12-104270 A.,,,,, ( 2- _ I 0 4 {FZ C
CITY OF --....
Fe '1 ELECTRICAL
SEP 1 s 2012 PERMIT APPLICATION
CITY OF FEDE}kAect a(lelectrical permits may be obtained on-line at www.cityo federalway.com**
CDS PROF 'ENTP0~;IO _*
SITE ADDRESS: 33915 1 �F uuAy 5ô --1_, /
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL#
020 0 \ Z 5 G zt _ Q 1 S O CURRENT/PROPOSED USE
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PROJECT NAME D(-1 5 C (> l G V�-- 1 OrA LT1-1 �I-� 4 LI
(Tenant or Homeowner Last Name) `f �=�-/t
_.6n QQ4 1 iit, CAT�(4n /I ,( /_ln U het. : ' , /,
PROJECT DESCRIPTION i+�i +`�b�,y tO c i al S oc. l4Yl(J C� . • �l
Detailed description of work to t
be included on this permit only � ���I rl, � �� � (�,,� � (1�,�}�
II
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-- NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY l STATE l ZIP FAX
(
NAMEPRIMARY PHONE
(3c VAn x Id . S.. (&O(, ) 5-15- 133
MAILING ADDRESS /J C� M E-MAIL ���p�
ELECTRICAL $'D® St). 3 S l &I7Gl ,it0,,IIIAC1Z11iC8� ^on1
s
CONTRACTOR CITY STATE ZIP ��, F
�' krIO�N WA q 7 (020 6) O-- 6 6(9 j'
WA ST��(�T��l�L�ENSE� � EXPIRATION DATE�(� FEDERAL WAY BUSINESS LICENSE it
NAME CC�_77^^JJ`` PRIMARY PHONE
APPLICANT (
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ' -
NAMEM PRIMARY PHONE
PROJECT CONTACT t Y�'l Ill& y (d53) 33t a2 o
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 t e city as a part of this application.
SIGNATURE: / •' DATE I 0 /C2,
PRINT NAME: t M in t 4C .
33325 8th Avenue South • Federal Way•WA•98003-6325 1 253-835-2607 1 fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160—January I,2011 Page 1 of 2 k:U-Iandouts\Electrical Permit Application
RESIDENTIAL COMMERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 15'Service/Feeder Additional Feeders
(including attached garage): 0 100 amp x$132.50 x$ 80.50
FEES: First 1300 ft2-$122.00; 101- 200 amp x$164.00 x$103.50
Each additional 500 ft2 $39.00 201- 400 amp x$307.00 x$12.1.00
NEW MULTIFAMILY (3 units or more) 401 600 amp x$358.00 x$143.50
1"Service/Feeder Additional Feeders 601- 800 amp x$463.00 x$196.00
0- 200 amp x $132.50 x $ 39.00 801- 1000 amp x$565.00 x$236.50
201 -400 amp x $164.00 x $ 80.50 Over 1000 amp x;$616.00 x$328.50
401 -600 amp x $224.00 x $111.50
601--800 amp x $287.00 x $153.50 Over 600 volts surcharge x$103.50
Over 800 amp x $410.50 x $307.00
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
1'L
Service/Feeder 1s Service/Feeder Additional Feeders
0- 200 amp x $101.00 0- 200 amp x$132.50 x$103.50
201 600 amp x $164.00 201- 600 amp x$307.00 x$121.00
Over 600 amp x`'$246.50 6.01-1000 amp. x$463.00 x$196.00
Over 1000 amp x$515.50 x$328.50
Added or Altered Circuits
1-4 circuits$80.50;each additional$8.00 Added or Altered Circuits
1-5 circuits$103.50;each additional$8.00
Mast or meter repair $60.50
Mast or meter repair $111.50
MANUFACTURED HOMES PLAN REVIEW FEES
Service or feeder only x $ 80.50 Plan Review required only for:
Service and feeder x` $132.50 • 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 $105.50/hour
MISCELLANEOUS SERVICE/EQUIPMENT
LOW VOLTAGE TEMPORARY SERVICE
❑ Fire Alarm System 1st Service/Feeder Additional Feeders
❑ ecurity Alarm System
Voice/Data Cabling 0 60 amp x`'$ 71.00. x $ 32.00
0 Other SOO 0 61-;100 amp x $ 80.50 x $ 39.00
Area to be served by system:
1st 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50 101 2:-200'amp " X $103.50 X $ 51.00
201-;400 amp x $121.00 °,x $ 60.50
#of Thermostats 401_600 ain
First$60.50;each additional$18.50 p, x $164 $ 80.50
Over 600 amp x $184.50 x $ 92.00
FEE CALCULATIONS
Yard Pole/meter loops/pedestal x$ 80.50 • Fees are determined by the scope of work as indicated.
Portable Generator(transfer equipment) x$101.00 • A$6.00 Automation Fee will be added to all permits.
Ditch cover/inspection only x$121.00 • For assistance in calculating fees or completing the
application form,contact the Permit Center at
253-835-2607
33325 8'h Avenue South•Federal Way•WA•98003-6325 •253-835-2607♦fax:253-835-2609 1 www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 2 of 2 k:U-landouts\Electrical Permit Application
' • • t:lecfrical
City ofFederal Way
Community&Econ.Dev.Services Permit #: 12-104270-00-EL
33325 8th Ave S
Federal Way,WA 98003Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: DIGESTIVE HEA 1'HA' i .'- S
Project Address: 33915 1ST WAY S Unit 200 Parcel Number: 926504 0150
Project Description: Installation of 114 cables to 57 locations for Voice and Data connections. In addition,lea
25pr Cat3 cable and 2ea Cat6 4pr Cables will be installed for Demarc feeds. 18/2 cable will
be installed for 11 ceiling speakers.
Owner Applicant Contractor
CUNA MUTUAL INVESTMENT JIM BRASSFIELD BLACK BOX NETWORK SERVICES dba B&
5910 MINERAL PT RD BLACK BOX NETWORK SERVICES C TELEPHONE INC(ELECTRICAL)
MADISION WI 53705 800 SW 34TH ST SUITE A BCTELCT882J3(4/2/14)
RENTON WA 98057 800 SW 34TH ST SUITE A
RENTON WA 98057
•
•
Additional Permit Information
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures'.
Low Voltage-Other(Commercial I
PERMIT EXPIRES Thursday, September 18, 2014
Permit Issued on Tuesday, September 18, 2012
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
a d the City of Federal Way. 1
Owner or agent: c Date: 61(' go(d
.... ..._____.,..s.c..„.......„.. 2 lottit( ze
•
THIS CARD IS TO ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-104270-00-EL Address: 33915 1ST WAY S Unit 200
Project: CUNA MUTUAL INVESTMENT FEDERAL WAY, WA 98003
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.
❑ UFER Ground (4295) El Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) 'El Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date ByyVS Date I O._3—(Z
O Final-Electrical(4055)
Approved
By 0 Date 1 0 .4\-12
❑ Rough Electrical Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date