07-105983City of Federal Way Electrical Permit #•• 07 -105983 -00 -ELL
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2606 Inspection Request Line: (253) 835-3050
Project Name: EVERGREEN LODGE`
Project Address: 31002 14TH AVE S
Parcel Number: 082104 9088
Project Description: Providing a 125 amp shunt trip breaker and a 30 amp, 6 circuit panel in machine room for
elevator renovation.
Owner
Applicant
Contractor
HEALTH CARE REIT INC
CITY ELECTRIC INC OF TACOMA
CITY ELECTRIC INC OF TACOMA
PO BOX 1475
217 E 25TH
CITYEIT461BA 4/30/08
TOLEDO OH 43603-1475
TACOMA WA 98402
217 E 25TH
TACOMA WA 98402
Additional Permit Information
Service greater than 1000 Amps? .......................... No
Electrical Fixtures
Alt. Serv./Feeder up to 200 amps - 2
PERMIT EXPIRES Friday, October 24, 2008
Permit Issued on Tuesday, October 30, 2007
1 hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and t ` use will be in accordance with the laws, rules and regulations of the State of Washington
nd the City of Federal Way.
Owner or agent: - Date: /go/07
��NA�ED
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -105983 -00 -EL
Owner:
Address: 31002 14TH AVE S
FEDERAL WAY, WA 98003-4712
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.
❑ Service (4235) ❑ Feeders/Sub-panels (4045) ❑ Rough Electrical (4225)
Approved Approved Approved
By Date By Date By Date
❑ Ceiling Cover (4020) ❑ Final - Electrical (4055)
Approved Approved
By Date B A, c Date �f
For inspector reference only___ _ _____ _
O Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
INSPECTION NOTICE
ADDRESS:,SIX-0 14,E #: 0'-7-Is-Z�L-.I-, A),L-c- 4,0Q) - AO 'nui anolIA,�
-
IF YOU HAVE ANY QUESTIONS
Call for reinspection before cover
WHEN CORRECTIONS HAVE BEEN MADE CALL 253 835-3050 F
FOR DETAILS.
//- /6-- �
NSPE_CTION. SEE BAC
DATE IINSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
CITY OF33325
Building Division
Eighth Avenue South
�.
Box 718
Federal Way•P
Wa Federal ay 98063-9718
decal
Phone 253-835-2607
Fax 253-835-2609
INSPECTION NOTICE
ADDRESS:,SIX-0 14,E #: 0'-7-Is-Z�L-.I-, A),L-c- 4,0Q) - AO 'nui anolIA,�
-
IF YOU HAVE ANY QUESTIONS
Call for reinspection before cover
WHEN CORRECTIONS HAVE BEEN MADE CALL 253 835-3050 F
FOR DETAILS.
