10-105084 w
Electrical
City of f=ederal Way II •
Community Development Services Permit #: 10-105084-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 F ! LEInspection Request Line: (253) 835-3050
Project Name: H&R BLOCK
Project Address: 31721 PACIFIC HWY S Suite A Parcel Number: 082104 9078
Project Description: New 20-amp 120 volt circuit alteration in existing office space.
r
Owner Applicant Contractor
ELLAYENN'S LLC BLAZE ELECTRIC&SRVC CO INC BLAZE ELECTRIC&SRVC CO INC
5363 S KENYON SW 209 125TH ST S BLAZEES010P8(10/28/09)
SEATTLE WA 98118 TACOMA WA 98444 209 125TH ST S
TACOMA WA 98444
Information 1
Is Use Educational or Institutional? No Service greater than 999 Amps? No
urs Permit y1k
t ,A, , 1w .
PERMIT EXPIRES Wednesday, December 7, 2011
Permit Issued on Tuesday, December 7, 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 wil b in accordance with the laws, rules and regulations of the State of Washington
d the City of Federal Way.
'Ilta
Owner or agent: �� �( Date: /Tior---7-7/0P/Rill
_-,14'40 IZ
THIS CARD IS TO MAIN ON-SITE
CITY OF � 0 Construction Ins action Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 10-105084-00-EL Address: 31721 PACIFIC HWY S Suite A
Project: ELLAYENN'S LLC 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) 0 Slab/Concrete Floor(425f35-1
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
B Date Z-��✓(/
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❑ Rough Electrical Final Electrical 111Right of Way
Approved Approved Approved
By Date By Date By Date
I
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CITY OF
Federal Way ELECTRICAL RECEIVED
PERMIT APPLICATION DEC 07 2(1,.;
**Most electrical permits may be obtained on-line at www.cityo" c'e'rarway.cbin** L WA'',
PROPERTY< ,F ? TION „44 - %htfA
SITE ADDRESS: ? I �.� `r
/ z_/ 'c r � /tA%y 5. %chile,/447 4/./4- 97W-7
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
C 1 CC
., .. a�
PROJECT NAME r �
(Tenant or Homeowner Last Name) 0� (}C_-/�
PROJECT DESCRIPTION /� j - ,4 /70 V C,,�'C (-1 i—f
Detailed description of work to (I
be included on this permit only
PEOPLE
NAME PRIMARY PHONE
PROPERTY OWNER 1 - L-4--( 2t1 5 I C c, ( ) -
MAILING ADDRESS E-MAIL
s63�, 5 ffe,v6" ' gzt)
CITY STATE ZIP FAX
5/e)41-772- :?///1 ( )
PRIMARY
N om `7 zHONE
e L. �- pr1 C'. j� � )s'7 P/ 6(Z-Z—.
MAILING ADDRESS E-MAIL
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ELECTRICAL E- �Z i S �to/9zeL/e k-k_S<Li t.
CONTRACTOR CITY AT ZI �i // FAX
7c_c-44i 9 Gfi'`� cJ `f (��3).S? -
WA STATE CONTRACTOR'S LICENSE# EXP TION DATE FEDERAL WAY BUSINESS LICENSE#
aL� f L_ O/D 1°C9 / /oigr? c;�C� 'L_.
NAME PRIMARY PHONE
APPLICANT ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT % ( )
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 oris out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the a 'art o his application.
-
SIGNATURE: �/�� DATE
PRINT NAME: ,141.1 C/(O6—,6/
33325 8'"Avenue South♦PO Box 9718•Federal Way♦WA•98063-9718♦253-835-2607 •fax:253-835-2609•www.cityoffederalway.com
Bulletin#160—April 9,2010 Page 1 of 2 k:\Handouts\Electrical Permit Application
RESIDENTS, •MMERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 1st Service/Feeder Additional Feeders
(including attached garage): .....10Q amp x$13,2 Sfl x$ 80;50
FEES: First 1300 ft2-$122.00; 101— 204 amp x$:164100 x$103:50
Each additional 500 ft2- 9
3 .00
NEW MULTIFAMILY (3 units or more) 401- 60O:amp x:$358:00 x:$143 50
s�
1 Service/Feeder... Additional Feeders
� $bl-iflbCFamp x$565:bb x:$236::50
201 -400amp x $264:00 x $:.80:5A
Glver:::1tM0if a� >
601:::800 amp x::$:287:00 x $153<m Oxer 600i volts:surcharge x$10&50
Over x' #10.54 '! x $3t1T;0 7
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
Ise Service Feeder 1"Serpice/Feeder_.......,_Additional Feeders
-0- 2ElQ.auip :; 7k:$101.Q0
201 -600'a p x:::$14 �1?0
201.--600:amp x:$307:00 x:$12:1:.00
4ver:6004uip _x:::$f2466 50
over::100D:amp x:$5:15.50 x:$328.50
Added or Altered Circuits... I
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 $::130 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 $105.50/hour
MISCELLANEOUS SERVICE/EQUIPMENT
LOW VOLTAGE TEMPORARY SERVICE
❑ Fire Alarm System i Service/Feeder Additional Feeders
❑ Security Alarm System
❑ Voice/Data Cabling
❑ Other 61—100 amp x_$ 80:50
Area to be served by system:
10:1--200 amp is $103 50 x $ 51;00
1.2500 ft2-$71.00;each additional 2500 ft2-$18.50
201.-400 autp .:::.;.:<.;:: :$:12liOQ::::::::....._:`::; :': ::$:60-56
#of Thermostats
First$60.50;each additional$18.50
Over 600::amp x $184:50 .....
FEE CALCULATIONS
Yard Pole/meter loops/pedestal x$ 80.50 • Fees are determined by the scope of work as indicated.
Portable Generator(transfer equipment) x$101.00 CO 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 8th Avenue South♦PO Box 9718•Federal Way♦WA♦98063-9718♦253-835-2607♦fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160-Axil 9,2010 Page 2 of 2 k:\Handouts\Electrical Permit Application