12-104921 • • 11 ctrical
City of FederalWay Permit #: 12-104921 00-E L
Community&Econ.
Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 35-3050
Project Name: DUMINICA ,2 b010
Project Address: 142 S 295TH PL Parcel Number: 543721 0160
Project Description: Add/Alter up to 4 circuits to relocate range plug,3 other plugs,4 switches,and install 12 6"
can lights
Owner Applicant Contractor
MARIJANA DUMINICA A&I ELECTRICAL REPAIR INC A&I ELECTRICAL REPAIR INC
142 S 295TH PL 12534 SE 16TH ST IELECRI954BR(1/19/13)
FEDERAL WAY WA 98003-3659 BELLEVUE WA 98005 12534 SE 16TH ST
BELLEVUE WA 98005
Additional Permit Information
Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 4
PERMIT EXPIRES Saturday, April 27, 2013
Permit Issued on Monday, October 29, 2012
I hereby certify that the above information is correct and that the construction on the above described prope and
the occupancy and the use will be in accord- e with the laws, rules and regulations of the State of Washing on
• the City of Federal Way. /
Owner or agent: / ' Date: / 2 9.
• THIS CARD IS TO MAIN ON-SITE
Federal Way C INSPECTIONo InE eSt2o 8Record
PERMIT#: 12-104921-00-EL Address: 142 S 295TH PL
Project: MARIJANA DUMINICA FEDERAL WAY, WA 98003-3659
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 Date By Date By0 Date t ``ag_t�
Rough Electrical CI Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
•. (-0.,;z
` CITY OF —
Fed �g� ELECTRICAL
29 2012 PERMIT APPLICATION
art ®F FEDERAL-
WAY
*West electrical permits may be obtained on-line at www.cityo ederalway.com**
sx,7;� ra� s,.. ..a+.�, �� �:-�� ;4�f�•2v...,� - ��3 `�r+msX�
SITE ADDRESS: I/2 �,� TA � F .64-3 g9 L a'A /C/yP/ �C3
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# C NT/PROPD USE
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PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION F L!J C /�- 7/' a/1 ive/� �G I +- 3�l r ev14 et
Detailed description of work to N S Thy / (” I�
be included on this permit only -- //1 rf).et s kI/(/-/ice s
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NAME - PRIMARY PHONE
PROPERTY OWNER j 7R 4(f)/K- ( ) -
MAILING 5
ADD E-MAIL
it/
C7 _ `CTAT ZIP l FAX
NAME PRIMARY PHONE
4 th(z 54-gc 7• <r AL 72gA4/4 /Its( (7e6) 2-27 115'475--
MAILING ADDRESS E-MAIL
ELECTRICAL /ZS') /' 7-6e
CONTRACTOR CITY STATE ZIP FAX
E"i'GFtr v (#/t Q'e°°C'' ( (ft S�1 65..3- 0//
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
rzr-eqsy
NAME PRIMARY PHONE
APPLICANT ,4t-c1( a c&,26 f ( ) -
MAILING ADDRESS E-MAIL
i2 5-3 y SF_ jc TQC S -
CITY STATE ZIP FAX
Are&/:`1J-V1 u cyC7C ( w?‘7j-6c ' ot(( `
NAME PRIMARY PHONE
PROJECT CONTACT 4-C-cx a e o/ (', ( ).2 2 ' g Prs-
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 he . as a part o is pplication.
SIGNATURE: /la ,00000' DATE / — Z
C's _ /Z
PRINT NAME: / /``\ (.) ole C1 (A
33325 8'”Avenue South♦Federal Way♦WA•98003-6325•253-835-2607 1 fax 253-835-2609♦www.cityoffederalway.com
Bulletin#160—January 1,2011 Page I of 2 k:\Handouts\Electrical Permit Application
• RESIDENTIAL COMMERCIAL.
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 7,Service/Feeder Additional Feeders
(including attached garage):
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$121.00
NEW MULTIFAMILY (3 units or more) 401 600 amp x$358.00 x$143.50
1st Service/Feeder Additional Feeders -,, 800 amp x$463.00 x$196.00
.. =1 x-204.._ '.i; W_1- 182 0 x $ 39.00 801 1000 amp x$565.00 x$236.50
20 L 400 mg: =J -may- -x 464.00 x $ 80.50 Over,1000 amp x$616.00 x$328.50
f
Rf _:a tf. .,q _ x $111.50
601.-- ,4130 a € i ,7: _ x $153.50 Over 600 volts surcharge x$103.50
• "t,,la�� ":,,,.,iry: t div ^ v „c--,::$307.00
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
1 t Service/Feeder Additional Feeders
1st Service/Feeder ..
3�3' 1 4 ca r�" '. 5 : t.- z MV:440,X .14.142 ,.. ' 4 -id$` ; `� , a
.x, _x;$103.50
20,1 damp x $L64 00 201"-='600.:41,413,f2-`,.. x$12100
iT 607 �.e� i � �
� � rA( 46419Q
�
Over 1000p. ztt$61$,80 x'$32840
Added or Altered Circuits ..
1-4 circuits$80.50;each addi ' nal$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 $111.50
MANUFACTURED HOMES PLAN REVIEW FEES
Service ar feeder m1 ti, x -s$ 80.50 Plan Review required only for:
,'' } 4: ..
> � X132:50 • 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 1st Service/Feeder Additional Feeders
CI Security Alarm System
❑ Voice/Data Cabling ,. 0- 60 amp .01a $°:71:00' x $ 32.00
❑ Other 61- 100 amp `x $ 80.50 x $ 39.00
Area to be served by system:
1st 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50 101-;2130 amp X $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 8t"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