09-100522 411
City of Federal Way Electrical
Q
Community Development Services Permit #. 09-100522-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: HELLICKSON
Project Address: 31516 10TH AVE S Parcel Number: 858800 0395
Project Description: Replace 200-amp panel.
Owner Applicant Contractor
MICHAEL HELLICKSON CLINTON FISHER FISHER ELECTRICAL SERVICES
21018 SNAG ISLAND DR FISHER ELECTRICAL SERVICES FISHEES931JC(4/3/09)
LAKE TAPPS WA 98391-8702 32537 112TH PL SE 32537 112TH PL SE
AUBURN WA 98092 AUBURN WA 98092
Vitt!Electrical Fixtures k
Alt. Serv./Feeder: 0 to 200 amps(F 1
PERMIT EXPIRES Wednesday, February 10, 2010
Permit Issued on Tuesday, February 10, 2009
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: _ V Date: 2-407D
D �{
414444,,,, • THIS CARD IS TliEMAIN ON-SITE •
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100522-00-EL
Owner: MICHAEL HELLICKSON
Address: 31516 10TH AVE S
FEDERAL WAY, WA 98003-5308
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
- 0 Pool Bonding(4195) ❑ Temporary Power(4275) ❑ 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 Date By Date
O Final-Electrical(4055)
Approved
Date
For inspector reference only _
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
0 iik
Federal Way0 ^L t�- 6 ® g a
FEB 1 zU .PERMIT SF MF Co ME 'L DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8*"AVENUE SOUTH•FO BOX 9,18 �,� I 1C AT I O N
FEDERAL WAY, 98063-9718 d'F. Ft;: TD / /
253-835-2607•FAXX 253.8352609 V
wunv.cit rioffederahuau.com
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS aL5 / i?,% (r...) p s, p�,1,`, f L-)c , tv.4 %Zi 3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 5 $• Oy2.. 0 - 03_5 S LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) -
ett.d.sePwatePagehr[ergthy legaI deeoip6oa)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION )TELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
( ,,t ) /
y Y � �v:rr,X..v�.� C �'�=�� �4t/� i����•1{�i— (A-.---1-- i 14.54-r,1 ' i tti� ci (�i'�tJ !�"l.[7t41fI C is
PROJECT NAME(Name of Business or Owner Last Name) l 11,16Y.Sl'-vn AL, I .L
• PEOPLE INFORMATION
PROPERTY ,NAPRIMARY PHONE
OWNER AJC,.+—z� -I 1 i r.k-S C-v, '— l'�C"t(( ' 5t- , ►�,k,n( F5 (2a. ) 30 C.) - 1 G t'�.iC
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
- .4(.c A' .' / �C•t-J t r /
r a l I C-12<S �11ti'tc�� l`�s 4.--�` ( Z5•�3 ) 7-o - a-2 1C'
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
'325-3-7 117-6'7 P1 5E h:, 6,;.-NZ-I6/4- `i.'`r`z'4� (''c3 ) 7-tz, - z-7'1C1
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
( ) -
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
F. -S N-E S S c( g r, }G `-1 /3/ze6c 1 r:,.zw. c-f l,st,..
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
(— t:Le C- C-it( Se^4 J\rC.-t`7 C \ 4ti r`s (----4-- (Zs-3 ) 7 -Z71 0 _
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
325 37 I (Z P, 5►- ftct.,uChtGr- 4tfeet2_ (2, 3 ) )'IC —27 e)
RELATIONSHIP TO PROJECT _ FAX NUMBER
0 Architect 0 Tenant ❑Agent s' f-•Other Lr2 G 1--►"r C-4( K t-r„C---f-01 ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ( ) -
LENDER NAME Per RCW 19.27.095:
Lender infonieation is required ifproject 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 $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
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 0
NUMBER OF FLOORS EXISTING PROPOSED inter. TOTAL!COSMO SF TOTAL PROPOSED SF TOTAL SF
**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 fixtures 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(commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(lodes
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), 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 oft application.