//- /6-- �
NSPE_CTION. SEE BAC
DATE IINSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
RECEIVED
F of '4T 3 0 2007 - -1
Federal w PERMIT
SF MF CO ME EL PL DE EN FP
COMMUNITY DEVE
3332'9-' ENUESO �. �� pip wa�ppLICATION 'U
FEDERAL WAY, WA 98 I N G /
253-835-2607• FAX 253-835-2609
ww w. cituo0ederalwau. mm
The following is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITEADDRESS 0 / rte/ /✓/rte S. SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # 0 � � � O � - / O O O LOT SIZE (sf)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Alt—f—parale page] (e,glhy Legal description)
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION XELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description ol' work included on this permit onlu)
ELE (if> -1 Z'�' /�C l�i4T10n� • /��' C Vi J�4 /d? S
4k4±FA ,-- 7430 nlf' G C_i�C[!/ % f' NAL /A/ /J/�4`fiNc /�CG/y1
PROJECT NAME (Name of Business or Owner Last
PEOPLE• •
PROPERTY
OWNER
CONTRACTOR
C'�/,
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
PRIMARY PHONE
MAILING ADDRESS
CITY, STATE, ZIP
E-MAIL ADDRESS
3/3/ ALL -077- Arc �S'S��
S'Es�iz wA 9?/.)/
-X255 i
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
cr'
c-� rVnii�f /z
0753) 6- ;t 7
-X255 i
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
wz i 7 C.S ' S; -
T,4cc.n wfl 9?'I'I /
(A53) 307
- 7173
CITY OFFEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
/9-9,�-IC5533-Cc -r_3�
%�/3i/c,7
025.3)6„217
-,,25%G
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
E-MAIL ADDRESS
�2 i�lEr% �y`4 X311
O i G''
ccmcPrr-,
e 1ec)�c:o
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSIUP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent: ❑ Other
( ) -
NAME PRIMARY PHONE E-MAIL ADDRESS
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, ST'AT'E, ZIP
PHONE
EXISTING ASSESSED/APPRAISED VALUE $_
SPRINKLERED BUILDING? ❑ YES ❑ NO
PROPOSED USE
VALUE OF PROPOSED WORK $
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
n
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
GAS WATER BEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
FIRST
COMPRESSORS
FURNACES
RANGES
SECOND
GAS LOG SE'T'S
REFRIG. SYSTEMS
❑ YES ❑ NO
THIRD
❑ YES
❑ NO
ADDITIONAL FLOORS (DESCRIBE)
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
FXISTDVO
PROPOSED
TOTAL
TOTAL EXISTING SF
TOTAL PIiOPOSFl19F
TOTAL SF
**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 riot include existing fixtures to remail.
MECHANICAL
Value of Mechanical Work $ (ACOP OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORA'T'IVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER BEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
IIOODS (connncretat)
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SE'T'S
REFRIG. SYSTEMS
BAI'BTUBS („r Tub/StmwerCmnbo) LAVS (Bathroom Sinks) URINALS MISC (Describe)
DISHWASHERS RAINWATER SYS'f VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS (7.110
ELECTRIC WATER HEATERS SINKS WASI IING MACI IINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty o perjury that 1 am thepropertyowner or authorized agent o thepropertyowner. I cert that to the best o m
fy Pe 9 .f Pe J ry 9 .% ifs ./ y
knowledge, the information submitted in support of this permit application is true and correct. I cert{fy 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 responsibilityfor compliance with local, state, orfederal laws regulating construction or environmental laws.
Ifurther 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 ofthis
'applica
SIGNATURE: t et - L'.�-^� .- Y��+ u� DATE a t 9 /G 7
Property Owner and/or Authorized Agent
❑ NEW ❑ ADDITION
BUILDING SHELL ONLY?
ZONING DESIGNATION
NEW ADDRESS REQUIRED?
PLATTED LOT?
Bulletin #100 —August 16, 2007
❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
❑ YES ❑ NO
BASIC PLAN?
❑ YES
❑ NO
CHANGE OF USE?
❑ YES
❑ NO
❑ YES ❑ NO
UP/SEPA/SU?
❑ YES
❑ NO
❑ YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
❑ NO
Page 2 of 4
k\Handouts\Permit Application
ELECTRICAL PERMIT INFORMATION
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 W - $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
Z x bd 0 to 200 amp $120.50
ALTERED SINGLE/MULTI FAMILY
❑ 201 - 600 amp 280.50
Ll 601 - 1000 amp 423.00
Service or Feeder
❑over 1000 amp 471.00
Ll 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 35% 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 PARK
Residential/Multi-Family $65.00
❑ # of service or feeders
(First service/feeder-$74.00; each add'n -$48.00)
Commercial/Industrial Service or Feeder Ampaeity
❑ 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
❑
..
141 2500 ft2-$65.00;
Each add'n 2500 ft2-17.00) ' Per NAC 296-46-910(5)(b)(i & W
Bulle(in #100 - August 16, 2007 Page 3 of 4 k\Handouts\Permit Application