10-105375 City of Federal Way • •
4' Electrical
Community Development Services Permit #: 10-105375-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: JENSEN
Project Address: 32835 3RD PL S Parcel Number: 926870 0210
Project Description: Replace electrical panel. a Li $'
Owner Applicant Contractor
SUSAN JENSEN SUSAN JENSEN SUSAN JENSEN
32835 3RD PL S 32835 3RD PL S 32835 3RD PL S
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
Additional Permit Information
Is Use Educational or Institutional' No
mss �i� a a y,� ,, :, fib
Alt. Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Tuesday, December 27, 2011
Permit Issued on Monday, December 27, 2010
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: ! ,L`,` Date: A-
FI1JALD Z/1 <<
�.. ' - • THIS CARD IS TO AIN ON-SITE '
CITY OF Construction Ins ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 10-105375-00-EL Address: 32835 3RD PL 6
Project: SUSAN JENSEN FEDERAL WAY, WA 98003-6367
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) ❑ Ditch cover(4030) 0 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
o Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
�0 Final-Electrical(4055)
Approved
Bq Date 7_/ -7/
0 Rough Electrical Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
•
• 0 - n 537a
CITY Of
Fed ay ELECTRICAL
2c- PERMIT APPLICATION
**Most electrical permits may be obtained on-line at www.cityoffederalway.com**
,cr° PROPERTY INFORMATION'
SITE ADDRESS: a 8 3 s� i c_ £ 0,5 o v T/�
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
x o (1) -- ( b
PROJECT INFORMATION
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION tt L
Detailed description of work to
be included on this permit only
PEOPLE
NAME PRIMARY PHONE
PROPERTY OWNER ' . *)A) T2-/JS f -
MAILING ADDRESS E-MAIL
3 ,3'3 P),4 C <O--�L"i' # !t L 4-bq rC l lc 1a1 9 6 4
CITY STATE ZIP FAX
,2_41— c ( ) -
NAME PRIMARY PHONE
Ute '-'` ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
NAME PRIMARY PHONE
APPLICANT L^� ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME .PRIMARY PHONE
PROJECT CONTACT .' ft.' its" FA,/ --
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 the city as a part of this application. f
SIGNATURE: "` DATE j Q/ 017
PRINT NAME: �' tt, - L
33325 8'h Avenue South•PO Box 9718•Federal Way•WA 198063-9718 1253-835-2607•fax:253-835-2609•www.cityoffederalway.com
Bulletin#160—April 9,2010 Page 1 of 2 k:\Handouts\Electrical Permit Application
16
RESIDENTI CO11lVIERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet
(including attached garage): I st Service/Feeder Additional Feeders
0- 100 aatp x$132.50 x$ s8t1.5£)
FEES: First 1300 ft2-$122.00; 101- 200:amp .x$164;00 x$103,50
Each additional 500 ft2-$39.00 x$I22t7!II
NEW MULTIFAMILY (3 units or more)
401 600:amp x:$358:(10 x$243::50
1
Service/Feeder Additional Feeders
x $l3 5O x. $ 39sAt3
801.--.1000 amp x$565:b0 � x:$23650
201';-'400 ax::: :164:00 .: ..:.;:: 32;.:.;50
$ x $.80.5A 0i1::>::>:>::>:::>:>:::: <::::<::::<:::::x:: .328;;50
601--.800 amp x:::$287:00 a $153<50 Over:600 volts surcharge x:$103.50
4ver:.8Ci0 amp x $410.50 > 'x $307>00
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
Ise Service/Feeder 1st Service/Feeder Additional Feeders
.0-;200 amp vice70:1.00 0- 200 P x$132.50 x$103:50
$:164:00
201- 600:amp x$30700....._ x:$12:1:00
601-100(1 ip... x$463.00 x$196 00
Qver::1000:attp x:$5:15 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
8e VICe:or:feederoDly x $ 80:50 Plan Review required only for:
•
New or alteration to service 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 si
❑ Security Alarm System 1 Service/Feeder Additional Feeders
❑ Voice/Data Cabling 0 . 60 ai P x $ '71 :'::`::> S:$;32 flQ.
o Other
61- 10O:8rap. x $:8(k:50 ,: k $.39:00
Area to be served by system:
1e 2500 ft2-$71.00;each additional 2500 ft2-$18.50
201._.400:amg 11.:$:12:1:00 :..........................
.:
#of Thermostats
First$60.50;each additional$18.50
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♦PO Box 9718•Federal Way•WA♦98063-9718♦253-835-2607 1 fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160-April9,2010 Page 2 of 2 k:\Handouts\Electrical Permit Application