07-104445City ity of Development
nt S Electrical Permit #: 07 -104445 -00 -EL t
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: WASHINGTON STATE LOTTERY OFFICE : 3
Project Address: 33701 9TH AVE S Parcel Number: 926480 0180
Project Description: Installation of wiring for a tenant improvement.
Owner
Applicant
Contractor
SIMON & JOHNSON
D F ELECTRIC INC
D F ELECTRIC INC
HERB SIMON & THEODORE JOHNSON
PO BOX 7205 ST
DFELEI*OIOD9 3/31/09
1019 PACIFIC AVE S SUITE 1119
TACOMA WA 98417
PO BOX 7205 ST
TACOMA WA 98402
CJCOT� TACOMA WA 98417
Addiddlitil Par it, J'
City of Federal Way
Community Develq�ment Services
P.O 6ox 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical Permit #: 07 -104445 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: WASHINGTON STATE LOTTERY OFFICE
Project Address: 9TH AVE S parcel Number: 926480 0190
337x.1
Project Description: Installation of wiring for a tenant improvement.
Owner
Applicant
Contractor
SIMON & JOHNSON
D F ELECTRIC INC
D F ELECTRIC INC
HERB SIMON & THEODORE JOHNSON
PO BOX 7205 ST
DFELEI*OIOD9 3/31/09
1019 PACIFIC AVE S SUITE 1119
TACOMA WA 98417
PO BOX 7205 ST
TACOMA WA 98402
TACOMA WA 98417
Additional Permit Information
Electrical Fixtures
1
.10 00 THIS CARD IS TO REMAIN ON-SITE , .
CITY CR Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -104445 -00 -EL
Owner: HERB SIMON & THEODORE JOHNSON
Address: 33>7o/ 9TH AVE 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
For inspector reference onl
O Rough Electrical ❑ FINAL - Electrical
Approved Approved
By DateBy Date //, `J'— 6
❑
❑
❑
Slab/Concrete Floor (4255)
Ditch cover (4030)
Pool Bonding (4195)
Approved to place concrete
Approved
Approved
By
Date
By
Date
By
Date
❑
Service (4235)
❑
Feeders/Sub-panels (4045)
❑
Temporary Power (4275)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑
Rough Electrical (4225)
❑
Ceiling Cover (4020)
❑
Final - Electrical (4055)
Approved
Approved
Approved
By
Date ' Q
By
Date//- - ` ' CS
By
Date S
❑
UFER Ground (4295)
Approved
By
Date
For inspector reference onl
O Rough Electrical ❑ FINAL - Electrical
Approved Approved
By DateBy Date //, `J'— 6
41k
4� Federal Way
Building Division
33325 Eighth Avenue South
• e Box 971
Federal Way 98063-9718
Phone 253-835-2607
Fax 253-835-2609
INSPECTION NOTICE
ADDRESS: 3-3 %6/ V /?X SUE s #;-E�-
/VEe7/Qic/ �/ 5'% ���� i �•q�
IF YOU HAVE ANY QUESTIONS CALLS/Y (253) 835- 2�?J
Call for reinspection before cover
WHEN CORRECTIONS HAVE BEEN MADE CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS.
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
MY OF
Building Division
` 33325 5+ghth Avenue South
P
ViZAL
Federal Way •
decalBox
Federal Way 98063-9718
Way
Phone 253-835-2607
Fax 253-835-2609
INSPECTION NOTICE
ADDRESS: -:�37a( #:677-/a`f4Jr-Uo-E�--
WA--- 24' 4�, - `746 f - �vdc7 -a t r
�'y/oPa/z7- t/1/i,V 4r S 17 `f7 41?e
��tSTENE 0 To T�
IN
IF YOU HAVE ANY QUESTIONS CALL
Call for reinspection before cover
✓."
(253) 835- Z-<- ,3<-1
WHEN CORRECTIONS HAVE BEEN MADE CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS.
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
CITY OF —
Federal Way RECENEDPERMIT
COMMUNITY DEVELOPMENT SERVICES SF MF CO MF® PL DE EN FP
33325 8TH AVENUE SOUTH • PO DOX 9718
2FEERAL WAY, WA 9809718
53-D835-2607- PAX 253 83b 2609 AUG 0 9 20A P P L I C AT I O N T°
unnw.cJtuofrederulumli om
DE L WAY
The following is r ci�r- an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS 3 ?iJ I1�� SUU 1 r7 SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # O - LOT SIZE (sj
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach aep—te page for lengthy lege! desalpHonf
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION?!rELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJEC DTCRIPTION (Provide detailed description of work included on this permit only)
1
PROJECT NAME (Name of Business or Owner Last Name)' L�0�� �T�► �-`eS
PEOPLE•- •
PROPERTY
NAME�1t+ Tf
�.�
PRIMARY PHONE
OWNER
r �t �—+�O��r vtZn
-4461
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
ADDRESS
FAX NUMBER
CITY, STATE, ZIP
E-MAIL ADDRESS
3S7-�
CONTRACTDIVS R GISTRATION N BER
EXPIRATION DATE
L AbDREkS
�H
CONTRACTOR
COPY of card regalrad
with each applicauon
APPLICANT
PROJECT
CONTACT
LENDER
COMPANY NAME
A LI T NAME
OFFICE PHONE
(2 �Z -3;W
MAILING ADDRESS
-zo
C TY, STATE, ZIP
CELL PHONE
Z & -;143
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
-"4 r,61
3S7-�
CONTRACTDIVS R GISTRATION N BER
EXPIRATION DATE
L AbDREkS
�H
COMPANY NAME
A5 "Dve
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent )i( Other
FAX NUMBER
N�E PRIMARY PHONE -MAI AD9RESS
�wh
cL�f�';
AME
Per RCW 19.27.095:
Lender information is required ifproject value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES ONO PRESSION SYSTEM PROPOSED/ REQUIRED? ❑YES ONO
WATER SERVICE PROVIDER ❑ LAKEHA ❑ HIGHLINE O TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION EXISTING
SQ. FT.
