10-100178�'Gity of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
[Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: NW DENTAL
Project Address: 720 S 348TH ST Suite A -1A
Project Description: Install security system
S -Electrical
Permit #: 10- 100178 -00 -EL
Inspection Request Line: (253) 835 -3050
Parcel Number: 233145 0010
Owner
Applicant
Contractor
720 SOUTH 348TH ST LLC
A D T SECURITY SERVICES INC
A D T SECURITY SERVICES INC
11409 GRAVELLY LAKE DR SW
11824 N CREEK PKWY N SUITE 105
ADTSES103205 (9/25/11)
LAKEWOOD WA 98499
BOTHELL WA 98011
11824 N CREEK PKWY N SUITE 105
BOTHELL WA 98011
Is Use Educational or Institutional ? ....................... No Service greater than 1000 Amps? ........................... No
�91141fll ww�-� M��
Low Voltage - Burglar Alarm (Cor 1
I here
the o
PERMIT EXPIRES Friday, January 14, 2011
Permit Issued on Thursday, January 14, 2010
ibove information is correct and that the construction can the
use will be in accordance with the laws, rules and regulation:
and the City of Federal Way.
Owner or agent:_ _ Date: C
15/1 Co
Federal Way
PERMIT #:
• THIS CARD IS T MAIN ON -SITE
Construction I ection Record
INSPECTION REQU TS: (253) 835 -3050
10- 100178 -00 -EL
Address: 720 S 348TH ST Suite AAA
Owner: 720 SOUTH 348TH ST LLC FEDERAL WAY, WA 98003 -7042
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.
Final - Electrical (4055)
Approved
By Date S `
UFER Ground (4295)
Ditch cover (4030)
Temporary Power (4275)
Slab /Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date S `
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders /Sub - panels (4045)
E]
Rough Electrical (4225)
❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date S `
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
AM Ctrro$.A RECEIVOD - -Zo0- 179
Federal Way PERMIT
COMMUNITY DEVELOPMENT SERVICES JA N 1 201 SF MF CO ME LPL DE EN FP
333253 -8 AVENUE FAX 2l • PO BOX 9718 APPLICATION A
FEDERAL WAY, WA 8
253 -835-2 itoo FAX 2 3- 5 0 F FED WAY
www.cituoffedern(wnu.com nnee
The, following is required injdr4r[a� ion - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS S ` 344 c1fl SUITE /UNIT # f �=
ASSESSOR'S TAX /PARCEL # �- - LI) C7 LOT SIZE (SO
LEGAL DESCRIPTION (e.g. Acme Estates, Lot l)
(Attach separate )xne. for tengthy ieoai description)
PROJECT • •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION 'ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of Lvork included on this permit onlu)
I tJ ST4 w S11 %
PROJECT NAME (Name of Business or Om ter Last Naame) N W �JG� � _ _—
E PEOPLE INFORMATION
PROPERTY
OWNER
CONTRACTOR
COPY of card required
with each appucauon
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME PRIMARY PHONE
MAMING ADDRESS CITY, STATE, ZIP E -MAIL. ADDRESS
COMPANY NAME
AbT 5"Mix / --WaVtCES
APPLICANT NAME -
'Ro$ 80X'
OFFICE PHONE
11(0L+
MAILING ADDRESS
1m N. cPmr— &a) r4 xE o5
CITY. STATE, ZIP
evio t- w4 41600
CELL PHONE
(Z5; Most
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
6(P"+
( )
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
E -MAIL. ADDRESS
of5E5L 3205
a -2s -Zo
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
SAOW Ab Gb*40L ..MJL
PHONE
—
( )
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
f ) —
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
NAME PRIMARY PHONE E -MAIL ADDRESS
5A� As c *kn94tXbR. ( ) - - ::1
NAME
Per RCW 19.27.095:
Lender irtforination is required ifproject value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING, ASSESSED /APPRAISED VALUE
PROPOSED USE
VALUE OF PROPOSED WORK $� 0-0-
_
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
PROJECT ••• AREAS
AREA DESCRIPTION EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIRST
HOODS (commercial)
COMPRESSORS
FURNACES
SECOND
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
THIRD
❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
ADDITIONAL FLOORS (DESCRIBE)
UP /SEPA /SU?
❑ YES
❑ NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
DEMO PERMIT REQUIRED?
