09-101167 . I, -- r� .. • Electrical
City of Federal Way 'i3 +
Community Development Services rc ;t ,.- ,va Permit #: 09-101167-00—EL
P.O.Box 9718
Federal-260,WA 98063-9718e
Ph:(253)835-2607 Fax (253)835-2609 �� J 1� Inspection Rquest Line: (253) 835-3050
Project Name: GERIATRIC DENTAL GROUP
Project Address: 728 S 320TH ST Suite A Parcel Number: 082104 9050
Project Description: Add 30 amp subpanel for new x-ray equipment.
Owner Applicant Contractor
CAPITAL SQUARE ASSOCIATES TALL'S ELECTRIC INC TALL'S ELECTRIC INC
31919 1ST AVE S 35916 249TH AVE SE TALLSEI169NL 9/30/09
FEDERAL WAY WA 98003 ENUMCLAW WA 98022 35916 249TH AVE SE
ENUMCLAW WA 98022
Additional Permit Info rmationz ,
Is Use Educational or Institutional? No Service greater than 1000 Amps? No
:��7?• r a'','7'''tip : 1 li &
al Fixture �'
Alt. Serv./Feeder 0 to 200 amps(C 1
PERMIT EXPIRES Tuesday, March 30, 2010
Permit Issued on Monday, March 30, 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: _,C- / Date: 3---,... O vF
4- ;L:v‘.,a1C)
09
I
1 11/41.1jk,...
. • •
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THIS CARD IS T EMAIN ON-SITE' '
4attpti.„ —
CITY OF II/Community Develop ent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-101167-00-EL
Owner: CAPITAL SQUARE ASSOCIATES
Address: 728 S 320TH ST Suite 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) ❑ 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
0 Final-Electrical(4055)
Approved
Bye,\ J Date ti..._i_,t,et
For inspector reference only 1
0 Rough Electrical 0 FINAL-Electrical j
Approved Approved
By Date By Date
•
DATE INSPECTOR 1,- AREA AND TYPE OF Ii PECTION
.V.ECEI\/ D • • _
CITY of
Federal Way � 2, PERMIT - -
COMMUNITYDEVSWPMENTSIRVICES SF MF CO ME EL PL DE EN FP
33325 ETH AVENUE SOUTH•PO BOX 9718-
, 25318 607 FAX253-8352609
EDERALAPPLI CATI O N TD /
wtaw.tatlioffederalwau.rnm
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION ry
SITE ADDRESS 72- 8 S 3 Z v t� 7- SUITE/UNIT# r1
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(Sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING ❑ MECHANICAL
0 DEMOLITION 'ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included' on this permit only)
..t -�-(''' ,-- Gr��.,, / 49/' .a"c--r% ilr ,e/CA= >O—/-' -,' .45 pe/�i`e(/i
PROJECT NAME(Name of Business or Owner Last Name) Gp r/p. r/ l- i --t-A/ U'P-c,-., . l�A- ✓16- 37�
• PEOPLE INFORMATION /
PROPERTY NAME" QRIMARY PHONE
OWNER C qo j i--4S _•_ CrC5S a c , ( ) _
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
fi L. J i Oe L-Fa/c 7-.1fi. ��,,„ J 77c L (36 u ) '2 -3 �/
MAIL-LNG ADDRESSCITY,STATE,ZIP CELL PHONE
3S"?, 6 z y9 '',4 -eS r�,c%c. (.--e/S-9,-02z (2-6-3 ) 7°F - 0 9 5 7
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
(-3(,,Q ) gz- -3z4S
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
4 C. L-S L /6 9/iL- 9-5 U -0 r (Zc TA Pin/Li, =ow
APPLICANT COMPANYpNAME APPLICANT NAME OFFICE PHONE
S.0 --,A, ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ,CPI 1 4"-r("c ( ) -
LENDER NAME Per RCW 19.27.095:
Lender information is required if project 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 o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAE. •
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
susru ®G PROPOSTam. TOTAL TmOst TOTALPROFOsaosF TOTALsF
NUMBER OF FLOORS
**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 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(co...LA
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 Iroseq
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 of this application.
SIGNATURE:
Property Owner and/or Authorized Agent DATE
li
a NEW ❑ADDITION ❑ALTERATION ❑REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? ❑YES a NO
..........:.
ZONING DESIGNATION CHANGE OF USE? ❑YES a NO
_ .
NEW ADDRESS ...
� .
REQUIRED? a YES a NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? ❑YES ❑NO
AAAA,..r........,w........................ ..AAAA ............,..,.,..,.,. .... .
