13-100023THIS CARD IS TOMAIN ON-SITE
F °F Construction In ection Record
@deral Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 13 -100023 -00 -EL Address: 31617 1 STAVE S
Project: LAKEHAVEN UTILITY DISTRICT FEDERAL WAY, WA 98003-5201
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.
0
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
E]
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
El
Pool Bonding (4195)
Temporary Power (4275)
E]
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
❑
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By fes. Date `
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
0 "1
CITY OF
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IAN 032013
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ELECTRICAL
PERMIT APPLICATION
PROJECT NAME
(Tenant or Homeoumer Last Name) Z1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
ELECTRICAL
CONTRACTOR
APPLICANT
PROJECT CONTACT
n
(61
CDvy_)+T' f�
FTEZo a1
10tywa 4 -Io Ce
NAME_ PRIMARY PHONE
MAILING ADDRESS E-MAIL
CITY STATE I ZIP FAX
NAME PRIMARY PHONE
MAILING ADDRESS E-MAIL
CITY • T �
STATE ZIP
, Lw q
WA STATE CONTRACTOR'S LICENSE # 1fT� EXPIRATION DATE
ta-)
NAME /� , � ���� EJ �� �� iX-Y l/► �l.
MAILING ADDRESS
CITY STAT ZIP
NAME .
(��)3� - C9 -
FEDERAL WAY BUSINESS LICENSE #
19_`73-6006dC0--t)6
PRIMARY PHONE
E-MAIL
1 W5
PRIMARY PHONE
()� q47�
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 apart of this application.
SIGNATURE: " � � / DATE
PRINT NAME:
33325 8"' Avenue South ♦ Federal Way ♦ WA ♦ 98003-6325 ♦ 253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin #160 —January 1, 2011 Page 1 of 2 k:\Handouts\Electrical Permit Application
NEW SINGLE FAMILY RESIDENCE
Total Square Feet
(including attached garage):
FEES: First 1300 ft2 - $122.00;
Each additional 500 ft2 - $39.00
NEW MULTIFAMILY (3 units or more)
1st Service/Feeder Additional Feeders
ALTERED SINGLE or MULTI FAMILY
Is' Service/Feeder
0 �- 200 alr, $101:00
201 - 600 amp x $164.00
Added or Altered Circuits _
1-4 circuits $80.50; each additional $8.00
Mast or meter repair $60.50
MANUFACTURED HOMES
Service or feeder only x $ ',80.50
-service and feeder x :" $132.50
NEW COMMERCIAL
1st Service/Feeder Additional Feeders
O- 100 amp
x $132.50
X"$ 80.541
101- 200 amp,
x $164.00
x $103.50
201- 400 amp
x $30,,00 . ;-
$121.00
401 600 amp
x $358.00
x$143.50
601"- 800 amp
x $463.00 ,
x;$196,00
801 1000 amp,
x $565.00
x $236.50
Over 1000 amp.
00".
x $328.54)
Over 600 volts surcharge x $103.50
ALTERED COMMERCIAL
1 st Service/Feeder Additional Feeders
#1 � amp x $132 `' x ($103.50
201- 600 amp',' x $30200 x'$121.00
Over 1000 amp x $515.50 x $328.50
Added or Altered Circuits I
1-5 circuits $103.50; each additional $8.00
Mast or meter repair $111.50
PLAN REVIEW FEES
Plan Review required only for:
• 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
❑ Fire Alarm System
❑ Security Alarm System
❑ Voice/Data Cabling
❑ Other
Area to be served by system:
Pt 2,500 ft2-$71.00; each additional 2,500 ft2 - $18.50
# of Thermostats
First $60.50; each additional $18.50
Yard Pole/meter loops/pedestal x $ 80.50
Portable Generator (transfer equipment) x $101.00
Ditch cover/inspection only x $121.00
TEMPORARY SERVICE
1 st Service/Feeder Additional Feeders
0 - 60 amp
x $ 71.00
x $ ;32.00
61 - 100; ampt
$ 80,50
x $ 39.00
101-"200 amp
X $103.50
x $-` 51,00
201 400 amp
x $121.00
x $ 60.50
Over 600 ampz4 $184.50 x $ 92.00
FEE CALCULATIONS
• Fees are determined by the scope of work as indicated.
• A $6.00 Automation Fee will be added to all permits.
• For assistance in calculating fees or completing the
application form, contact the Permit Center at
253-835-2607
33325 8"Avenue South 1 Federal Way ♦ WA ♦ 98003-6325 1 253-835-2607 ♦ fax: 253-835-2609 1 www.cityo-ffederalway.com
Bulletin #160 - January 1, 2011 Page 2 of 2 k:\Handouts\Electrical Permit Application
CITY OF 'A
Federal Way
..m..a.BER 470 Z73; _ Gn
ELECTRICAL
PERMIT APPLICATION
SITE ADDRESS: 12-t S 3 3 -1*3h l k" L
SUITE/UNIT/SPACE 4
PROJECT VALUATION
2ga0 0('
ASSESSOR'S TAX/PAR7 /
19 17,� �_ � � Co 0
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
C-, L
�' U ilii Q� J 1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
CA-c� \ 00a6s - Ove -
C/ Z Cl eo
PROPERTY OWNER
NAME
C 0YY1 fl t7 1(i S t'
PRIMARY PHONE
(S'4 (o) 915 -ZS L'
MAILING ADDRESS
E-MAIL
C IFSTATE
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) FAX
ELECTRICAL
CONTRACTOR
NAMEID A- ?-" Ctec,h�
MAILING ADDRESS C y
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&
-1 V e I e C 0MCC St.
I STATE
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WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE
ILl CQ M5 L (5
FEDERAL WAY BUSINESS LICENSE N
APPLICANT
NAME C
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
1 C ,�� e
PRIMARY PHONE
(51)3) 2 g_ -120
I certify under penalty of perjury that 1 am the property owner or authorised 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 authorised 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 cityas apart of this application.
SIGNATIIRE:DATE U 1 I
PRINT NAME:
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:0andoutsTlectricai Permit Application
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