08-105712 I - Electric,,il
City of Federal Way Q
Community Development Services Permit #: 08-105712-00-EL
P 0.Box 9718
Federal Way,WA 98063-9718 253 Request Inspection Re t Line:
Ph:(253)835-2607 Fax (253)835-2609 p q ( ) 83 5-3050
Project Name: CHRISTIAN FAMILY CARE
Project Address: 33507 9TH AVE S Bldg A Parcel Number: 926500 0020
Project Description: Installation of(2)t-stats
Owner Applicant Contractor
CHRISTIAN FAMILY CARE EVERGREEN REFRIGERATION LLC EVERGREEN REFRIGERATION LLC
8725 S TACOMA WAY (GENERAL) (ELECTRICAL)
LAKEWOOD WA 98499 727 S KENYON ST EVERGRL957R9(1/15/10)
SEATTLE WA 98108 727 S KENYON ST
SEATTLE WA 98108
Service greater than 1000 Amps? No
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Thermostat 2 y.
PERMIT EXPIRES Friday, December 4, 2009
Permit Issued on Thurssday, December 4, 2008
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
a d the City of Federal Way.
Owner or agent: iil------
Date: IL/' 111/-6
I38�5t979d
‘,.. THIS CARD IS TO REMAIN ON-SITE
CITY OF '. Community Development Inspection Record
Way ay IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-105712-00-EL
Owner: CHRISTIAN FAMILY CARE
Address: 33507 9TH AVE S Bldg A
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.
❑ UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
_ ❑ Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
•
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By 0 i.e`',3 Date 17. 1 1,,,,..o. By Date
.❑ Final-Electrical(4055)
Approved
By Date
i
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
CElik
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OM Or A
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Federal Way DEC 01 2008 PERMIT
COMMUNIYDEVELOPMENTSERVICES SF MF CO ME\ L .DE EN FP
33325 FEDERAL
NUE SOUTH• 8O 1 FED`D�_Tl T T A�ATI O N
FEDERAL WAY.FAX
98 7 8 E Li-�11C1 IIF-�(WAF/.l�ydl / /
253 835-2607•FAX 259 S
www.ctttoffedem4naii com CDS
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The ollowin, is re,aired i ormation-an tricorn,lete a,'Mention will not be acre,ted. Please • nt le, ,l n Ink)or :j. .
•1 PROPERTY INFORMATION
Ud r
SITE ADDRESS . (-) 1 3 3 6641'‘ 574l h/ I(9 4-- SUITE/UNIT# 4
ASSESSOR'S TAX/PARCEL# i 1 Z. _I a S - C) U (-) ° LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page far lengthy Iegal description)
® PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑, PLUMBING 0 MECHANICAL
0 DEMOLITION (ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work tncinrlad on this permit onto.)
(I (z ) 1 heyI (1 4 1
PROJECT NAME(Name of Business or Owner Last Name) Chi i i1-+`''` C.,,,,..,. 11 ('4' C_
® PEOPLE INFORMATION
PROPERTY NAME (, 11 PRIMARY PHONE
OWNER C h✓\(-j-iln fur•. 11 C' — ( ) -
MAILING ADDRESS ,, CITY,STATE,ZIP
5CIr 0 rft � SS: sit u$ J4" 1 It"(I r kA-
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE 'a
t V.V el(/lOA giiiiVt i�t„l-yA I,L 1C-e-‘)C. P' --I-GeV-- (-4a, ) 74'1 - /7411
_/
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
—t 1,1 S. I&ON Se CAI 14. ,1 , Ci/9-- 41/i'' ( )CITY
I IYf F FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
Ceig
/ CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) - EXPIRATION DATE
✓e$ a- e- r 1 9 1 / 1 c/
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
L
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT NAME rG11 1 / PRIMARY PHONE
( ) - E-MAIL ADDRESS
l �V
LENDER Pet'RCW 18,#?O9SS *fir it4 t}n 4, NAME
VIP ( vaiu* $&tom
MAIUNGADDRESS � 'CITY,STATE.ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
410
I
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. Sq.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDPTIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT 0