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Perniit Application
0 I
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
U Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2 $121.00;Each add'n 500 R2-$39.00) ❑ 0 to 100 amp $131.50 $80.00
U 101-200 amp 163.00 103.00
U Detached outbuilding or garage(w/service) $51.00
❑ Detached outbuildingor ❑ 201-400 amp 305.50 120.50
garage(inspected separately) $80.00
U Swimming pool(w/service) $80.00 U 401-600 amp 356.00 142.50
CISwimming pool(inspected separately) $120.50 CI 601-800 amp 460.50 195.00
❑ Hot tub/spa/sauna(1.v/service) El 801- 1000 amp 562.50 235.50
$51.00
0 Over 1000 amp613.00 327.00
❑ Hot tub/spa/sauna(inspected separately) $80.00
U Septic pumping system(w/service) $51.00
❑ Over 600 volts surcharge $103.00
U Septic pumping system(inspected separately) $80.00
❑ Mast or meter repair $111.00
NEW MULTI-FAMILY(three units or more) ALTERED COMMERCIAL/INDUSTRIAL
Service Feeder (Does not include circuits.)
CIUp to 200 amp $131.50 $39.00 Service or Feeders
❑ 201 -400 amp 163.00 80.00 43 to 200 amp $131.50
U 401-600 amp 223.00 111.00 CI 201 -600 amp 305.50
CI601 -800 amp 285.50 152.50 U 601 - 1000 amp 460.50
CI Over 800 am CI over 1000 amp 513.00
p 408.50 305.50
U #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
$103.00 plus 35%of Permit Fee
CI 0 to 200 amp $100.50
U Service 1,000 amps or greater
CI 201 -600 amp 163.00
U Medical/Educational/Institutional Facility
❑ 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
MANUFACTURED HOMES Service or Feeder Each Add'n
U 0 to 60 amp $ 71.00 $32.00
U Service or feeder only $80.00 ❑ 61-100 amp 80.00 39.00
U Service and feeder $131.50
0 101-200 amp 103.50 51.00
❑ 201-400 amp 120.00 60.50
MOBILE HOME/RV PARK U 401-600 amp 163.50 80.00
❑ #of service or feeders U 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) U #of Signs
U 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
U Portable Generator(transfer equipment) $100.50
o Security Alarm System
❑ Voice Cabling ❑ Ditch cover/inspection only $120.50
❑ Data Cabling
0
1.t 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\Pern it Application
This is an overview of possible fees associated with the issuance of permits and is not intended to be inclusive.
BUILDING, MECHANICAL 8s FIRE PREVENTION PERMIT FEES
—> Building,mechanical,and fire prevention system fees are calculated based on the following schedule.
—i Project valuation for new construction or additions is based on a set cost per square foot as determined by the
Building Official.
-4 Valuation for remodels,tenant improvements,alterations,etc.shall be provided by the applicant based on a
legitimate bid or cost estimate which reflects the fair market value of all elements of the project.
TOTAL PROJECT VALUATION INCREMENTAL FEE FACTOR
(1)$1.00 to$500.00 (1)$35.50
(2)$501.00 to$2,000.00 (2)$35.50 for the first$500.00 plus$4.50 for each additional$100.00 or fraction thereof,to and
including $2,000.00
(3)$2,001.00 to$25,000.00 (3)$103.00 for the first$2,000.00 plus$21.50 for each additional$1,000.00 or fraction thereof,to
and including$25,000.00
(4)$25,001.00 to$50,000.00 (4)$597.50 for the first$25,000.00 plus$15.00 for each additional$1.000.00 or fraction thereof,to
and including$50,000.00
(5)$50,001.00 to$100,000.00 (5)$972.50 for the first$50,000.00 plus$10.50 for each additional$1,000.00 or fraction thereof,to
and including$100,000.00
(6)$100,001.00 to$500,000.00 (6)$1,497.50 for the first$100,000.00 plus$8.50 for each additional$1.000d0 or fraction thereof,
to and including$500,000.00 V
(7)$500,001.00 to$1,000,000.00 (7)$4,897.50 for the fist$500,000.00 plus$7.50 for each addition. •1 000.00 or fraction thereof,to
and including$1,000,000.00
(8)$1,000,001.00 and up (8)$8,647.50 for the first$1,000,000.00 plus$6.00 for eac • ditional$1.000.00 or fraction thereof.
Table A
PLUMBING PERMIT FEES
• $31.00 Permit Fee plus$10.50 per fixture
PLAN REVIEW FEES
- Plan review fees are collected in addition to permit fees, sed on a percentage of the associated permit fee
• Building Permit 6.Vo of Building Permit Fees
• Mechanical Permit •5% of Mechanical Permit Fees
• Plumbing Permit 65% of Plumbing Permit Fees
• Fire Prevention Permit 65% of Fire Permit Fees
• Fire Review Fees 15% of Building Permit Fees (Commercial building permits only)
• Additional Building Division '-view $105.00/hour
OTHER FEES (Vary according t. project type and scope)
• WA State Building Code C.•ncil(SBCC) Surcharge $4.50/issued permit
• Public Works review fee $130.00 for new single family
$782.00 for new commercial
• Zoning review fees $54.50 (residential only)
• School District pact fees(new residential only) $4,218.00/single-family residence
(includes a. 'strative fee) $1.819.50/multi-family unit
• Automatio fee on all permits $6.00
you need assistance completing the permit application form, or have
questions concerning the application process, please contact:
Community Development Customer Service Counter at (253) 835-2607
Bulletin#100—January 1,2009 Page 4 of 4 k\Handouts\Permit Application