- SIGNATURE: DATE v (0
Property Owner and/or Authorized Agent
y
,... .,_ a „zi- ,a '., rd kt"d ba1Nz.
❑NEW a ADDITION a ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
_ I
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application
• 11111
ELECTRICAL PERMIT INFORMATION
*NOTE: an automation fee of$6.00 will be charged for all permits.
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 ft2-$121.00;Each add'n 300 ft2-$39.00) ❑ 0 to 100 amp $131.50 $80.00
O 101-200 amp 163.00 103.00
❑ Detached outbuilding or garage(w/service) $51.00
0 201-400 amp 305.50 120.50
❑ Detached outbuilding or garage(inspected separately) $80.00 ❑ 401-600 amp 356.00 142.50
❑ Swimming pool(w/service) $80.00 ❑ 601-800 amp 460.50 195.00
U Swimming pool(inspected separately) $120.50 ❑ 801 - 1000 amp 562.50 235.50
U Hot tub/spa/sauna(w/service) $51.00 ❑ Over 1000 amp 613.00 327.00
❑ Hot tub/spa/sauna(inspected separately) $80.00
U Septic pumping system(w/service) $51.00 ❑ Over 600 volts surcharge $103.00
❑ Septic pumping system(inspected separately) $80.00 ❑ Mast or meter repair $111.00
ALTERED COMMERCIAL/INDUSTRIAL
NEW MULTI-FAMILY(three units or more)
Service Feeder (Does not include circuits.)
Service or Feeders
❑ Up to 200 amp $131.50 $39.00 ❑ 0 to 200 amp $131.50
0 201 -400 amp 163.00 80.00 0 201 -600 amp 305.50
0 401 -600 amp 223.00 111.00 0 601 - 1000 amp 460.50
❑ 601 -800 amp 285.50 152.50 U over 1000 amp 513.00
❑ Over 800 amp 408.50 305.50
❑ #of circuits to be added/altered
ALTERED SINGLE/MULTI FAMILY (1-5 circuits-$103.00;Add'n circuits,$8.00/ea)
Service or Feeder COMMERCIAL/INDUSTRIAL PLAN REVIEW
to 200 amp $100.50 $103.00 plus 35%of Permit Fee
❑ 201 -600 amp 163.00 ❑ Service- 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
U over 600 amp 245.50
❑ Additional plan review for
❑ #of circuits to be added/altered
modified submittals $115.00/per hour
(1-4 circuits-$80.00;Add'n circuits$8.00/ea)
❑ Mast or meter repair $60.50 TEMPORARY SERVICE
Service or Feeder Each Add'n
MANUFACTURED HOMES ❑ 0 to 60 amp $ 71.00 $32.00
U Service or feeder only $80.00 ❑ 61-100 amp 80.00 39.00
❑ Service and feeder $131.50 Cl 101-200 amp 103.50 51.00
❑ 201-400 amp 120.00 60.50
MOBILE HOME/RV PARK Cl 401-600 amp 163.50 80.00
❑ #of service or feeders ❑ Over 600 amp 183.00 92.00
(First service/feeder-$80.00;each add'n-$52.50)
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats
(First-$60.50;add'n-$18.50/ea) ❑ #of Signs
❑ Low Voltage (First sign-$60.50;add'n sign$28.50/ea)
Square Feet to be served by system(s) U Yard Pole/meter loops/pedestal $80.00
❑ Fire Alarm System ❑ Portable Generator(transfer equipment) $100.50
❑ Security Alarm System
U Ditch cover/inspection only $120.50
❑ Voice Cabling
❑ Data Cabling
0 1a 2500 ft2-$71.00; For fees not listed,contact the Permit Center at
Each add'n 2500 ft2-$18.50) 253-835-2607
Bulletin#100-January 1,2009 Page 3 of 4 k\Handouts\Permit Application