07-105075I it V
City of Federal Way Electrical Permit #' 07 -105075 -00 -EL
4 Community Development Services •
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: SAMARA HUBNER INC
Project Address: 29200 PACIFIC HWY S p �� Parcel Number: 042104 9223
Project Description: Alter 60A service from overhead to underground feed
Owner
Applicant
Contractor
SAMARA HUBNER INC
TOTEM ELECTRIC OF TACOMA, INC.
TOTEM ELECTRIC OF TACOMA, INC.
19655 1ST AVE S SUITE 208
PO BOX 1093
TOTEMET315BS (9/30/09)
NORMANDY PARK WA 98148
TACOMA WA 98401
PO BOX 1093
TACOMA WA 98401
Additional Permit -Information
Service greater than 1000 Amps?...........................No
Electrical Fixtures
Alt. Serv./Feeder up to 200 amps - 1
PERMIT EXPIRES Saturday, September 6, 2008
Permit Issued on Wednesday, September 12, 2007`
1 hereby certify that the above information is correct and that the construction on the above described property and
the occupancy andthe u e will b in acco ance with the laws, rules and regulations of the State of Washington
nd the al Way.
Owner or agent: Date: `1 / t_
THIS CARD IS TO REMAIN ON-SITE y
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -105075 -00 -EL
Owner: SAMARA HUBNER INC
Address: 29200 PACIFIC HWY S
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.
❑ Slab/Concrete Floor (4255)
Approved to place concrete
By Date
❑ Ditch cover (4030)
Approved
By Date Z'6
❑ Pool Bonding (4195)
Approved
By Date
❑
Temporary Power (4275)
❑
Service (4235)
❑
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑
Ceiling Cover (4020)
❑
Final - Electrical (4055)
❑
Rough Electrical (4225)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑ UFER Ground (4295)
Approved
By Date
For inskector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date 1. /,/,P
PROJECT DESCRIPTION (Provide detailed descrintton of work included on this nermit oniu)
PROJECT NAME (Name of Business or Owner Last Namel _ r�?1�L ✓ ��' l �--`� y^
s
PEOPLE INFORMATION
PROPERTY
OWNER
CONTRACTOR
/0
COPY of card required
with each appucatlou
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAM � ( ) ' , ^ Y �
1C1?�
MAILING ADDRESS � �� ✓ \ V`��
Iff
C , STATE. ZIP ��
ASI D
(a53) 383 - Soaa
MY OF
RECEIVED
CELL PHONE
Federal Way
P E
( ) _
ITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
COMMUIVlTS'DEVELOPMENTSERVICES
J � l
�T o 07 SF MF
COME LPL DE EN FP
33325 M AVENUE SOUTH • PO BOX 9718
53-83FEDERAL-2607- WA 98063-9718-260AP
253-835-2607• FAX 253-835-2609
P LI CATI D N
EXPIRATION DATEE-MAILADDRESS
www.cityo!(ederalwau.MM
�; gU�IPSjQ QEF'i'.
The following is required irtformation - an incomplete application will not be accepted. Please print legibly Cn ink) or type.
PROPERTY INFORMATION
q oo
SITE ADDRESS A a
pry GI A C_ A VpE S .
SUITE/UNIT #
ASSESSOR'S TAX/PARCEL #
_ qVC__ _!-fl- _ _ _
LOT SIZE (sp
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page,ior len9 ft legal descrtPCoN
PROJECT•' •
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION XELECTRICAL ❑ ENGINEERING
❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed descrintton of work included on this nermit oniu)
PROJECT NAME (Name of Business or Owner Last Namel _ r�?1�L ✓ ��' l �--`� y^
s
PEOPLE INFORMATION
PROPERTY
OWNER
CONTRACTOR
/0
COPY of card required
with each appucatlou
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAM � ( ) ' , ^ Y �
PRIMARY PHONE -
lE-MAIL
MAILING ADDRESS � �� ✓ \ V`��
Iff
C , STATE. ZIP ��
ASI D
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
TOTEM ELELTr-L'C- OF TAG<WA
14c,
(a53) 383 - Soaa
MAILING ADDRESS
CITY, STATE, ZIP
_r4
CELL PHONE
P.O. aox 1043
LO "ka WA ge4o 1
( ) _
ITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
)9-qq-co(P'l30-00-3L
+;2/31/0-7
( ) -
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATEE-MAILADDRESS
'roTEMS?3iSBS
q/30/O
COMPANY NAME
"TOTEM ELFc1-Q_1C_ OF iAwM
APPLICANT NAME
-Twee-
OFFICE PHONE
(aS3) 383 - 5c)a z
MAILING ADDRESS
CITY, STATE, ZIP
-
CELL PHONE
P 0 - �3 ax (0 q .3
T A c.o n. A uj a
-
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent jtOther
Go M"MA gra it-
(a S 3) a'7.a -Sal 14
NAME PRIMARY PHONE E-MAILADDRESS
R1G6IAtzia S'TZLONG, (253) 383 - 50 as
NAME
N /A
Per RCW 19.27.095:
Lender irtformation is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ MGHLINE 0 PRIVATE (SEPTIC)
PROJECT •••
AREA DESCRIPTION
AREAS
GAS PIPE OUTLETS WOODSTOVES
BBgS
EXISTING
SQ.FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
HOODS (Commemw)
COMPRESSORS
FURNACES
FIRST
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
SECOND
o YES
❑ NO
NEW ADDRESS REQUIRED? o YES ❑ NO
THIRD
o YES
o NO
PLATTED LOT? o YES o NO
ADDITIONAL FLOORS (DESCRIBE)
o YES
o NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
MB1NO
rooms®
'°'°'
MAL Nasrwosr
7orALrNOPOszDsr
rorusr
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type offixture to be installed or relocated as part of this project Do not include existing_jixtures to remain.
