06-102117 • S ® y� .>...- • R 'EC I Y �"g0/
2/ 7
CITY of' (0— j
Fecieral Way .RR M I T
COMMUNITY DEVELOPMENT SERVICES J, L' PR 2 7 2oO§F MF CO ME • PL DE EN FP
33325 878 AVENUE SOUTH•PO BOX 9718 A P P L I C A T I
FEDERAL WAY, 98063-9718 FEDERAL QN `� / /
253-835-2607•FAX
253-835-2609 �P
www.cituoffederalway.corn DEP L •
The ollowin• is re•aired in ormation-an incom•tete a••lication will not be acce•ted. Please •rint le•ibl in in or . •
ryG� • PROPERTY INFORMATION
SITE ADDRESS IC\9--E-, C s ett—di&,Cl-L5.-:.. , .:k v— -- >'‘.A.\, ' VIA clEt •.a, SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 1 2 2- `1 0 - C) C) Il C-) LOT SIZE (sf)
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1) pcta-C ¢A
(Attach separate page for lengthy logo!descnpOonl
• PROJECT INFORMATION
TYPE OF PERMIT 416UILDING PLUMBING ❑ MECHANICAL
DEMOLITION )(ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
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PROJECT NAME(Name of Business or Owner Last Name) _1 C 4 y�l >��;A -- -, O
L r i. -lti' /
P OP INFO: I
PROPERTY NAME PRIMARY PHONE
OWNER `-i ....&r!,—rA. �:'[ ��EZt-s1t'\ A% LA_.--e-'- . ((Wk) (�C.4:ji :'6-4cC.
MAILING ADDRESS CITY,STATE, P
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CONTRACTOR COMPANY NAME /, APPLICANT NAME OFFICE PHONE y
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
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<,t c}CAC. .).11-1- tN 1ik. - '-, . V` k4-A CI((tf* .; (12-53?) (f tte -t; k 1-° ,
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER t EXPIRATION DATE FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
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MAILING ADDRESSCITY,STATE,ZIP CELL PHONE
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RELATIONSHIP TO PROJECT r\!'LLtt.0 FAX NUMBER
t ,
❑ Architect 0 Tenant 0 Agent Other (Describe)c.v_ J V (r vk't) -1---f--4--- ti:=,..--,„A,
CONTACTNAME PRIMARY PHONE E-MAIL ADDRESS
IA
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.LENDER e0,0 = ar #a NAME C .....t41reuo,,,, pr' c3 ,, $5OOG. -'1 .- C(:t-rtcnie-l--C.t t ` t 1.1 ..&=:
MAILING ADDRESS u1'
CITY,STATE,ZIP PHONE p�.t L y {,
t it:" ►`t!.`� > -,a.,:-) , c .- I l ell I 'tx ` -,k (ct 1E)
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II DETAILED BUILDING INFORMATION
EXISTING USECt 4- CL"t 1 -r--- PROPOSED USE ` ;.-c__;t-`) 0. ..N.A;0-_a
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 1 1-- I O�b0 . OD
SPRINKLERED BUILDING? )<YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES )<NO
i
WATER SERVICE PROVIDER LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER AKEHAVEN D HIGHLINE 0 PRIVATE(SEPTIC)
' s • •
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL ,',6'::',!,16.,F.9141 EX38TINO ? TOTAL PROPOSED SF TOTAL NP
**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 $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS _ _ SUMPS RAINWATER SYST
_ WASHING MACHINES _ _ URINALS HOSE BIBBS
LAVS(Bathroomsnks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
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 workm
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 tnvesttgation 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 rel nce of th city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
I
NAME TITLE ^,
<:77---A:-7— ti
/ __\ �1 —� C=( ( �C04 DATE1 t ''
(Sign turd)$Owner
RELATIONSHIP TO PROJEC ❑ Agent o Contractor ❑ Architect 0 Other
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IMP O MzEimi;,g, i : tarn. . " E1A'TT11 CFRg ts , '