EXISTING PROPOSED TOTAL � (O� :y TOTAL,i. 04:050 r�f i �'. i�:t f '__
NUMBER OF FLOORS kN
**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 in.chirle existing fixtures to remain.
MECHANICAL coy—
Value
jValue of Mechanical Work $ 0 U °
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/shower Combo) SHOWERS WATER CLOSETS trolley MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Both.00m MOW VACUUM BREAKERS ELECTRIC WATER HEATERS.
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 m%' by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance of city,incl ng its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLEDATE
( 'ature) (Title)
RELATIONSHIP TO PROJE 0 Owner o Agent o Contractor o Architect o Other
o NEW ADDITION a ALTERATION a I EPAI t ENANT OVEMENT
BUILDING SHELL ONLY? 4YES 0NO C PT.AN' F p a YES a NOS
ZONING DESIGNATIO:*: i ,.;,C +TCGE OP4 J'SE a' a
k
NEW ADL RESS REQUIRED? '' a 1tES§ ,NO til'/SEPA/SU? ` YES 4.1wO'
PLATTEDLOT? a YES,r a NO. DEMO l! '.REQUI D? ,. a'YI a Nt ..x
Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application
`.. 4 :.
• I
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
C3Single Family Square Feet Service or Feeder Each Add'n
(First 1300 92-$107.50;Each add'n 500 ft2-$34.50) U 0 to 100 amp $117.00 $71.50
U Detached outbuilding or garage U 101-200 amp 145.00 91.50
(Inspected with service) $45.50 U 201-400 amp 272.00 107.50
❑ Detached outbuilding or garage U 401 600 amp 317.00 127.00
(Inspected separately) $71.50
U 601 800 amp 410.00 173.50
U 801 - 1000 amp 500.50 209.50
NEW MULTI-FAMILY(three units or more) U Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp $117.00 $34.50 ❑ Over 600 volts surcharge $91.50
❑ 201 -400 amp 145.00 71.50 U Mast or meter repair $99.00
❑ 401 600 amp 198.50 99.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ 601 -800 amp 254.00 136.00
D. Over 800 amp 364.00 272.00 Service or Feeders
U 0 to 200 amp $117.00
ALTERED SINGLE/MULTI FAMILY 0 201 -600 amp 272.00
U 601 - 1000 amp 410.00
Service or Feeder
U over 1000 amp 456.50
U 0 to 200 amp $89.50
U 201 -600 amp 145.00 U #of circuits to be added/altered
U over 600 amp 218.50 (1-5 circuits-$91.50;Add'n circuits,$7.00/ea)
U #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$71.50;Add'n circuits$7.00/ea) $91.50 plus 35%of Permit Fee
U Service- 1,000 amps or greater
U Mast or meter repair $53.50 U Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $71.50
• Service and feeder $117.00
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $63.00
U #of service or feeders
(First service/feeder-$71.50;each add'n-$46.50) Commercial/Industrial Service or Feeder Ampacity
U 0-100 amps $71.50
U 101-200 amps 91.50
U 201-400 amps 107.50
U 401-600 amps 145.00
U over 600 amps 157.00
MISCELLANEOUS SERVICE/EQUIPMENT
�7. #of Thermostats #of Signs
(First-$53.50 add'n-$16.50/ea) (First sign-$53.50;add'n sign$25.00/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $107.50
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $71.50
❑ Security Alarm System ❑ Additional Plan Review $107.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling ❑ Automation Fee on all Permits .. $5.00
0
(Per System(s) 1.t 2500 ft2-$63.00;
Each add'n 2500 ft2-16.50)•Per WAC 296-46-910(5)ib)li&u)
Bulletin#100-January 1,2006 Page 3 of 4 k\Handouts\Permit Application