Value of Mechanical Work $ fA COPY OF BID OR ESTLMATE MUST BE 17VCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBgS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (Commemw)
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
BATTnIMS (or fub/Shower Combo)
LAVS (Bathroom Sinks)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS poIley
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
I certWy 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 lincluding 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. - In
NAME/TITLE•✓ 4-AQ� DATE
(Signature) (nue)
RELATIONSHIP TO PROJECT ❑ Owner o Agent Contractor ❑ Architect ❑ Other
FOR OFFICE IISE:QNLY
o NEW o ADDITION
o ALTERATION
o REPAIR ❑ TENANT DIPROVEMENT
BUILDING SHELL ONLY? o YES o NO
BASIC PLAN?
o YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
❑ NO
NEW ADDRESS REQUIRED? o YES ❑ NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT? o YES o NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 - April 2, 2007 Page 2 of 4 k\Handouts\Permit Application
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet
Service or Feeder Each Add'n
(first 1300 ft2- $111.00: Each add'n 500 ft2 - $35.50)
❑ 0 to 100 amp $120.50 $ 74.00
❑ Detached outbuilding or garage
❑ 101 - 200 amp 149.50 94.50
(Inspected with service) $47.00
❑ 201 - 400 amp 280.00 111.00
❑ Detached outbuilding or garage
❑ 401 - 600 amp 327.00 131.00
(Inspected separately) $74.00
❑ 601 - 800 amp 423.00 179.00
❑ 801 - 1000 amp 516.50 216.00
NEW MULTI -FAMILY (three units or more)
❑ Over 1000 amp 563.00 300.00
Service Feeder
❑ Up to 200 amp $120.50 $ 35.50
❑ Over 600 volts surcharge $94.50
❑ 201 - 400 amp 149.50 74.00
❑ Mast or meter repair $102.00
❑ 401 - 600 amp 205.00 102.00
❑ 601 - 800 amp 262.00 140.50
ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 375.50 280.50
Service or Feeders
0 to 200 amp $120.50
ALTERED SINGLE/MULTI FAMILY
❑ 201 - 600 amp 280.50
❑ 601 - 1000 amp 423.00
Service or Feeder
❑over 1000 amp 471.00
❑ 0 to 200 amp $ 92.50
❑ 201 - 600 amp 149.50
❑ # of circuits to be added/altered
❑ over 600 amp 225.50
(1-5 circuits - $94.50; Add'n circuits, $7.00/ea)
❑ # of circuits to be added/altered
COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits -$74.00; Add'n circuits $7.00/ea)
$94.50 plus 350/6 of Permit Fee
❑ Service - 1,000 amps or greater
❑ Mast or meter repair $55.00
❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $74.00
❑ Service and feeder $120.50
TEMPORARY SERVICE
MOBILE HOME/RV PARR
Residential/Muld-Family $65.00
❑ # of service or feeders
(First service/feeder-$74.00; each add'n -$48.00)
Commercial/industrial Service or Feeder Ampacity
❑ 0 - 100 amps $ 74.00
❑ 101 - 200 amps 94.50
❑ 201 - 400 amps 111.00
❑ 401 - 600 amps 149.50
❑ over 600 amps 162.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats
❑ # of Signs
(First -$55.00; add'n-$17.00/ea)
(First sign -$55.00; add'n sign $26.00/ea)
❑ Low voltage
❑ Swimming pool/hot tub ................ $111.00
Square Feet to be served by system(s)
(Includes additional circuit, if required)
❑ Fire Alarm System
❑ Yard Pole meter loops ..................... $74.00
❑ Security Alarm System
❑ Additional Plan Review $111.00/hour
❑ Voice Cabling
(for modified submittals)
❑ Data Cabling
Automation Fee on all Permits .. $5.00
Pt 2500 ft2-$65.00;
Each add'n 2500 ft2-17.00) -Per WAC 296-46-910(5)(b)(i & ii)
Bulletin #100 -April 2, 2007 Page 3 of 4 k\Handouts\Permit Application