02-103392City on Federalway
Community
DevelopmentJorviies Electrical Permit #: 02 - 103392 - 00 - EL
Development
33530 Ist Way S
Federal Way, WA 98003-62 10
Ph: 253.661.4000 Fax: 253 661.4129 Inspection request line: 253.835.3050
Project Name: BJORK
Project Address: 28612 26TH S Parcel Number: 746690 0270
Project Description: ELE - Altering 200amp service/feeder
Owner
Applicant
Contractor
Jack G & Harriet J Bjork
Jack G & Harriet J Bjork
NONE
3002 43RD ST NE
3002 43RD ST NE
TACOMA WA
TACOMA WA
98422-2368
98422-2368
Electrical Fixtures
*_ Qe50t7 ?l , R I
Alt. Serv./Feeder: 0 to 200 amps
PERMIT EXPIRES February 3, 2003, IF NO WORK IS STARTED.
Permit issued on August 7, 2002
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: t Date:
CONSTRUCTION PERMIT T APPLICATION
VVL
APPLICATION NUMBER:j =0 3 3 2 -
APPLICATION NUMBER: -
APPLICATION NUMBER: - -
**The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORKATION
�>
SITE ADDRESS: � �(; ;��:- !`r �� �.7UC_ ��� �� [ ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING O -PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREyENTIPP SYSTEM
PROJECT DESCRIPTION (Provide detailed description): k'-, a ' u -z' _ yLK 2
i,' c � Iz � ✓> r /� rte-�=%�..,��� r
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
NAME:
DAYTIME "'ONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME:
'�;4-'7/:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
(
'1--(
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):
DAYTIME PHONE:
(.�� J� LCL/_✓: _�- ._ �
(EVENING PHONE:
FAX NUMBER:
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR I I
i�-.� ---- -- - -
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 11 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
❑ NO
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate nu/hbe'r of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) _
FAN(S) _
FIREPLACEINSERT(S) _
FURNACE(S)
GAS PIPE OUTLET(S)
QPLUMBING
LAVATORY(S)
RAIN WATER SYS.
"SHOWER(S)
SINK(S)
SUMP(S)
GAS LOG(S) REFRIG. SYSTEM(S)
HOOD(S) WOODSTOVE(S)
RANGE(S) MISC. ( )
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of
Federal Way, 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. �J
N
AME/TITLE: V ' `�/ / r 0�-Q ( DATE:
APROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129
www.ckwffederalway.com
. L,
TABLE B
NEW RESIDENTIAL SERVICES
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
_ Single Family
- Service or feeder only .........................
$50.00
- # of Thermostats (First -$37.50; add'n-$1 1.50ea)
(First 1300 ft' -$75.00; Each add'n 500 ft'
-$24.00)
_ Service and feeder ...............................
$81.00-
# of Low voltage fire or burglar alarms
Square Feet:
First 2500 11'443.50; Each add'n 2500 ft2-$11.50
Each outbuilding or garage ...........................
$31.00MOBILE
HOME/RV PARK
Square Feet:
(Inspected with service)
# of service or feeders
` Per WAC 296-46-910(5)(b)(i R ii)
_ Each outbuilding or garage ...........................
$50.00
_
(First service/feeder-$50.00; Add'n
service/
- # of Signs (First sign -$37.50; add'n sign
(Inspected separately)
feeder -$32 each)
$17.50 each)
- Swimming pool, hot tub, spa ...............$75.00
_ Yard Pole meter loops .........................$50.00
NEW MULTI -FAMILY
COMMERCIAL/INDUSTRIAL
COMMERCIAL/INDUSTRIAL
(Includes three units or more)
Altered Service or Feeders
Service
Feeder
Amps Service or
Add'n
- 0 to 200 ..............................................$ 81.00
- Up to 200 amp .............. $ 81.00................
$ 24.00
Feeder-
201 -600 .............................................. 189.00
_ 201 - 400 amp ................ 101.00 ....................
50.00
_ 0 to 100.........................5 81.00.......
$ 50.00
_ 601-1000 ............................................ 284.50
_ 401 - 600 amp ................ 138.00.....---............
68.50
- 101-200 ........................ 101.00...........
63.50
- over 1000.............................----............317.00
601 - 800 amp ................ 176.50....................
94.50
- 201-400 ........................ 189.00...........
75.00
- # of circuits
_ Over 800 amp ................. 252.50..................
189.00
_ 401-600 ........................ 220.50...........
88.50
(1-5 circuits -$63.50; Add'n circuits, $5 ea)
ALTERED SINGLE/MULTI FAMILY
- 601-800 ........................284.50.........
120.50
(When inspected separately from the services.)
_ 801-1000 ...................... 348.00.........
145.50
TEMPORARY SERVICE
ice or Feeder
erv20
0 to 200 amp ...............................................
$ 68.50
_ Over 1000 ...................... 379.00.........
- Over 600 volts surcharge ......................
202.50
63.50
Residential/Multi-Family/Commercial/Industrial
_ 0-100 ................................................ S 50.00
_ 1 - 600 amp ----• .........................................
101.00
Mast or meter repair ..............................
- P
68.50
- 101-200 ................................................63.50
_ over 600 amp ................................................
151.50
- 201-400 ................................................ 75.00
- Mast or meter repair .......................................
37.50
-
- 401-600 ...................... ....................... 101.00.
_ # of circuits
_ over 600 ...............................................109.00
(14 circuits -$50.00; Add'n circuits $5 ea)
It a new vi artcicu cvnunctcAat service is evv amps or greater, or a new or aacreo resiaenuai service is greater tnan wvv amps, a plan review is required. Pee is S:0"/u of
permit fee +$63.50. Add'I plan review for other submissions is $75.00/hr.
I FIXTUREDESCRIPTION (A) ( FIXTURE 'FEE -FROM -TABLE B (B) ..NUMBER OF. UNITS (C) TOTAL (D)
Estimated Permit Fee: (12)
Estimated Plan Review Fee: $63.50 +
Estimated Permit Fee: (14
Bond Amount: (15)
Estimated Permit Fee: (16)
Bond Amount: (17)
Total Column (D)
Permit Fee from line 12
X .35) = (13)
' Mitigation Fee:(18) (20) (22)
SBCC Surcharge: (19) - (21) (23)
TOial (Pa9es0ne&Two): - e(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100 - February 19, 2002