13-105603 r !
CITY OF ey ELECTRICAL
Federal Way PERMIT APPLICATION
(� RECEIVtL
PERMIT NUMBER - / O 0 0�/
- - - - - DEC 17 2013
SITE ADDRESS: t i 7 ... ::�i�r1ldr>+ N�IFA�kir WAY
d6 2-0 (- ���eizi C VA/ CDS
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ • 2 O - Cr Z °
PROJECT NAME
(Tenant or Homeowner Last Name) tC=' 3 7(~c
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) —
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME _
. J f i('
'-. -Pit) � i ) PRIMARY PHONE
MAILING ADDRESS f h.. ! F/ E-MAIL
ELECTRICAL d
CONTRACTOR CITY STATE ZIP
FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
-J / 42
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.
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: DATE
PRINT NAME:
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application
•
ELECTRICAL PERMIT FEES
-> Electrical permit fees are calculated based on the value of the electrical wo• to be
performed using the table below.
- A copy of a contractor's bid or estimate may be required for verificatio of the valuation
provided. The Building Official has the authority to assign a projec valuation when the
cost information provided is not consistent with industry stand. .s.
- An Automation Fee of$20.00 is also charged on each permit.
-* Plan review fees, when required, are in addition to permit fe-., based on 65% of the electrical
permit fee
Plan Review is required only for:
• New, or alteration to, service of 1,000 amps or gre, er
• Medical/Educational/Institutional Facility
• Commercial generator installation
• Inordinately complex projects, as determine. .y the Building Official
TOTAL PROJECT VALUATION INCREMENTAL FEE FACTOR
(1)$1.00 to$500.00 (1)$36.00
(2)$501.00 to$2,000.00 (2)$36.00 for the first•.500.00 plus$4.50 for each additional$100.00 or fraction thereof,to and
including $2,000...
(3)$2,001.00 to$25,000.00 (3)$103.50 for th 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)$598.00 f. the first$25,000.00 plus$15.50 for each additional$1,000.00 or fraction thereof,to
and incl g$50,000.00
(5)$50,001.00 to$100,000.00 (5)$985.-r for the first$50,000.00 plus$10.50 for each additional$1,000.00 or fraction thereof,to
and' eluding$100,000.00
(6)$100,001.00 to$500,000.00 (6)$ ,510.50 for the first$100,000.00 plus$8.50 for each additional$1,000.00 or fraction thereof,
and including$500,000.00
(7)$500,001.00 to$1,000,000.00 ( $4,910.50 for the fist$500,000.00 plus$7.00 for each additional$1,000.00 or fraction thereof,to
and including$1,000,000.00
(8)$1,000,001.00 and up (8)$8,410.50 for the fust$1,000,000.00 plus$5.50 for each additional$1,000.00 or fraction thereof.
Table A
**Ma Electrical Permits can be applied for using our on-line system.
Visit cityoffederalway.com for more information.**
PERMIT CENTER
33325 8th Avenue S
Federal Way, WA 98003-6325
253-835-2607 • FAX 253-835-2609
permitcentel{u)u,cityoffederalway.com
Bulletin#160—January 1,2013 Page 2 of 2 k:\Handouts\Electrical Permit Application
f t
• Electrical
City of Federal Way
Community&Econ.Dev.Services Permit #: 13-1®5603-00•-E
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p
Project Name: BIG 5 SPORTING GOODS
-221 Syi
Project Address: 1916 S 320TH ST Parcel Number: 092104 9208
Project Description: Adding(1)circuit to(2)duplex receptacles
Owner Applicant Contractor
SEATAC VILLAGE SHOPPING CENTER C J ELECTRICAL SUPPLY&SVCS LLC C J ELECTRICAL SUPPLY&SVCS LLC
PO BOX 2708 21817 88TH PL S CJELEES966M7(10/23/14)
PORTLAND OR 97208-2708 KENT WA 98031 21817 88TH PL S
KENT WA 98031
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Circuits-Commercial 1
PERMIT EXPIRES Sunday, June 15, 2014
Permit Issued on Tuesday, December 17, 2013
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use •n a co s ance with the laws, rules and regulations of the State of Washington
the City of Federal Way. / `7
Owner or agent: Date: 2-/ / �/
THIS CARD IS TO MAIN ON-SITE
`IT~0 Construction In ection Record
Federal INSPECTION REQUESTS: (253)835-3050
PERMIT#: 13-105603-00-EL Address: 1916 S 320TH ST
Project: SEATAC VILLAGE SHOPPING CEff FEDERAL WAY, WA 98003
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.
LIFER Ground (4295) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) 0 Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
O Final-Electrical(4055)
Approved
By e_____ -- Date ,S A.--2.3—k.
•
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date