12-104157 ( 2-- t o 4- l 57
CITY OF
FedetaJ ELECTRICAL
SEP 10 2012 PERMIT APPLICATION
CITY OF FEDfAtioVItiekctrical permits may be obtained on-line at www.cityoffederalway.com**
SITE ADDRESS: `i n(.i 7-- , Q' CIINe( ( ma VA (1T'fl',
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL#
U
CRRENT/PROPOSED USE
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PROJECT NAME
(Tenant or Homeowner Last Name) 1 _+r` ;
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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PRIMARY PHONE
PROPERTY OWNER i (• , ) „, , -
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MAILING ADDRESS E-MAIL
STATE ZIP If FAX
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NAME " 1 PRIMARY PHONE
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MAILING ADDRESS
E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME0
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APPLICANT ( )
MAILING ADDRESS
STATE ZIP
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 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.
..- ---77-ri,t/ C'1/4
SIGNATURE: DATE /: iI'
PRINT NAME: 1( I+!tv.' P/1'[H•.
33325 8'"Avenue South♦Federal Way 1 WA♦98003-6325 •253-835-2607•fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160—January 1,2011 Page 1 of 2 k:AHandouts\Electrical Permit Application
RESIDENTIAL COMMERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 1st Service/Feeder Additional Feeders
(including attached garage):
FEES: First 1300 ft2-$122.00; 101--200Amp x-$164.00 x$103.50
Each additional 500 ft2-$39.00
$307,.00S 2 x$1.21=
NEW MULTIFAMILY (3 units or more) 401 $358.00 $143.50
Is'Service/Feeder Additional QFeede(ry{s� 1V14 ,•z7[
�Ui�,1000'amp, X;$565:130 x$236.50
201 400 amp.., IK 16?i,00 . •.; '' x "$ 80.50 1 4.' 3 e ; Nl f.t , $61fs , 5a"i " ' $328 5
x ;`-'$153.50 O1r 0(3 volts surcharge . ,";, • x$103.50
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
1 t Service/Feeder Additional Feeders
... 1st Service/Feeder
%NW 3 x$13244 x$103.50
2#31 h00=amp _.._ x 5164.00 203 x600 autg x$3(37 00 x$121 00
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:feeder-.onlYV 80.50 Plan Review required only for:
A � 132:5- • 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
O Voice/Data Cabling 0, .<5E3 ml? $5' .Xf 71, Q.y „, ., a ,x,$•,32<00
O Other 61- 100'amp ••f"':'"x $ 80.50 XC,$ 39.00
=
Area to be served by system:
l,t 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50
201-400 amp„ x $121.00 =$ 60.50
#of Thermostats
First$60"50;each additional$18.50
Ehret"60b"amp x $1844.50 • = x.$ 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 • • •.00 •utomation 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'"Avenue South♦Federal Way 1 WA♦98003-6325 1 253-835-2607♦fax:253-835-2609 1 www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 2 of 2 k:\Handouts\Electrical Permit Application
•
•Electrical
City of FederalWay Permit #:
Community&Econ.n.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 ;
Ph:(253)835-2607 Fax:(253)835-2609 N
I'� Inspection Request Line: (253)835-3050
Project Name: DINH-TRA
Project Address: 28116 20TH AVE S Parcel Number: 422231 0260
Project Description: Remove/replace 0-200 amp service panel
•
Owner Applicant Contractor
HUNG DUC DINH HUNG DUC DINH OWNER IS CONTRACTOR
NGOC THU TRAN 28116 20TH AVE S
28116 20TH AVE S FEDERAL WAY WA
FEDERAL WAY WA 98003
98003
Additional Permit Information
Is Use Educational or Institutional? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Saturday, March 9, 2013
Permit Issued on Monday, September 10, 2012
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: Date: g(10/12_
1‘- -1D
tofIlilt
• THIS CARD IS TO MAIN ON-SITE .
CITY OF ' - Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-104157-00-EL Address: 28116 20TH AVE S
Project: HUNG DUC DINH FEDERAL WAY, WA 98003-3229
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.
O UFER Ground(4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
.
0 Final-Electrical(4055)
Approved
41<t-C____ Date 10- / /--
O Rough ElectricalEl Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date