09-100414 ' f • • Electrical
CommuCnitityy of Federal Way
Developmentrvices
SePermit #: 09-100414-00-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: C H ROBINSON
Project Address: 33400 9TH AVE S SUITE 210 Parcel Number: 926501 0060
Project Description: ADD/ALTER up to (5)circuits for outlets,recepticles and switches in a Ti space.
Owner Applicant Contractor
GOLDEN STONE LLC KIRBY ELECTRIC INC KIRBY ELECTRIC INC
33400 9TH AVE S 4826"B"ST NW SUITE 101 KIRBYEI077BN(1/13/11)
FEDERAL WAY WA 98003 AUBURN WA 98001 4826"B"ST NW SUITE 101
AUBURN WA 98001
Service greater than 1000 Amps? No
• '10ki k tief4ttlf/ 4,3 it'1"10154P ' NEEN11 ,r'-tf..t 4;
Circuits-Commercial 5
PERMIT EXPIRES Tuesday, February 2, 2010
Permit Issued on Monday, February 2, 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 accor an with the laws, rules and regulations of the State of Washington
the City of Federal Way.
Owner or agent: �� Date: 4 7
FINALED <\°/
44/totte..—
THIS CARD IS TIDEMAIN ON-SITE
CITY OF CommunityDevelopment Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09-100414-00-EL
Owner: GOLDEN STONE LLC
Address: 33400 9TH AVE S SUITE 210
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.
0 UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O 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 A Approved Approved
By Date By Date Z .5 BDate 2 ./2 se 7
❑ Final-Electrical(4055)
Approved
B Date 2 '2-6 •07
•
•
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
or. 6- 0 EC E IV E r). _
Fete,.rat way • PERMIT
COMMUNITrDEVELOPMENTSERVICEC 0K •MF CO ME�L�PL DE EN FP
3332FEDERAENUE SOOT!-!•P3-97181BR 22000
A L I CATION ```�---
FEDERAL WAY,WA 98063-9718 _TD / /
253-835-2607•FAX 253-835-2609 : FEDERAL +
www.atgo/%deral att com
The following is require• 1ti, . ation-an incomplete ap•lication will not be acce•ted. Please •rint legibly(in ink)or type.
O PROPERTY INFORMATION
SITE ADDRESS 700 'y` / / i' S e � )1/ /l a/49 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# — _ _ — _ - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
IN 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 only)
add. rec.tte4-&c l4 swoktin es i A."ok rk-k-I�4-s
PROJECT NAME(Name of Business or Owner Last Name) L /1 lY ,- IT y64S 6.1i 73
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER ( )
MAILING ADDRESS CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
K( i'h ek-c h-,`c_ k)C'c7_SC4c,c%e/64,4/ U-43 ) 3 5-9 -.2oc
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
411 1? 5: 7': rpt,) SLY:M!7/ Le/".64, -► ,4 '7'e1 (2c3 ) 405- -6/4-5 _
CITY F FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
19- r10_-1 _Q 1 .Z g l- B L / z / 31 idci ( )
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
K I 4 5 Y rlC .i40Iv 11 /3 / i/
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
kgq C 42 iL PN0. sc,,,,t,t Af(8. L 3 )8'�cy -2,000ILING ADDRESS CITY,STATE,ZIP CELL PHONE
t/gl& 13 sr I/n/ 5444e/0, 4 hur,i INA- 9o( (2-SI )qo-r-0 17 3
RELATIONSHIP TO PROJECT n "" FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe){'/Die / •"41141 ) i', -2,30
CONTACT NAME PRIMARY PHONE/ / E-MAIL ADDRESS
1 l �u 6�s1�Imo, (2 3) tfos G 2-1 o
c••,•4. <v-�.:.;- s•• e.^ r. NAME
LENDER er CW r 0 i••Len•er«information is
f provaiuetee"ds$5,000
MAILING ADDRESS CITY,STATE,ZIP
. . , .■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
. . PROJECT FLOOR AREAS
•
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT.
TOTAL
BASEMENT
FIRST —
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
TOTAL EXISTING 10XI
TOTAL PROPOSED TAL LSTING AND PROPOSED
HOW MANY FLOORS?
"NEW HOMES ONLY NUMBER OF BEDROOMS
ESTIMATED SELLING PRICE $
FIRTURES' ..> -
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 $
GAS LOGS REFRIG.SYSTEMS
MR HANDLING UNITS EVAPORATIVE COOLERS WOODSTOVES
BBQS FANS HOODS(commardal
BOILERS FIREPLACE INSERTS
RANGESMISC(Describe)
COMPRESSORS
FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
r1
PLUMBING WATER CLOSETS (-roue( MISC(Describe!
