08-103293ty of
ClityDevelopment Services Federal Way
Community DElectrical Permit 008=103293 -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: QWEST
Project Address: �o AJW,,, `AjpiW `y ` rte., Parcel Number: CITY WIDE
Project Description: Service installation at the corner of 1ST PI S & approx 339th PI
Owner
Applicant
Contractor
QWEST
KEN BOBKO ELECTRIC CO INC
KEN BOBKO ELECTRIC CO INC
1005 17TH ST ROOM 1570
PO BOX 7009
KENBOECO66BA ( 1/1/10)
DENVER CO 80202
TACOMA WA 98406-0009
PO BOX 7009
TACOMA WA 98406-0009
Additional PisiftWinfortnation
Service greater than 1000 Amps?...........................No
New Sen
I hereby
the occl
Electrical "Fixtures
icelFeeder: 0 - 100 amps 1
PERMIT. EXPIRES Su
Owner or agent:
nd
January 4, 20139
-V J
• PIIS CARD IS T MAIN ON-SITE
CITY OF ��•..r Community Developr ent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 08 -103293 -00 -EL
Owner: QWEST
Address:
FEDERAL WAY, WA
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)
Approved
By Date "
❑ Temporary Power (4275)
Approved
By Date
❑ Slab/Concrete Floor (4255)
Approved to place concrete
By Date
❑ Service (4235)
Approved
BMd& Dat
❑
❑
UFER Ground (4295)
❑
Rough Electrical (4225)
Approved
❑
By
Date
—
❑
Pool Bonding (4195)
Approved
Approved
Date
By
Date
❑ Ditch cover (4030)
Approved
By Date "
❑ Temporary Power (4275)
Approved
By Date
❑ Slab/Concrete Floor (4255)
Approved to place concrete
By Date
❑ Service (4235)
Approved
BMd& Dat
❑
Feeders/Sub-panels (4045)
❑
Rough Electrical (4225)
❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑ Final - Electrical (4055)
Approved
C �►�-'_"
By Date
For inspector reference
❑ Rough Electrical
Approved
By Date
❑ FINAL - Electrical
Approved
By Date
CITY OF
Federal W"�M/-
a
PERMIT SF M
COMMUNITY DEVELOPMENT SERVICESnnnp F CO ME, EL PL DE EN rr
33325 AVENUE SOUTH • BOX 971 B, L 08 20! I p P L I C AT I O N
FEDERAL WAY, FAX
9806363 -9718 TD
253-835-2607• FAX 253-835-2609
www.cit o m ..A FEr)ER L QUAY
The following is required information -an incomplete application will not be accepted. Please print legibly (in ink) or type.
gg PROPERTY •. •
SITE ADDRESS Q 1 P L SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # _ _ _ _ - _ _ — _ LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
PROJECT• •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only
DS
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE•- •
PROPERTYNAM
_
j,
PRIMARY PHONE
OWNER
)
j1
-
CELL PHONE
MAILING ADDRESS
TY, STATE, ZIP
E-MAIL ADDRESS
( -
CELL PHONE
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
OMPA NAMEJJ
Ve 1
APPLICANT NOME 11
OFFICE PHONE
CITY, STATE, ZIP
OFFICEPHONE
\4t
1 oF.
k
CELL PHONE
` 13 4111 C
AILINQ ADD ESSCITY,
STATE, ZIP
( -
CELL PHONE
Y F FEDERAL WAY BUS) ESS LICENSE NUMBERcc
EXP TION DATE
FAX NUMBER
ONTRACTORIs REGISTRWrION NUM
XPI
ON DAT
E-MAIL ADDRESS
IF,
COMP
APPLICANT NAME
OFFICE PHONE
CITY, STATE, ZIP
PHONE
M G ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( -
NAME- PRIMARY PHONE E-MAIL ADDRESS
NAME-
Per RCW 19.27.095:
Lender fgformation is required (f project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED/APPRAISED VALUE
PROPOSED USE
VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SO. FT.
TOTAL
SQ. FT.
BASEMENT
WATER CLOSETS (TolleQ
SINKS
WASHING MACHINES
FIRST
SECOND
THIRD
ADDITIONAL FLOORS (DESCRIBE)
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
"ISTING
PROPOSED
TOTAL
TOTAL ERISTINO Sr
TOTAL PROPOSED Sr
TOTAL ST
"NEW HOMES ONLY*" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHAXICAL
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (or Tub/Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
(A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
FANS GAS WATER HEATERS MISC (Describe)
FIREPLACE INSERTS HOODS (commerciaq
FURNACES RANGES
GAS LOG SETS REFRIG. SYSTEMS
LAVS (Bathroom Sinks)
URINALS MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
SHOWERS
WATER CLOSETS (TolleQ
SINKS
WASHING MACHINES
SUMPS
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certt& that to the best of my
knowledge, the triformation 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. 1 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 such claim), which may be made by any person, including the undersigned, and filed against the city, but only
where such claim arises o of th elianc of a city, { cludingitofficers and employees, upon the accuracy of the information supplied to
the city as apart of is pfie n.
