06-102353 City of Federal way FILE'
lectrical Permit #: 06-102353-00-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: STATE FARM INSURANCE/FAMILY ELE CLINIC
Project Address: 28815 PACIFIC HWY S Parcel Number: 042104 9024
Project Description: Adding 2 new circuits for future installation of 2 new wall signs
•
Owner Applicant Contractor
S 288TH ST ASSOC FOX ELECTRIC FOX ELECTRIC
28815 PACIFIC HWY S#10 PO BOX 630 FOXELC*278DA 8/30/06
FEDERAL WAY WA KENT WA 98032 PO BOX 630
98003-3906 1 KENT WA 98032
Additional Permit Information
Electrical Fixtures
Circuits- Commercial 2
PERMIT EXPIRES Monday, November 6, 2006
Permit Issued on Wednesday, May 10, 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 f Federal Way. /-
Owner or agent: — Date: I a ` `� v
s ``Z '3 _
THIS CARD IS TO REMAIN ON-SITE
- _..".„.....
,, 41/4.CITY of ,
Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06-102353-00-EL
Owner:
Address: 28815 PACIFIC HWY S
FEDERAL WAY, WA 98003-3906
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) Et, Final - Electrical (4055)
Approved Approved Approved
By Date By Date ByC, -- Date %..
❑ Under-slab groundwork(4295)
Approved
By Date
RECEIVED
CIlY OF O (•l — I 3c-- 3
Federal Way MAY 1 0 2006 PERMIT SF MF CO Ma113)PL DE EN FP
COMMUNITY OSVELOPMEN7 SERVICES
3331SH^•AVENUE FAX 253PoBOX 9718 } PLI CATI 0 N / /
fEDERAL WAY,WA2 9HHH3-97id 1 Y. Cjh 1=EDER TD
• 15J-836Y607•PAR 1S7d35-4�H1
uwwwei$Vafledernit64c a BUILDING D
The olio • is .wired in ormation-an inco •tete a../Ration wI11 not be accepted. Please •rint le•ibty in I or •
■ PROPERTY INFORMATION
SITE ADDRESS e2 l5 P o, c\ i . o '1 v C SUITE/UNIT# Q ' 1S
ASSESSOR'S TAX/PARCEL# - _ LOT SIZE(sn
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
leant arymae:Pmfw k^Ot9 I I desoiptlay .
I ■ PROJECT INFORMATION
1
TYPE OF PERMIT ❑BUILDING 0 PLUMBING ❑ MECHANICAL
❑ DEMOLITION lir ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed des tion of work included on this permit only)
St ccp C \rc,i^` S ` a o V
PROJECT NAME(Name of Business or Owner Last Name) 5 A C?L C G,t-,r, -L vs_S Cc-s V..�, ti9 C y Q `( 1 i'11 C.
II PEOPLE INFORMATION \1
PROPERTY NAME ,y� Ln , PRIMARY PHONE
,
OWNER S 2 V
5s% S \ '1 O s5 1 0 vN ( )
MAILING ADDRESS CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME - OFFICE PHONE
C. aX EleC--\\v \L. 0VC\\.. \\o. w•5-A (2s3)'ss=l. - ()Silo
MAILING ADDRESS C, CITY,EWE, Zi • g5 (ELL PHONE
9 U & x I(; <r 1 -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
r I-9 ci -L 0 6 9 3 (0 -B`L 1�1 . p / o ( ( ) -
CONTRACfORS REGISTRATION NUMBER!copy of card required with each application) EXPIRATION DATE
Eel � 1.. 0 * )- •� IC 08 / o /3I /off
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
5 G w12 ( ) -
MAILINO ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑Tenant o Agent ❑ Other(Describe) ( ) —
CONTACT NAME - PRIMARY PHONE E-MAIL ADDRESS
I) tt�r, aO\ ;i�ck ( 0C ) 9x63-x.25‹
LENDER r_ NAME
MAILING ADDRESS . .. _.. CITY,STATE,ZIP PHONE
( )
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
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PROJECT FLOOR 0 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
=moo 1101101161) TOTAL 1
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.
MECEIA2 CAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commenced) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS - GAS PIPE OUTLETS -
PLUMBING
BATHTUBS{u hb/shower combo) SHOWERS WATER CLOSSIS tromp MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
• IAVS(Bathroom since) 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 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. - RV
NAME/TITLE / �- C� / DATE (3 .— 0 fa
(Signature( (Title)
RELATIONSHIP TO PROJECT U Owner 0 Agent ❑ Contractor ❑Architect ,Other S 9.< V,
( �t
Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application
' ELECTRICA PETLMIT INFORMATION
F
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet CI 0 to 100 amp $117.00 $71.50
(First 1300 ft2-$107.50; Each add'n 500 ft=-$34.50) P
❑ 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
❑ 601 -800 amp 254.00 136.00 ALTERED COMMERCIAL/INDUSTRIAL
1 ❑ Over 800 amp 364.00 272.00 Service or Feeders
❑ 0 to 200 amp $117.00
ALTERED SINGLE/MULTI FAMILY
El -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 .P #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
MO BILE HOME/RV PARK Residentia1/Mu1ti-Family $63.00
❑ #of service or feeders
(First service/feeder-$71.50;each add'n-$46.501 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 .4 401 #of Signs
(First-$53.50;add'n-$16.50/ea) (First sign-$53.50; add'n sign$25.00/ea)
❑ Low Voltage ❑ 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 ❑ Additional Plan Review $107.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
❑ ❑ Automation Fee on all Permits .. $5.00 •
(Per System(s) lA 2500 ft2-$63.00; -
Each add'n 2500 ft2-16.50) `Per WAC 296-46-910(5)Ni&ii( ,
Bulletin#100-January 1.2006 Pave 4(-it'd L\Aondmdc\PPrm;. A....r...,.;,.,.