11-105099City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
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Electrkal
Permit #: 11- 105099 -00 -E L
Inspection Request Line: (253) 835 -3050
Project Name: MIRROR LAKE ELEMENTARY - 2011 PORTABLE
Project Address: 625 S 314TH ST
Parcel Number: 082104 9035
Project Description: Installation of low- voltage voice /data cable for portable classroom.
Own r
Applicant
Contractor
FEDERAL WAY PUBLIC SCHOOLS
LEVERAGE INFORMATION SYSTEMS INC
LEVERAGE INFORMATION SYSTEMS INC
31405 18TH AVE S
18815 139TH AVE NE SUITE B
LEVERIS909LT (7/28/12)
FEDERAL WAY WA 98003 -5433
WOODINVILLE WA 98072
18815 139TH AVE NE SUITE B
WOODINVILLE WA 98072
Is Use Educational or Institutiona l ? ....................... No
Low Voltage - Other (Commercial: 1
Service greater than 999 Amps? .............................No
PERMIT EXPIRES Wednesday, December 26, 2012
Permit Issued on Tuesday, December 27, 2011
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use 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: 1Z L2- / </
THIS CARD IS T MAIN ON -SITE
CrrY OF • Construction I ection Record '
Federal Way INSPECTION REQUE TS: (253) 835 -3050
PERMIT #:
11- 105099 -00 -EL
Address: 625 S 314TH ST
Project: -'"' FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY, WA 98003 -5214
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.
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
UFER Ground (4295)
Ditch cover (4030)
El
Slab /Concrete Floor (4255)
E]
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
Final - Electrical (4055)
Approved
By e S Date
Service (4235)
Approved
By
Date
Final - Electrical (4055)
Approved
By e S Date
Feeders /Sub - panels (4045)
E:]
Rough Electrical (4225)
E]
Ceiling Cover (4020)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By e S Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
16 57
CITY OF
Fedi4 ,. ELECTRICAL
ov_:G ' P;�„ IT APPLICATION
�eae
_-eN QVog' trical vermits may be obtained on -line at www.citvoffederativay.com
ADDRESS:
M%, �- 6- 6 c Ivl r
SUITE /UNIT /SPACE N ASSESSOR'S TAX /PARCEL M CURRENT / PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
ELECTRICAL
CONTRACTOR
APPLICANT
PROJECT CONTACT
NAME
MAILING ADDRESS
CITY
NAME
MAILING ADDRESS
CITY
�tirx" l;A�C,
WA STATE CONTRACTOR'S LICENSE 8
.L-- € '/ ✓ i 3 "1 r cl t'4-
WO,
MAILING ADDRESS
CITY
STATE I ZIP
t
STATE ZIP
EXPIRATION DATE
7 /zt - � / kz-
STATE 1 ZIP
/ PRIMARY PHONE
1 � -
E -MAIL
FAX
PRIMARY PHONE
�1 422— - `i 2 c,
E --MAIL
FAX
(c 5 1 lied - g L -r'V
FEDERAL WAY BUSINESS LICENSE X
ZC� --,,sq jc� 1 -1 7y_()()_
PRIMARY PHONE
E -MAIL
FAX
PRIMARY PHONE
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 apart of this application.
SIGNATURE:
PRINT NAME: �f
iz z 1
33325 8h Avenue South ♦ Federal Way ♦ WA 1 98003 -6325 ♦ 253- 835 -2607 1 fax: 253 -835 -2609 ♦ www.cityoffederalway.com
Bulletin #160 — January 1, 2011 Page 1 of 2 k: \Handouts \Electrical Permit Application
L_
NEW SINGLE FAMILY RESIDENCE
Total Square Feet
(including attached garage):
FEES: First 1300 ft2 - $122.00;
Each additional 500 ft2 - $39.00
NEW MULTIFAMILY (3 units or more)
ALTERED SINGLE or MULTI FAMILY
1s' Service /Feeder
0`- 200 amp
201 600 amp x $1.64.00
Oder 600 amp ; x . $246:50
Added or Altered Circuits
1 -4 circuits $80.50; each additional $8.00
Mast or meter repair $60.50
MANUFACTURED HOMES
Service or feeder only x $ 80.50
Service and fieeder x'" - U32.50
NEW COMMERCIAL
111 Service /Feeder
I st Service /Feeder
Additional Feeders
0 - '200 amp
x $132.50
- x $'39.00
201 - 400 amp
x $164.00
x $ 80.50
401 - 600 amp
x $224.00
' x $111.50
602 - 800 amp
x $287.00 -
- x $153.0
Over 800 amp
x $410.50
x $307.00
ALTERED SINGLE or MULTI FAMILY
1s' Service /Feeder
0`- 200 amp
201 600 amp x $1.64.00
Oder 600 amp ; x . $246:50
Added or Altered Circuits
1 -4 circuits $80.50; each additional $8.00
Mast or meter repair $60.50
MANUFACTURED HOMES
Service or feeder only x $ 80.50
Service and fieeder x'" - U32.50
NEW COMMERCIAL
111 Service /Feeder
Additional Feeders
$
101 = 200 aMp
x $164.00
x $103.50
2E1,t)b•,atnp
*307.0()"
$121:00
401 - 600 amp
x $358.00
x $143.50
X00 amp .,..:'; T
x $463:00
x-$196.00
801 - 1000 amp
x $565.00
x $236.50
)ver„ 100? amp
X" 6
,$6
x$32850
Over 600 volts surcharge? x $103.50
ALTERED COMMERCIAL
11, Service /Feeder Additional Feeders
0 a20U amp F x,$132.50 x $103.50
201 - 666'amp x $307.00 x $121.00
6Q3. �OOQ����,,�k,. �$4f3�.,z:.. � ,.;• it °$ ^196�t1
Added or Altered Circuits
1 -5 circuits $103.50; each additional $8.00
Mast or meter repair $111.50
PLAN REVIEW FEES
Plan Review required only for:
• 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
Yard Pole /meter loops /pedestal x $ 80.50
Portable Generator (transfer equipment) x $101.00
Ditch cover/ inspection only ___ x $121.00
FEE CALCULATIONS
• Fees are determined by the scope of work as indicated.
• A $6.00 Automation Fee will be added to all permits.
• For assistance in calculating fees or completing the
application form, contact the Permit Center at
253- 835 -2607
33325 8" Avenue South ♦ Federal Way ♦ WA ♦ 98003 -6325 1 253 -835 -2607 1 fax: 253- 835 -2609 ♦ www.cityoffederalway.com
Bulletin #160 - January 1, 2011 Page 2 of 2 k:\Handouts \Electrical Permit Application