12-100112 City of Federal Way
Community&Econ.Dev.Services Permit E1er ,ca.l
rt #: 12-100112-00-EL
33325 8th Ave S "
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
1.4 _
Project Name: DICKERSON
Project Address: 29641 11TH PL S Parcel Number: 515160 0346
Project Description: Altering&adding up to 4 circuits for kitchen remodel
Owner Applicant Contractor
GREGORY 0 DICKERSON J M S ELECTRIC J M S ELECTRIC
DEANNA DICKERSON 5033 S 289TH PL JMSELMS905ML(7/16/12)
29641 11TH PLS AUBURN WA 98001 5033 S 289TH PL
FEDERAL WAY WA 98003 AUBURN WA 98001
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•
Is Use Educational or Institutional? No
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may'' �' e iff� �� Q yi i3s � �i
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Circuits-Residential 4
PERMIT EXPIRES Tuesday, January 8, 2013
Permit Issued on Monday, January 9, 2012
I hereby certify that the above information is correct and that the construction on the above described propertyand
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` ippo Date: 1
(41 12P1.7--N
9/502.
THIS CARD IS TO REMAIN ON-SITE
•
CITY'OF S Construction 253 I ection Record
Federal Way INSPECTION REQ ( )UE TS: 835-3050
PERMIT #: 12-100112-00-EL Address: 29641 11TH PL S
Project: GREGORY 0 DICKERSON FEDERAL WAY, WA 98003-3727-
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 Rough Electrical(4225) ❑ Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved Approved
By QA59._— Date st._6--l (1 I ,By Date ByOt_ Date r-L ..a___;3 _l , ,
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
. ,, •
CITY OF
Federal 0-)eR-ELECTRICAL
PERMIT APPLICATION
**Most electrical permits may be obtained on-line at www.cityoffederalway.com**
SITE ADDRESS: „Z 1(0LH 11V:, Pt Je A rr• �1 c�',// LI k 1003
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# I CURRENT/PROPOSED USE
PROJECT NAME ;1, ]�1,
(Tenant or Homeowner Last Name) �J 1 G R_Ars 0 in
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PROJECT DESCRIPTION
(4)
lit vuA-(t
Detailed description of work to
be included on this permit only
NAME/ PRIMARY PHONE
PROPERTY OWNER l7 r(-, c O-u,4\ ►hv�c, OI LLr CD n ( Z M)Gly 1 - ?bb(O
MAILbL\1 11NSS 4'1 1 S C3 E-MAIL
2
CITY , STATE ZIP FAX
f- . * ( oO3 ( ) -
NAME
PHONE
�w1S Clujr' L (ZS3 )- 2.i..,-1.30q
MAILING ADDRESS E-MAIL
ELECTRICAL co33 S0 24$41 1''l.
CONTRACTORc V o{v
CONTRACTORSTATE% '1 f600 t ( FAX
F-
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
nEiLh1sCj05 L. 47 /26 /Zq Z
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( ) -
NAME 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.
Ifurther 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` V
city as a part of this application.
SIGNATURE: `\ DATE l `20 Z
PRINT NAME: . ..-.61\r‘h 5 r
33325 8`"Avenue South♦Federal Way•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
• 411 • .
RESIDENTIAL COMMERCIAL
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet
(including attached garage): 1 s`Service/Feeder Additional Feeders
0- 100 amp x$132.50 x$ 80.50
FEES: First 1300 ft2-$122.00; 101- 200 amp x$164.00 x$103.50
Each additional 500 ft2-$39.00 201- 400 amp x$307,00 x$12100
NEW MULTIFAMILY (3 units or more) 401- 600 amp x$358.00 x$143.50
1s`Service/Feeder Additional Feeders 601"- 800 amp x$463.00 x$196.00
0- ';200 amp x $132.50 x $ 39.00 801-1000 amp x$565.00 x$236.50
201 400 amp x $164.00 x $ 80.50 Over 1000 amp x$616.00 x$328,50
401-600 amp x $224.00 x ! $111.50
601 -800 amp x $287.00 _x $153.50 Over 600 volts surcharge x$103.50
Over 800 amp x $410.50 x $307.00
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
1st Service/Feeder 1st Service/Feeder Additional Feeders
0- 200 amp, x $101.00 0- 200 amp x$132.50 _ x$103.50
201 600 amp x $164,00 201- 600 amp x$307.00 x$121.00
Over 600 amp x $246.50 601-1000 amp x$463.00 x$196.00
C(3
(if)
Over 1000 amp x$515.50 x$328.50
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 only x $ 80.50 Plan Review required only for:
Service and feeder x $132.50 • 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 1s`Service/Feeder Additional Feeders
❑ Security Alarm System
❑ Voice/Data Cabling 0-"60 amp x $ 71.00 _ x $ 32.00
O other 61- 100 amp x $ 80.50 x $ 39.00
Area to be served by system:
15t 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50 101-200 amp ix $103.50 ..�x $ 51.00
201-400 amp 'x $121.00 x $ 60.50
#of Thermostats 401-600 amp x $164.00 x $ 80.50
First$60.50;each additional$18.50
Over 600 amp x $184.50 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 • A$6.00 Automation 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 8th Avenue South•Federal Way♦WA♦98003-6325♦253-835-2607♦fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 2 of 2 k:\Handouts\Electrical Permit Application