02-103303City of Federal Way
Conunun ty Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Pb: 253.661.4000 Fax: 253.661.4129
Project Name: MITCHELL
Project Address: 123 S 340TH UnitF
Electrical Permit #:02 - 103303 - 00 - EL
Project Description: ELE - Install low voltage intrusion alarm
Inspection request line: 253.835.3050
Parcel Number: 325945 0180
Owner
Applicant
Contractor
ANGELICA MITCHELL
BRINKS HOME SECURITY INC
BRINKS HOME SECURITY INC
123 S 340TH ST UNIT F
19115 WEST VALLEY HWY SUITE H-106
19115 WEST VALLEY HWY SUITE H-106
FEDERAL WAY WA 98003
KENT WA 98032
KENT WA 98032
(425) 251-9727
Electrical Fixtures
Low Voltage Burgler Alarm - Residen 850
PERMIT EXPIRES January 28, 2003, IF NO WORK IS STARTED.
Permit issued on August 1, 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: (J%G M12& C1� r�4'YC� Date: D
ortror G `
OUR
**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. 1\
SITE ADDRESS: / Gf ��;7L'ASSESSOR'S TAX/PARCEL
LEGAL DESCRIPTION OF SUBJECT
SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
[ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): -Tn+i'U�Ion 0- L ac�,
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME: DAYTIME PHONE:
M LING ADDRE S STR ET ADDRESS; CITY ST TE, ZIP):
NAME:
r n 5
DAYTIME PHONE:
(q as) a51 - q7a�
MAILING ADDRR-ESSS (STREET ADDRESS-,CVY, STATE, P):
EVENING PHONE:
Q�
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTk)1CTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE):
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE:
PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
TABLE B
NEW RESIDENTIAL SERVICES
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVIR
_ Single�Family
_ Service or feeder only .................. $50.00
_ # of Thermostats (First add'n-
(First 1300 ftp -$75.00; Each add'n 500 ft2-
_ Service and feeder ....................... $81.00
$11.50ea)
$24.00)
# of Low voltage fire or burglar alarms
Square Feet:
MOBILE HOME/RV PARK
First 2500 fe-$43.50; Each add'n 2500 fe-
_ Each outbuilding or garage .................. $31.00
(Inspected
_ # of service or feeders
$11. 6 50
with service)
(First service/feeder-$50.00; Add'n
Square Feet: C
_ Each outbuilding or garage .................. $50.00
service/*
Per WAC 296-46-910(5)(b)(i & ii)
(Inspected separately)
feeder -$32 each)
_ # of Signs (First sign -$37.50; add'n sign
$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_601-
201 - 600 ....................................189.00
_ 201 - 400 amp .......... 101.00 ................. 50.00
_ 0 to 100.................. $ 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
Service or Feeder
_ Over 1000 ................ 379.00....... 202.50
Residential/Multi-
- 0 to 200 amp .................................... $ 68.50
_ Over 600 volts surcharge ............... 63.50
Family/Commercial/Industrial
_ 201 - 600 amp .................................... 101.00
_ Mast or meter repair ...................... 68.50
-0- 100......................................$ 50.00
_ over 600 amp ..................................... 151.50
_ 101-200 ......................................63.50
_ Mast or meter repair ............................. 37.50
201-400 ......................................75.00
_ # of circuits
_
401-600 ....................................101.00
(1-4 circuits -$50.00; Add'n circuits $5 ea)
_
_ over 600 .....................................109.00
If a new or altered commercial service is 200 amps or greater, or a new or altered residential service is greater than 400 amps, a plan review is required. Fee is
35% of permit fee +$63.50. Add'I plan review for other submissions is $75.00/hr.
OMNI
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Estimated Permit Fee: (1
Total Column (D)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50 + ( X.35) _ (13)
DISCLAIMER/SIGNATURE RI r
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 applicati
I7
NAME/TITLE: A .IO 121-71-7d �%/l vGY��� DATE:
❑ PROPERTY 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.cityoffederalway.com