07-100151 r i '
City of Federal Way Electrical Permit #: 07-100151-00-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: ORIGINAL ROADHOUSE GRILL
F 1 E
Project Address: 31525 20TH AVE S Parcel Number: 092104 9019
Project Description: Installation of street light service,street lights and outlets
Owner Applicant Contractor
VERMONT MANAGEMENT,INC. OTI ELECTRICAL SERVICES OTI ELECTRICAL SERVICES
620 N BRAND BLVD FLOOR 6TH PO BOX 982 OTISEED986K9 05/29/08
GLENDALE CA 91203 MCKEIINA WA 98558 PO BOX 982
MCKENNA WA 98558
Additional Permit Information
Electrical Fixtures
Service 'eeder: 0-100 amps-Con 1
PERMIT EXPIRES Monday, July 9, 2007
Permit Issued on Wednesday, January 10, 2007
I hereby Certify that the above informer is correct and that the construction on the above described property And
the occupancy and the use wi11 be in accordance with the laws, rules and regulations of the State Of-Washington
nd Ci of Federal Way.
Owner or agent: // ? Date:
�
`T t— 3 Q - O ts-f
THIS CARD IS TO REMAIN ON-SITE - ,
CITY of Community Development Inspection Record "
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-100151-00-EL ,
Owner: VERMONT MANAGEMENT, INC.
I Address: 31525 20TH AVE S
FEDERAL WAY, WA 98003-5457
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.
'
❑ Slab/Concrete Floor(4255) ❑ Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) 10 Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date `Bya Date ti�3._e- By Date
Rough Electrical(4225) Ceiling Cover(4020) Final-Electrical 4055
❑ g ( ) ❑ g ( ) ❑ ( )
Approved Approved Approved
By Date By Date By v41,,,,. Date 1,--3∎—csZ
❑ Under-slab groundwork(4295)
Approved •
By Date
KY OF.
Federal Way ` ' PERMIT '
•' COMMWNrPY DEVELOPMENT SERVICES SF MF CO M EL L DE EN FP
33325 ET"AVENUE SOUTH• 8 ;APPLICATION
FBbERAL WAY,WA 98063.9718 TD
www.cituoffederalway.com
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or. type.
•
S PROPERTY INFORMATION
SITE ADDRESS ;j Lc: 5 A.Q f C14 V So .
SUITE/UNIT
ASSESSOR'S TAX/PARCEL# 69 q i Q Y- q& LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) •
/Attach separate pop rfor lengthy legal description)
R PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING PLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL ❑ ENGINEERING ❑FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Providg detailed description of Work included on this permit o ly
5;7 ?el- / kA Sevv fCr- 5 e )c � 4'
r-c-- a h Y c
At
PROJECT.NAME(Name of Business or Owner Last Name) 0/46..d /.L '. !y i / nirdir
. ' • I PEOPLE INFORMATION
PROPERTY NAME
OWNER /PRIMARY PHONE -
f:J (
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANYME AO APPLICANT NAME OFFICE PHONE
7 4 41. - ( ) _
MAILNi99ITME : • CITY,STATE,ZIP CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
(
COPY of c 'requited CONTRACTOR'S REGISTRATION NUMBER EXPIRATION.DATE E-MAIL ADDRESS
with os_ksh ppileetion —,/
! APPLIC T COMPANY NAME < APPLICANT NAME OFFICE PHONE
/ 07 7 Sob'.%c:ec ,c(et-�DIV (3 k,) / -
\
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) _
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑Agent 0 Other ( ) -
PROJECT NAME 'fin /� t PRIMARY PH ENE E-MAIL ADDRESS -
f CQNTACT Yff t r 7/'( ���lv'?i' (� 7) �! -3O �� p1�/SPY'lllt�°_S'a)/l tifCtE'
LENDER NAME Per RCW 19.27.095: .
Lender in formation is required if prefect 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 $
SPRINKLERED BUILDING? • ❑YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER O LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
PR•J • ' • .�.1
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ;FT. SQ.FT. SQ.FT.
BASEMENT •
•
•
FIRST
SECOND
THIRD '
•
ADDITIONAL FLO• 'S(DESCRIBE)
DECK(0 COVERED O' U UNCOVERED?) •
GARAGE 0 CARPORT ❑
NUMBER OF FLOORS 1 wow. rout.TOTAL rbr =Brow sr 1 Tony.rs• •:., TOTAL SP
•
"NEW HOMES ONLY** NUMBER OF BEDROO` ESTIMATED SELLING $
IJXTURES
Indicate number of each type of fixture to be installed or relocated as p7r of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $ (A COPY OF BID a ESTIMATE MUST c INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORAT COOLERS GAS PIPE • ETS WOODSTOVES
BBQS FANS GAS WATER H TERS MISC(Describe)
BOILERS Fl:" 'LACE INSERTS _ HOODS(commerdaq
COMPRESSORS URNACES RANGES
D GAS LOG SETS REFRIO.SYSTEMS u�S
PLUMBING
BATHTUBS(orTub/Shower 'mho) LAYS(Bathroom silks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FO .' AINS SHOWERS _ WATER CLOSETS goner)
ELECT' WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
•
SIGNATURE
I certify under.penalty of perjury that the information 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 claims, 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 information supplied to the city as a part of
this application. �, p�
NAME/TITLE i� i//� A�I4,i r r5-40- `�� DATE C - ! �-/
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner to Agent ❑ Contractor o Architect ❑ Other
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT. • .
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? a YES o NO
•
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. Bulletin#100-January 1,2007 Page 2 of 4 kU-Iandouts\Permit Application .
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I _ _ ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 ft2-$111.00;Each add'n 500 ft2-$35.50) to to 100 amp $120.50 $74.00
❑ Detached outbuilding or garage ❑ 101-200 amp 149.50 94.50
(Inspected with service) ; $47.00 ❑ 20,1-400 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
❑ 601 -800 amp 262.00 140.50 ALTERED COMMERCIAL/INDUSTRIAL
❑ 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)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$74.00;Add'n circuits$7.00/ea) $94.50 plus 35%of Permit Fee '
❑ 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 Residential/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
.
MISCELLANEOVS SERVICE/EQUIPMENT
❑ # of Thermostats ❑ #of Signs
(First-$55.00;add'n-$17.00/ea) (First sign-$55.00;add'n sign$26.00/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $111.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $74.00
O Security Alarm System ❑ Additional Plan Review $111.00/hour
❑ Voice Cabling (for modified submittals)
O Data Cabling
❑ yi Automation Fee on all Permits .. $5.00
1.2500 ft2-$65.00;
Each add'n 2500 62417.00) •Per WAC 29646-910(5)(b)f&ii)
Bulletin#100-January 1,2007 . Page 3 of 4 k\Handouts\Permit Application