08-102292 CITY OP �`/ • ? i O L
Federal � � V ay *a/ PERMIT .a �
COMMUNITY DEVELOPMENT SERVICES SF MF CO ME iP'L DE EN FP
33325 Ilm
AVENUE SOUTH
WA •PO BOX 9718 0 " Z°138
253-835-2607•FAX 253-835-2609
APPLICATION TD m /
wunw.dtyoiTedemlway.com - FEDEP At.. \N A =
The foliowi t�r s rYquire��rmation-an incomplete application will not be accepted. Please print legibly(in ink)or type.
J • PROPERTY INFORMATION -
i
SITE ADDRESS SUITE/UNIT#_~ �.
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlq)
Necti Rhe r. - n 'a groom ear "c-f iA 9 pQs :s fa 1 kIQ ,
AP'gd /V .,h, on,.
PROJECT NAME(Name of Business or Owner Last Name) I'' PI ‘;)I C 1 r. (1.,
• PEOPLE INFORMATION
PROPERTY NAME 17/...„49,7 SC`! / PRIMARY PHONE _
OWNER r//v`6/z�-- ( )
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT N ME OFFICE PHONE
-- ( TRIC Ir(o' ( )-t�? .s -5 Y
A
MAILING ADDRESS CITY,STATE,ZIP PHONE
CELL
rdser, Ai?, Rehf' .:h1 9R c ( )r211 -qor
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
( ) -316/ t
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
.i I-,I pry)",
APPLICANT COMPANY NAME
� APPLICANT NAME OFFICE PHONE
MAILING ADDRESS (�R CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑ Tenant 0 Agent 0 Other ( )
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT Cr ( ) _
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $I A(3rd.G(')
SPRINKLERED BUILDING? 0 YES m NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES C# NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
Now
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT ❑
EXISTING PROPOSED TOTAL TOTAL EXISTING sr TOTAL PROPOSED SF TOTAL SP
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing factures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commerdal)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBSb/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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), wuhich`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 thiypplication.
SIGNATURE: DATE j r
Property Owi er and/or Authorized Agent
❑NEW ❑ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? o YES ❑NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? u YES o NO
Bulletin#1100—January 1,2008 Page 2 of 4 k\.Handouts\Permit Application
•
ELECTRICAL PERMIT INFORMATI•N .
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
U Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$115.50;Each add'n 500 ft2-$37.00) U 0 to 100 amp $125.50 $76.50
U Detached outbuilding or garage ❑ 101-200 amp 155.50 98.00
(Inspected with service) $48.50 ❑ 201-400 am
U Detached outbuilding or garage P 291.00 115.00
(Inspected separately) $76.50 U 401 -600 amp 339.50 136.00
U 601-800 amp 439.00 186.00
❑ 801 - 1000 amp 536.50 224.50
NEW MULTI-FAMILY(three units or more) U Over 1000 amp 584.50 311.50
Service Feeder
U Up to 200 amp $125.50 $37.00 U Over 600 volts surcharge $98.00
U 201 -400 amp 155.50 76.50 U Mast or meter repair $106.00
U 401 - 600 amp 212.50 106.00
U 601 - 800 amp 272.00 145.50 ALTERED COMMERCIAL/INDUSTRIAL
U Over 800 amp 389.50 291.00
Service or Feeders
❑ 0 to 200 amp $125.50
ALTERED SINGLE/MULTI FAMILY U 201 -600 amp 291.00
Service or Feeder U 601 - 1000 amp 439.00
U 0 to 200 amp $96.00 ❑ over 1000 amp 489.00
U 201 -600 amp 155.50
U #of circuits to be added/altered
U over 600 amp 234.00
(1-5 circuits-$98.00;Add'n circuits,$7.50/ea)
U #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
U Service- 1,000 amps or greater
U Mast or meter repair $57.50
U Medical/Educational/Institutional Facility
MANUFACTURED HOMES
L Service or feeder only $76.50
U Service and feeder $125.50
TEMPORARY SERVICE
(MOBILE HOME/RV PARKResidentia#of service or feedersl/Muiti-Family $67.50
irst service/feeder-$76.50;each add'n-$50.00) Commercia
1/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $76.50
U 101-200 amps 98.00
U 201-400 amps 115.00
U 401-600 amps 155.50
U over 600 amps 168.00
MISCELLANEOUS SERVICE/EQUIPMENT
U #of Thermostats U #of Signs
(First-$57.50;add'n-$17.50/ea)
Li Low Voltage (First si gn $57.50;add'n sign$27.00/ea)
Square Feet to be served bysystem(s) U Swimming pool/hot tub $115.00
s y ( ) (Includes additional circuit,if required)
❑ Fire Alarm System
U Yard Pole meter loops
❑ Security Alarm System $76.50
❑ Voice Cabling ❑ Additional Plan Review $115.00/hour
❑ Data Cabling (for modified submittals)
0 U Automation Fee on all Permits $5.50
1.t 2500 ft2-$67.50;
Each add'n 2500 ft2-$17.50) *Per WAC 296-46.910(5)(b)(i&ii)
Bulletin#100-January 1,2008 Page 3 of 4
k\Handouts\Permit Application
City of Federal Way
Community Development Services Electrical Permit: 08-102292-00-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: BELMOR MOBILE HOME PARK SPACE 264
Project Address: 2101 S 324TH ST SPACE 264 Par - 1 umbe 62104 ' `7
Project Description: Install electrical feeder from existing pedestal to new mobile ho„ .
Owner Applicant
•ntractor
NANCY EVANS PRONG ELECTRIC LLC PR• ELECTRI C
BELMOR MOBILE HOME PARK 1901 ABERDEEN AVE SE PRONes 938' 1/11/09)
2101 S 324TH ST RENTON WA 98055 1901 AB -- 'N AVE SE
FEDERAL WAY WA 98003 \ RENT WA8055 ,
to 6-3
Additional •ermit Infos 'on ..
Service greater than 1000 Amps? No
(5%
•''' \
111110P \
, lectrical .
Service or Feeder-Manu./M.H.P 1
P NI We. - day, November 5,2008
Perm ed on Friday,.May 9, 2008
I herebrtify th• e above inf., -tion is correct and that the construction on the above described Property and
the paney a le use Will b- , .accordance with the-laws, rules and regulations of the State of Washington
fie
and the City of Federal Way.
ne agent:
..11/II►1 � Date: .,..,..,1_
LiuL________- -''
F//VAI
- THIS CARD IS TWEMAIN ON-SITE
CITY OF ,A, •Community DevelopOrent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-102292-00-EL
Owner: NANCY EVANS
Address: 2101 S 324TH ST SPACE 264
FEDERAL WAY, WA 98003
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.
❑ Slab/Concrete Floor(4255) ElFinal-Electrical(4055)
Approved to place concrete Approved/-� //
By Date B Date�J '!�O
For inspector reference only —_ -_-._ — _
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
i