07-104428l Way
City if6velopaentS Electrical Permit #' 07 -104428 -00 -EL
Comn},mity,DA elopment 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: HIXSON
Project Address: 30415 28TH AVE SI L Parcel Number: 092104 9070
Project Description: A 200A service change
Owner
Applicant
Contractor
JOHN HIXSON
THEBAC ELECTRIC
THEBAC ELECTRIC
30415 28TH AVE S
2045 E MORTON ST
THEBAE*978KK (6/25/09)
FEDERAL WAY WA
TACOMA WA 98404
2045 E MORTON ST
98003-4801
TACOMA WA 98404
Additional PermitInformation
Eleolcit"fixtures
Alt. Serv./Feeder: 0 to 200 amps -1 1
THIS CARD IS TO REMAIN ON-SITE
6TYOF, Community Development Inspection Itec ord
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -104428 -00 -EL
Owner: JOHN HIXSON
Address: 30415 28TH AVE S
FEDERAL WAY, WA 98003-4801
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)
❑
Ditch cover (4030)
❑
Pool Bonding (4195)
Approved to place concrete
Approved
Approved
By
Date
By
Date
By
Date
❑
❑
❑
Temporary Power (4275)
Service (4235)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑
❑
❑
Rough Electrical (4225)
Ceiling Cover (4020)
Final - Electrical (4055)
Approved
Approved
Approved
By
Date
By
Date
By
Date 1/. 7,
❑ UFER Ground (4295)
Approved
By Date
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date / / . . Q
A o
CIry OF
Federal Way
1ryC�,PERMIT SF MF CO ME EL PL DE EN FP
COMMUNITY DEVELOPMENT SERVICEy.2
33325 8TM AVENUE SOUTH • 9 97 ` APPLICATION
FEDERAL WAY, 9806363 -97171 8
7
253-835-260FAX
753-835-2609 � O 9
ummcituolPederuhu
ua.mm AI
The following is requirej(;i1n incomplete application will not be accepted. Please print legibly (in ink) or type..
SITE ADDRESS SUITE/UNIT #
ASSESSOR'S TAX/PARCEL #
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(AttaM sq--te page fw lengthy 1egd d--ptionl
PROJECT• •
LOT SIZE (sj)
TYPE OF PERMIT ❑ BUILDING ❑PLUMBING ❑ MECHANICAL
❑ DEMOLITION/) ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of workincluded on this ermit onlyj
C'
.— PROJECT NAME (Name of Business or Owne Last Na _) _ U 19,7-' '1".
PEOPLE•- •
PROPERTY
OWNER
CONTRACTOR
COPY of card required
with each applieation
APPLICANT
NAME
APPLICANT NAME
ONE
(2 �3ARY 9
MAILIN AD`DRJESS
r y s
CITY, STATE IP
E-MAIL ADDRESS
FAX.NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS p—
CITY ATE, ZIP
T.
CELLPHONE
RELATIONSHIP TO PROJECT
FAX.NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
ONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
E-MAIL ADDRESS
COMPANY NAME
zi�
APPLICANT NAME
OFFICE PHONE
( ) -
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX.NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
PROJECT NAME PRIMARY PHONE Z E-MAIL ADDRESS
CONTACT
LENDER N
EXISTING USE
NAME
Per RCW 19.27.095:
Lender information is required Ifproject value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED/APPRAISED V.
SPRINKLERED BUILDING?YES ❑ NO
WATER SERVICE P ER ❑ LAKEHAVEN
SEWER SERVIC PROVIDER 11 LAKEHAVEN
USE
VALUE OF PR86POSED WORK
FIRE SUPPRESSION SYSTEM PROPOSIQ
❑ HIGHLINE ❑ TACOMA ❑ PRIV.
❑ HIGHLINE ❑ PRIVATE (SEPTIC)
❑ YES ❑ NO
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
Sq. . FT.
TOTAL
SQ. FT.
BASEMENT
HOODS (commerdel)
FURNACES
FIRST
REFRIG. SYSTEMS
CHANGE OF USE?
.SECOND
o NO
NEW ADDRESS REQUIRED?
o YES o NO
THIRD
o YES
o NO
PLATTED LOT?
ADDITIO ORS (DESCRIBE)
DEMO PERMIT REQUIRED?
o YES
o NO
DECK -(0 COVERED O UNCOVERED?)
GARAGE O CARPORT O
NUMBER OF FLOORS
s�asnso
raoroasn
TOT
ronuazrarsroar
rorupsoroszssr,
Toru.ar
"NEW HOMES ONLY" NUMBER OF BEDROO ESTIMATED SELLING PRICE $
Indicate number of each type of fixture tobik installed or relocated a1trCof this project: Do not include existing furfures to remain
Value of Mechanical Work $
i
DLING UNITSSSORSS for Tub/Shover combo)SHERSG FOUNTAINSIC WATER HEATERS
HOSE BIBBS
(A COPY OF BID OR ESTIMATE MUST LUDED WIY'H APPLICATION)
EVAPORATIVE COOLERS
GAS PIPE OUTL WOODSTOVES
FANS
GAS WATER HEATERS RISC (Describe)
FIREPLACE INSERTS
HOODS (commerdel)
FURNACES
RANGES
T_ GAS LOG SETS
REFRIG. SYSTEMS
LAV.S (Bathroom Sink,)
RAINWATER SYST
SHOWERS
SINKS
URINALS
VACUUM BREAKERS
WATER CLOSETS (Toney
WASHING MACHINES
MISC (Describe)
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 investigationartd 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 ir(jormation supplied to the city as a part of
this application.
NAME/TITLE DATE' 7
(Signature)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent
(Title)
❑ Architect o 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 o 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 k\HandoutsTermit Application
-- ELECTRICAL PERMIT INFORMATION". -
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIAL/INDUSTRUL SERVICE
•❑ Single Family: Square Feet
Service or Feeder Each Add'n
(Fii•at 1300 W-4 1.11.00; Each add'n 500 ft' - $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
0 401.: 600 amp 205.00 102.00
C3601 - 800 amp 262.00 140.50
ALTERED COMMERCIAL%INDUSTRIAL
❑ Over 800 amp 375.50 280.50
Service or Feeders
Cl 0 to 200 amp $120.50
LTERED 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; Addb 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/EducatiQnai/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)
CommerciaVIndustrial Service or Feeder Ampacity
❑ 0 - 100 amps $ 74:00
❑ 101 - 200 amps 94.50
Q 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
0 Additional Plan Review $111.00/hour
❑ Voice .Cabling
❑ Data CablingEl
(for modified submittals)
❑ Automation Fee on all Permits .. $5.00
1-t 2500 ft2-$65.00;
Each add'n.2500 ft2-•17.00) • Per WAC 29646-910(S)(b)(f 6 ii)
Bulletin #100 - April 2, 2007 Page 3 of 4 k\H and outs\Permit Application