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Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application
4 •
• •
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$107.50;Each add'n 500 ft2-$34.50) ❑ 0 to 100 amp $117.00 $71.50
❑ Detached outbuilding or garage ❑ 101-200 amp 145.00 91.50
(Inspected with service) $45.50 ❑ 201-400 amp 272.00 107.50
❑ Detached outbuilding or garage ❑ 401 -600 amp 317.00 127.00
(Inspected separately) $71.50 ❑ 601 -800 amp 410.00 173.50
❑ 801 - 1000 amp 500.50 209.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp $117.00 $34.50 ❑ Over 600 volts surcharge $91.50
❑ 201 -400 amp 145.00 71.50 ❑ Mast or meter repair $99.00
❑ 401 -600 amp 198.50 99.00 ALTERED COMMERCIAL/INDUSTRIAL
U 601 -800 amp 254.00 136.00
❑ Over 800 amp 364.00 272.00 Service or Feeders
. El Oto 200 amp $117.00
ALTERED SINGLE/MULTI FAMILY .1n•201 -600 amp 272.00
❑ 601 - 1000 amp 410.00 /
Service or Feeder ❑ over 1000 amp 456.50
❑ 0 to 200 amp $89.50
❑ 201 -600 amp 145.00 )il, 1.. v #of circuits to be added/altered
❑ over 600 amp 218.50 (1-5 circuits-$91.50;Add'n circuits,$7.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$71.50;Add'n circuits$7.00/ea) $91.50 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $53.50 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $71.50
❑ Service and feeder $117.00
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $63.00
❑ #of service or feeders
(First service/feeder-$71.50;each add'n-$46.50) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $71.50
❑ 101-200 amps 91.50
❑ 201 -400 amps 107.50
❑ 401-600 amps 145.00
❑ over 600 amps 157.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats U # of Signs
(First-$53.50; add'n-$16.50/ea) (First sign-$53.50;add'n sign$25.00/ea)
U Low Voltage U Swimming pool/hot tub $107.50
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $71.50
❑ Security Alarm System
U Additional Plan Review $107.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling0 U Automation Fee on all Permits .. $5.00
(Per System(s) le 2500 ft2-$63.00;
Each add'n 2500 ft2-16.50) .Per WAC 296-46-910(5)(b)(i&ii)
Bulletin#100-January 1,2006 Page 3 of 4 k\Handouts\Permit Application
City Development Services Federal Way
Community De Electrical Permit #: 06-102117-00-EL
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 COMMONS FOOD COURT
Project Address: 1928-B S COMMONS Parcel Number: 762240 0010
Project Description: Altering up to (30) circuits for new lighting and rework of existing receptacles.
Owner Applicant Contractor
H M A ENTERPRISES-SEA-TAC DON LARSEN JEM CONSTRUCTION INC
249 E OCEAN BLVD#3RD STEADFAST COMPANIES JEMCOI*033DD 5/12/07
LONG BEACH CA 4343 VON KARMAN AVE SUITE 300 29506 8TH AVE S
90802-4849 NEWPORT BEACH CA 92660
ROY WA 98580
Additional Permit Information
Electrical Fixtures
Circuits- Commercial 30.00
PERMIT EXPIRES Sunday, December 10, 2006
Permit Issued on Tuesday, June 13, 2006
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: IA04/(t)ti�i%l.z, Date: ( � 10 6-
THIS CARD IS TO REMAIN ON-SITE
CITY OF . _ Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-102117-00-EL
Owner: H M A ENTERPRISES-SEA-TAC
Address: 1928-B S COMMONS
FEDERAL WAY, WA 98003-8548
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
❑ Ditch cover(4030) Ito Pool Bonding(4195)
Slab/Concrete Floor(4255) ❑ Approved
Approved to place concrete 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) IX Final-Electrical (4055)
Approved
Approved Approved
�
B Date �\ ByC�Ij�j J Date��\ () By 10 Date Qki?
❑ Under-slab groundwork(4295)
Approved
By Date
1