SIGNATURE:DATE
n
Property Owner and/or Authorized Agent
❑ NEW ❑ ADDITION ❑ ALTERATION
BUILDING SHELL ONLY? ❑ YES ❑ NO
ZONING DESIGNATION
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTE4,LOT? ❑ YES q NO
❑ REPAIR ❑ TENANT IMPROVEMENT
BASIC PLAN? ❑ YES ❑ NO
CHANGE OF USE?
UP/SEPA/SU?
DEMO PERMIT REQUIRED?
❑ YES ❑ NO
❑ YES a NO
❑ YES ❑ NO
#100—January IV20-08 Page 2 of k\Handouts\Permit Application
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIALANDUSTRIAL SERVICE
❑ Single Family Square Feet
Service or Feeder Each Add'n
(First 1300 ft2- $ 115.50; Each add'n 500 ftp - $37.00)
0 to 100 amp $125.50 $ 76.50
❑ Detached outbuilding or garage
101 - 200 amp 155.50 98.00
(Inspected with service) $48.50
❑ 201 - 400 amp 291.00 115.00
❑ Detached outbuilding or garage
❑ 401 - 600 amp 339.50 136.00
(Inspected separately) $76.50
❑ 601 - 800 amp 439.00 186.00
0 801 - 1000 amp 536.50 224.50
NEW MULTI -FAMILY (three units or more)
❑ Over 1000 amp 584.50 311.50
Service Feeder
❑ Up to 200 amp $125.50 $ 37.00
❑ Over 600 volts surcharge $98.00
❑ 201 - 400 amp 155.50 76.50
❑ Mast or meter repair $106.00
❑ 401 - 600 amp 212.50 106.00
❑ 601 800 amp 272.00 145.50
ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 389.50 291.00
Service or Feeders
❑ 0 to 200 amp $125.50
ALTERED SINGLE/MULTI FAMILY
❑ 201 - 600 amp 291.00
Service or Feeder
El 601 - 1000 amp 439.00
Ll 0 to 200 amp $ 96.00
❑ over 1000 amp 489.00
❑ 201 - 600 amp 155.50
❑ over 600 amp 234.00
❑ # of circuits to be added/altered
(1-5 circuits - $98.00; Add'n circuits, $7.50/ea)
❑ # of circuits to be added/altered
COMMERCIAL /INDUSTRIAL PLAN REVIEW
(1-4 circuits -$76.50; Add'n circuits $7.50/ea)
$98.00 plus 35% of Permit Fee
❑
❑ Service - 1,000 amps or greater
Mast or meter repair $57.50
❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $76.50
❑ Service and feeder $125.50
TEMPORARY SERVICE
MOBILE
MOBILE HOME/RV PARK
Residential/Multi-Family $67.50
Ll of service or feeders
(First service/feeder-$76.50; each add'n -$50.00)
CommerciaWndustrial Service or Feeder Ampacity
❑ 0 - 100 amps $ 76.50
❑ 101-200 amps 98.00
❑ 201 - 400 amps 115.00
❑ 401 - 600 amps 155.50
❑ over 600 amps 168.00
MISCELLANEOUS SERVICE/ EQUIPMENT
❑ # of Thermostats
❑ # of Signs
(First -$57.50; add'n-$17.50/ea)
(First sign -$57.50; add'n sign $27.00/ea)
❑ Low Voltage
❑ Swimming pool/hot tub ................ $115.00 -
Square Feet to be served by system(s)
(Includes additional circuit, if required)
❑ Fire Alarm System
❑ Yard Pole meter loops ..................... $76.50
❑ Security Alarm System
❑ Voice Cabling
❑ Additional Plan Review $115.00/hour
❑ Data Cabling
(for modified submittals)
❑
❑ Automation Fee on all Permits .. $5.50
1-12500 ft2-$67.50;
Each add'n 2500 ft2 - $17.50) • Per WAC 296-46-910(5)(b)(i & ii/
r
tsulletm 4100 - January1, 2008 Page 3 of 4 k\IIandouts\Permit Application