❑ YES
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
EffiBTING
PROPOSED
TOTAL
TOTAL EBL4TINO SF
TOTAL PROPOSED SF
TOTAL SF
"NEW HOMES ONLY'"* NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture 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 COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (commercial)
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS (or1),b /Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
LAYS (Bathroom Sinks)
URINALS _,_ MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
SHOWERS
WATER CLOSETS crone[)
SINKS
WASHING MACHINES
SUMPS.
I certify under penalty of perjury that the irtformation 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 filed against the City of Federal Way, but only where such claim
arises out of the reliance of the city, including its officers and employees, upon the accuracy of the irtformation supplied to the city as a part of
this application.
NAME /TITLE �� "�—�� DATE �'�; ' /O
(Signature) Cntie)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent contractor ❑ Architect ❑ Other
,zs
❑ NEW ❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
BASIC PLAN?
o YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP /SEPA /SU?
❑ YES
❑ NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
❑ NO
Bulletin #100 —January 1, 2007 Page 2 of 4 k\Handouts\Permit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIALANDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
❑ 0 to 100 amp $120.50 $ 74.00
(First 1300 ft2- $111.00; Each add'n 500 ftz - $35.50)
❑ Detached outbuilding or garage
❑ 101 - 200 amp 149.50 94.50
(Inspected with service) $47.00
❑ 201 - 400 amp 280.00 111.00
❑ Detached outbuilding or garage
❑ 401 - 600 amp 327.00 131.00
(Inspected separately) $74.00
❑ 601 - 800 amp 423.00 179.00
❑ 801 - 1000 amp 516.50 216.00
NEW MULTI- FAMILY (three units or more)
❑ Over 1000 amp 563.00 300.00
Service Feeder
❑ Up to 200 amp $120.50 $ 35.50
❑ Over 600 volts surcharge $94.50
❑ 201 - 400 amp 149.50 74.00
❑ Mast or meter repair $102.00
❑ 401 - 600 amp 205.00 102.00
ALTERED COMMERCIAL /INDUSTRIAL
❑ 601 - 800 amp 262.00 140.50
❑ Over 800 amp 375.50 280.50
Service or Feeders
❑ 0 to 200 amp $120.50
ALTERED SINGLE /MULTI FAMILY
❑ 201 - 600 amp 280.50
❑ 601 - 1000 amp 423.00
Service or Feeder
❑ over 1000 amp 471.00
❑ 0 to 200 amp $ 92.50
❑ 201 - 600 amp 149.50
❑ # of circuits to be added /altered
❑ over 600 amp 225.50
_
(1 -5 circuits - $94.50; Add'n circuits, $7.00 /ea)
❑ be
COMMERCIAL/INDUSTRIAL PLAN REVIEW
# of circuits to added /altered
$94.50 plus 35% of Permit Fee
(1 -4 circuits- $74.00; Add'n circuits $7.00 /ea)
❑ Service - 1,000 amps or greater
❑ Mast or meter repair $55.00
❑ Medical /Educational /Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $74.00
❑ Service and feeder $120.50
TEMPORARY SERVICE
MOBILE HOME /RV PARK
Residentiai/Multi Family $65.00
❑ # of service or feeders
(First service /feeder- $74.00; each add'n - $48.00)
Commercial/Industrial Service or Feeder Ampacity
❑ 0 - 100 amps $ 74.00
❑ 101 - 200 amps 94.50
❑ 201 - 400 amps 111.00
❑ 401 - 600 amps 149.50
❑ over 600 amps 162.00
MISCELLANEOUS SERVICE /EQUIPMENT
❑ # of Thermostats
❑ # of Signs
(First - $55.00; add'n - $17.00 /ea)
(First sign- $55.00; add'n sign $26.00 /ea)
10Lo Voltage
Square Feet to be served by system(s) Ob
❑ Swimming pool /hot tub ................ $111.00
(Includes additional circuit, if required)
❑ Fire Alarm System
❑ Yard Pole meter loops ..................... $74.00
curity Alarm System
❑ Additional Plan Review $111.00 /hour
❑ Voice Cabling
(for modified submittals)
❑ Data Cabling
❑ Automation Fee on all Permits .. $5.00
lat 2500 ft2- $65.00;
Each add'n 2500 W-17. 00) • Per WAC 296- 46- 910(5)(b)(i & i0
Bulletin #100 - January 1, 2007 ' Page 3 of 4 k\Handouts\Permit Application