BATHTUBS(or Tub/Shoe.<rComb.) SHOWERS
DISHWASHERS SINKS DRINKING FOUNTAINS
SUMPS RAINWATER SYST
GAS PIPE OUTLETS HOSE BIBBS
WASHING MACHINES URINALS
LAVS(eauvoom su> )
VACUUM BREAKERS ELECTRIC WATER HEATERS
_ , '_ =;:DISCLAIMER/SIGNATQREBLOCK ..
lc notoledge, and
I certify d byr penalty of of perjury
the above premises tottperformon furnished
the work for which the permit application syrmade. I further agree ee to hold
h authorized City
the owner
harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the Inv-estigation and defense of
such claim), which may be made by any person, including the undersigned, and filed against the City of Federal Way,b ut only where such claim
arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information s+.ippti ed to the city as a part of
this application.
� i� / 41,- 4.---- DATE I
NAME/TITL ` -ice % (Title)
r (Signature)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent 0 Contractor ❑ Architect ,2 Other
FOR OFFICE USE ONLY
a NEW o ADDITION a ALTERATION 0 REPAIR D TENANT IMPROVEMENT
YES D NO
BUILDING SHELL ONLY? D YES o NO BASIC PLAN?
ZONING DESIGNATIONCHANGE OF USE? o YES D NO
NEW ADDRESS REQUIRED? D YES D NO UP/SEPA/SU? o YES o NO
PLATTED LOT? ❑YES D NO DEMO PERMIT REQUIRED? in YES ❑NO
k\Handcouts—Revised\Permit Application
Bulletin#100—March 30,2004 — Page 2 of 4
ELE 'RICA?'PERMIT INFORMATION
•
RESIDENTIAL COMMERCIAL
NEW COMMERCIAL/INDUSTRIAL SERVICE
NEW RESIDENTIAL SERVICE
Service or Feeder- ....Each Add'n
O Single Family Square Feet ❑ 0 to 100 amp $ 94.50 $ 58.00
(First 1300112-$87.00;Each add'n 500 ft2-$28.00) 0 101 -200 amp 117.50 74.00
O Detached outbuilding or garage 0 201-400 amp 220.50 87.00
(Inspected with service) $36.50
❑ Detached outbuilding or garage
0 401-600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601-800 amp 332.00 140.50
0 801 - 1000 amp 405.50 169.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 442.00 236.00
Service Feeder
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201 -400 amp 117.50 58.00 0 Over 600 volts surcharge $74.00❑ 401 -600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50 Service or Feeders
❑ 0 to 200 amp $ 94.50
ALTERED SINGLE MULTI FAMILY ❑ 201 -600 amp 220.50
Service or Feeder
0 601 - 1000 amp 332.00
O 0 to 200 amp $ 72.50
0 over 1000 amp 369.50
O 201 -600 amp 117.50 0 #of circuits to be added/altered
O over 600 amp 177.00 (1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
O # of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58.00;Add'n circuits$6.00/ea) $74.00 plus 35%of Permit Fee
0 Service over 200 amps
O Mast or meter repair $43.50 0 Medical/Educational/Institutional Facility
SINGLE MULTI FAMILY PLAN REVIEW
O Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES TEMPORARY SERVICE
O Service or feeder only $58.00
❑ Service and feeder $94.50 Commercial Residential
MOBILE HOME/RV PARK 0 0- 100 $58.00 $51.00
0 101 -200 74.00 51.00
O #of service or feeders n/.
(First service/feeder-$58.00;each add'n-$37.50) 0 201 -400 87.00
a
❑ 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Signs
O # of Thermostats (First s# of Signs ;add'n sign$20.50/ea)
(First $43.50;add'n-$13.50/ea) ❑ Swimming pool/hot tub $87.00
❑ Low Voltage (Includes additional circuit,if required)
Square AlarmaSystem be served by system(s) ❑ Yard Pole meter loops $58.00
❑ Fire $87.00/hour
❑ Security Alarm System ❑ Additional Plan Review
(for modified submittals)
O Voice Cabling
❑ Data Cabling
(Per❑ System(s) 1•,2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) •Per WAC 29646-910(5)(b)(&i,)
Page 3 of 4
k\handouts-Rcviscd\Pennil Application
Bulletin#100-March 30,2004