PROPOSED
S • . FT.
TOTAL
SO. FT.
BASEMENT
BUILDING SHELL ONLY?
o YES o NO .
FIRST
o YES
n NO
.SECOND
CHANGE OF .USE?
THIRD
o NO
NEW ADDRESS REQUIRED?
ADDITIONAL FLOORS (DESCRIBE)
UP/SEPA/SU?
o YES
DECK -(0 COVERED OR O UNCOVERED?)-
NCOVERED?)GARAGE
PLATTED LOT?
o YES o NO
GARAGE❑ CARPORT ❑
o YES
o NO
NUMBER OF FLOORS
suanso
FsoFosso
T rornL sr
roreL rA10rasso sr
Toni, sr
"NEW HOMES ONLY" NUMBER OF BEDROO ESTIMATED SELLING CE $
Indicate number of each type of fixture to be installed or relocated as part'of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $'
AIR HANDLING UNITS
BBQS.
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (w Tub/Shover Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
(A COPY OF BI OR
EVAPORATIVE COO
FANS
FIREPI,,ACE INSERTS
FURNACES
GAS LOG SETS
LAV.S is sb*.)
RAINWA R SYST
ESTIMATE MUST BE INCLUDED WITH APPLICATION)
RS AS PIPE OUTLETS WOODSTOVES
GAS WATER•HEATERS MISC (Describe)
HOODS (commerdeq .
RANGES
REFRIG. SYSTEMS
NALS MISC (Describe)
VAC M BREAKERS
WATE 1.0SETS (roueq
WASHING MACHINES
I certify under penalty of perjury that the i4ormation furnished by me is true and correct to the best -of-my knowledge, and further, that I
am authorised 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 o fj ears and employees, upon the accuracy of the ir4/'ormation supplied to the city as a part of
this application.
NAME/TITLE&�� I
r-- 1 DATE
igrnature
RELATIONSHIP TO PROJECT ❑ Owner
Agent f Contractor
o Architect ❑ Other
o NEW o ADDITION
o ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO .
BASIC PLAN?
o YES
n NO
ZONING DESIGNATION
CHANGE OF .USE?
o. YES
o NO
NEW ADDRESS REQUIRED?
o YES a NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT?
o YES o NO
IIEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100—April 2, 2007. Page 2 of MHandouts\Permit Application
ELECTRICAL PERMIT rINFORMATION
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIAL/INDUSTRUL SERVICE
•❑ Single Family. Square Feet
Service or 'Feeder Each Add'n
(Fust 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'separateiy) $74.00
❑ 601 - 800 amp 423.00 179.00
13 801 - 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
0 401. _ 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
❑ 0 to 200 amp $ 92.50
❑ over 1000 amp 471.00
❑ 201 - 600 amp 149.50
❑ over 600 amp 225.50
of circuits to be added/altered
(1-5 circuits - $94.50; Add'n circuits, $7.00/ea)
❑ # of circuits to be added/altered
COMMERCIAL/INDUSTRIAL PLAN REVIEW
11-4 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 $I20.50
TEMPORARY SERVICE
MOBILE.HOME/RV PARK
Residential/Multi-Family $65.00
El -# of service or feeders
(First service/feeder-$74.00; each add n -$48.00)
Commerciat4ndustrial Service or Feeder Ampacity
❑ 0 - 100 amps $ 74:00
101-200 amps 94.50
0 201 - 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 systems)
(includes additional circuit, if required)
❑ Fire Alarm System
❑ Yard Pole meter loops ................. $74.00
❑ Security Alarm System
Q Additional Plan Review $111.00/hour
❑ Voice Cabling
L7 Data Cabling
(for modified submittals)
automation
Fee on all Permits .. $5.00
la 2500 ft2-$65.00;
Each add'n.2500 ft2-•17.00) • Per WAC 296-46-910(5)(b)(i & ii)
Bulletin 17100- April 2, 2007 Page 3 of 4 k\HandoutsTermit Application