee on all Permits --
$111.00
$74.00
$111.00/hour
$5.00
Bulletin #100 - January 1, 2007 Page 3 of 4 WUndoutsTennit Application
iith.
r- I 02
CITY OF 1L (D-1_FederaIway EIV ERMIT
COMMUNlIYDEVELOPMENTSERVlCES 6...Fi" FCO ME EL PL DE EN FP
33325 8TH AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 JUN 1- 3 t. A P P L I C A T I ON TD
1117,
, I
253-83 w cituo•FAX 253-83 on, I Y ber
wlow.dl4olFerlemlwn,lcom /�
The following -i'giy a Fi tib4La Z�J�f Aficomplete application will not be accepted. Please print legibly(in ink)or type.
■ PROPERTY INFORMATION -
SITE ADDRESS 34:PI(i /491/C.— S• - -• ��L y�eQv SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# D 6 - O /�Q a"v!J r LOT SIZE(s
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
OM S1Ia , _,
(Attach separate page for lengthy legal description) IPO
IN PROJECT INFORMATION
TYPE OF PERMIT CI.BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
c---,/,' . _- + �� tri f.'a.
,„4..,...:md,....„ ;2,,,,.,-,00� t,,-�-L ail t d_44...) ,t. 6ntu..i i ljo_ tt.24 -cL0t ,
PROJECT NAME(Name of Business or Owner Last Name) \-e /��
• PEOPLE INFORMATION
PROPERTY NAME /%� et„' /� PRIMARY PHONE
OWNER ) J`��E�l„ (` - - ) - liLc/o'
MAILING ADDRESS / CITY,STATE,ZIP E-MAIL ADDRESS �f
-?(j //71 f2A�YI-e-Q—? �L- 1 k y A 06,, c4.4. 1 K r(t� et etrr►
CONTRACTOR COMPANY NAME 4.71747_ APPLICANT NAME `OFFICE PHONE 1
-MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
I
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
( ) -
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
APPLICANT COMPANY NAMEAPPLICANT NAME OFFICE PHONE
, /i i -
MAILING ADDRESS �`~ CITY,STATE,ZIP /� CELL PHONE
't<f i [��t.-..t.. <-6- - 'iy),1/+�, 4)h ?2,r��) U; i ) " '' - 2'
RELATIONSHIP
TOO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other ( ) -
PROJECT NAMEPRIMARY PHONE E-MAIL ADDRESS
CONTACT i. /+- . KZ' ( ; ) -
LENDER NAME Per RCW 19.27.095:
Lender information is required If project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ - t,6a, (A
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES >�i NO
E
WATER SERVICE PROVIDER • LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) °�
SEWER SERVICE PROVIDER d LAKEHAVEN 0 HIGHLINE o PRIVATE(SEPTIC)
a PROJECT FLOOR AREAS -
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ.FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
toilDEICK -,;-.7.7.:.':_-, : $ r PJ UNCOVERED?)
if
e r '1 CAR• ' R
t
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING Sr TOTAL PROPOSED SF TOTAL SF
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• ■ FIXTURES
Indicate number of each type offb ure to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COO/LERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS Icommeraml
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(orTub/showor Combo) LAVS(Bathroom Sulks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYS VACUUM BREAKERS(roue)DRINKING FOUNTAINS SHOWERS \ WATER CLOSETS(roue)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 information submitted in support of 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 of a permit. I understand that the issuance of 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 information supplied to
the city as a part of tills application. z
SIGNATURE: /� G� DATE 6'_ i 3
- operty Owner and/or Authorized Agent
a NEW a ADDITION o ALTERATION ❑ REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? ❑YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES a NO
PLATTED LOT? ❑YES a NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Perrnit Application