11-102426 Electrical
Ci ofFederalWay Permit #: 11-102426-00-EL
Community Development Services
P.O.Box 9718 FILE
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: DAWSON,DAVID R,MD
Project Address: 720 S 320TH ST Suite G Parcel Number: 082104 9266
Project Description: Installation of 100-amp feeder for X-ray machine.
Owner Applicant Contractor
CAPITOL SQUARE LLC OLSEN ELECTRIC INC OLSEN ELECTRIC INC
PO BOX 18194 718 GRIFFIN AVE OLSENEI931PE(10/5/11)
SEATTLE,WA 98118-0194 ENUMCLAW WA 98022 718 GRIFFIN AVE
ENUMCLAW WA 98022
say „ 'el') ,1
,s Additional ' 4 t
Is Use Educational or Institutional9 No Service greater than 999 Amps? No
i Electricak. ,, , , , ,
Alt. Srvc I Feeder 0 to 200 amps(( I
CONDITIONS:
OTCISTFI
PERMIT EXPIRES Tuesday, June 19, 2012
Permit Issued on Monday, June 20, 2011
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
d theeity of Federal Way.
Owner or agent: dr-6/�' GU (t Date: L f I
_4.__ --)._,
- ,f,,„acL & Z3 ( (
THIS CARD IS TO REMAIN ON-SITE
OF Construction Ilkection Record
Federal WayINSPECTION RE UESTS: (253 835-3050
PERMIT#: 11-102426-00-EL Address: 720 S 320TH ST Suite G
Project: CAPITOL SQUARE 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.
El UFER Ground (4295) 0 Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
ID Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) CI Rough Electrical(4225) Cl Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
By Q,\40.. .„ Date — a3__\ \
Rough Electrical Final Electrical C3Right of Way
❑ Approved ❑ Approved Approved
By Date By Date By Date
Feder_ PERMIT MF CO ME " I EN F'
ITY
'1
c Itvvm ,. .. , 0N$ z 41141 CATI O N
253895-2609•FAX 253835-2608
www.dtyofTederalway.com ��0
SITE ADDRESS o c,,,..5 SUITE/UNIT i
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL i
$ Si5.-6 0, CLQ -OS a —I D 7 - 9 2 (a
TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) V iZ. f') t ,c'C 0A/ Cite I re„ C"^v ,q_,�
f%�'IVvv (,,-rt t' 'v caul �1 1 1C�t
PROJECT DESCRIPTION 1-MA- 1✓��- 2" X fZf� /1l/4C4.1 INC
Detailed description of work to O /Uto R V1r1&) P cip_
be included on this permit only
PROPERTY OWNER (/J
NAME (54:2;Y/ 0., +Jut. 6 1 C PRIMARY PHONE
MA/LING ADD E-MAIL
CITY STATE ZIP
NAME PHONE
6L €? etk—r-IYL1( PO .
MAILING ADDRESS E-MAIL
I, 40, en.,SS (1t2FriN #
•
� Uvvvtc.c, �q`�D22 FAX
25'21 2.(.0 C) 02-(1,IS
/ WA STATE CONTRACTOR'S LICENSE i EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE i
C.)(... 0-17 �l / � ` (o / ¶ / I( -Cis-its 2tff2-zb_GL-
NAME PHONE
/4-11/41D 2exA, L i.i k (A.JI C..k,
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAME PHONE /�
(The individual to receive and la PA Pc 1'.) tJ 2.0 S-i?) 4-71) ZS`S-'i
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALSiBNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING mem
0 OWNER-FINANCED
Required value of$5.000 or more
(RCW 19.29.0951 MAILING ADDRESS.CITY.STATE,ZIP PHONE
I certify under penalty of perjury that I 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.
Ifurther agree to hold harmless the City gf 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,Jiled against the city, ^'
but only where such claim arises out of the reliance of the city, including its o icers and employees, upon the accuracy of the .
information supplied to the city as a part of this application.
r
SIGNATURE:
/ ✓,c-6 — £/U/&fDATE y d 2_0— (
PRINT NAME: 2? `1J.2 (±/PD
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Bulletin#100-January 1,2011 Page l of 3 k:\Handouts\Permit Application
s _
RESIDENTIAZ ( MERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 1 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$121.00
NEW MULTIFAMILY (3 units or more) 401 600 amp x$358.00 x$143.50
1sr 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 anip x$616.00 x$328.50
401 -600 amp. $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
1st Service/Feeder 1't Service/Feeder Additional Feeders
0- 200 amp x`$101.00
0- 200 amp I 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
60.1 -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 feederonly x $ 80.50 Plan Review required only for:
Service aad_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
O Security Alarm System
❑ Voice/Data Cabling €l _60 amp ,,, x $ 71110.,„",::4'),', $,32_00
❑ Other 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 ft'--$18.50 x"-TZOt1 1 X.$ 08:50 X_$51.00
201'-,4O0:amti - x $121.00 .$ 60.50
#of Thermostats
First$60.50;each additional$18.50
Over;600 amp x $184.50 $ 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 8th Avenue South♦Federal Way 1 WA•98003-6325•253-835-2607♦fax:253-835-2609•www.cityoffederalw•ay.corn
Bulletin#160-January 1,2011 Page 2 of 2 k:\Handouts\Electrical Permit Application