07-100812 City of Federal Way Electrical Permit #: 07-100812-00-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: THE WELLNESS STORE
Project Address: 1640 S 318TH PL Suite D Parcel Number: 092104 9208
Project Description: Installing a new T-stat ,-
Owner Applicant Contractor
SEATAC VILLAGE SHOPPING C AMBIENT CONTROL CO INC AMBIENT CONTROL CO INC
1121 SW SALMON ST 1411 R ST AMBIECC003CJ(3/1/08)
PORTLAND OR AUBURN WA 98001 1411 R ST
97205-2000 AUBURN WA 98001
Additional Permit Information
Electrical Fixtures
Thermostat 1
PERMIT EXPIRES Monday, August 13, 2007
Permit Issued on Wednesday, February 14, 2007
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:
FINAL ED
THIS CARD IS TO REMAIN ON-SITE
. „.,,A,,,,CITY OF Community Development Inspection Record .
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07-100812-00-EL
Owner:
Address: 1640 S 318TH PL Suite D
FEDERAL WAY, WA 98003
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) ❑ Pool Bonding (4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power (4275) ❑ Service(4235) ❑ Feeders/Sub-panels (4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical (4225) ❑ Ceiling Cover (4020) ❑ Final-Electrical (4055)
Approved Approved Approved
B l - Date 5-.__(l. o7 By Date By Date
❑ Under-slab groundwork(4295)
Approved
By Date
- Federal Way RECEIVED PERMIT '
COMMUNn'Y DEVELOPMENT SERVICES SF MF CO M EL PL DE EN FP
33325 8'AVENUE SOUTH•PO BOX 9718 --
598 607•FAX153632609 4 APPLICATION To � i /
www.oI offedendwnr.com FEB 1 V `'
The following is regiii?lE DINT Inca •iete application will not be accepted. Please print legibly(in ink)or type.
��i PROPERTY INFORMATION
SITE ADDRESS 16 (1'V 3- 1 e 7' 1 . -11 Q—.6,--- . SUITE/UNIT# III
ASSESSOR'S TAX/PARCEL# O 9 I 0
(7- O . O 4 LOT SIZE(sf)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)_ \
(Mach separate pagefn.Iccp At legal deevipdon)
/'/ PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING O PLUMBING ❑ MECHANICAL
❑ DEMOLITION,4ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
-s u1/( (t ) $C-(4i -'
PROJECT NAME(Name of Business or Owner Last Name) L/f ., 7641 G(i 6-t Sp/Le-
PA•
PEOPLE INFORMATION
PROPERTY NAME / A, - - / PRIMARY PHONNEE J OWNER HA IWC--�'}F-� � /ice— , - % a6. (V2c)-3S b - e'PO
MAILING ADDRESS ...et v...7.)/3i / O /✓IG ��JL. O1 � ,' / � �0^ ,MAIL ADDRESS
CONTRACTOR C PA �I1AME APPLICAHZIiAME OFFICE PH)ONE
MAILING ADDRESS
ZrAt
,ZIP /,, 9100/ CELL PHONE
CI OF
/Z r' • — i1Jl� . tn, .(Zd 6) 170 - /VZ0
C OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRArf10N T FAX NUMBER
0 C= 10l 71/ . /z -3/ - n7- (Z7) cfn - s17
txlrY of evd ngvLaa CONTRACTORS REGISTRATION NUMBER . EXPIRATION DATE E-MAIL ADDRESS
with eneh appllcatlon
APPLICANT COMPANY NAM APPLICA oili. ME OFFICE PHONE
( ) -
MAILING ADDRESS - '•I (` ,21P CELL PHONE
RELATIONSHIP TO PROJECT �i FAX NUMBER
0 Architect ❑ Tenant O Agen ❑ 0 r ( -
PROJECT NAM— —' l PRIMARY PHONE / E-MAIL ADDRESS
CONTACT / "�. ! 7 (Z45)-Z45) -//26)
c?C)
LENDER NAME Per RCW 19.27.095:
Lender information is required if prefect value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
(
U=DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE .
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑PRIVATE(SEPTIC)
PR• ee • -i
:��, ,.9�...�.-,,a�„�, .,22 <a.,.�..:u,,,. ,�„�...�y..,.;�.. m�..�.,.....�,..�..re, ,..,. . �m,��. m,.2.�n• .,..,<�-,..m. �.,�. ,r,e_. ..m yv ,,a. ... ..A, .�,,
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ,FT: SQ. FT. SQ.FT.
BASEMENT
FIRST ' •
SECOND
THIRD
•
ADDITIONAL FLOORS(DESCRIBE)
•
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE O CARPORT ❑
NUMBER OF FLOORS nitrsTwo MROTO/3TO TOTAL TbTAL ERVETMO Sr TOTAL PROPOSED 87 - TOTAL 87
•
"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(coumerdas
COMPRESSORS FURNACES RANGES
D 3; _ . . GAS LOG SETS REFRIO,SYSTEMS
PLUMBING
BATHTUBS or Tub/shower Combo) LAYS(Bathroom Sinks) URINALS . 'MISC(Describe)
DISHWASHERS - RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS _ . SHOWERS WATER CLOSETS(roses
ELECTRIC 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 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 information supplied to the city as a part of
this application. (�-
NAME/TITLE �� DATE // D
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner � ),,,,,,a.I+///"""gent ❑ Contractor a Architect 0 Other _,,
o NEW o ADDITION o ALTERATION a 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 a NO UP/SEPA/SU? . o YES a NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES a NO
•
•
•
Bulletin#100—January 1,2007 Page 2of4 k\flandouts\PermitApplication
-- - ' ELECTRICAL PERMIT.INFORMATION - ` .
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 f2-$111.00;Each add'n 500112-$35.50) ❑ 0 to 100 amp $120.50 $74.00
❑ 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) LI 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 ser■ice/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
//�� din LANEOVS SERVICE/EQUIPMENT
Y� Jr-#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
0 Security Alarm System ❑ Additional Plan Review $111.00/hour
❑ Voice Cabling (for modified submittals)
abling _____------ ❑ Automation Fee on all Permits $5.00
❑
1P■2500 ft'-$65.00;
Each add'n 2500 02(17.00) •Per WAC296-46-910(5)(b)(i&ii) .
•
Bulletin 4100-January 1,2007 . Page 3 of4 k\Handouts\Permit Application