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02-101868City of Federal Way Community Development Services 33530 1 s Way S Federal Way, WA 98003-6210 Ph: 253.661.4000 Fax: 253.661.4129 Electrical Permit #:02 - 101868 - 00 - EL Inspection request lid! Project Name: MOSS Project Address: 640 S 295TH Parcel ber: 100080 Project Description: ELE - Installing new LN security system Owner Applicant C or Kurt Moss PROTECTION ONE ALA ROTECTI NE ALARM 640 S 295TH PL 3900 S 220TH ST 0S ST FEDERAL WAY WA KENT WA 98032 A 98032 98003-3614 5 5-7140 ectrical Fix=es Desdription____%JQuanfityl ription " Quantity Description Quantity Low Voltage Burgler Alarm - RestIL 3500 • IT EX November 3, 0 O IS TED. Permit issued on 2 2 I hereby c that the above ' rmati is correct and that e n n on the above described property and the occupan d the use e in accordance with the r lations of the State of Washington and the City of Fe Owner or agent: Date: �r G CONSTRUCTION PERMIT APPLICATION . �• FOErz RECEIVED uV fay APPLICATION. NUMBER: APPLICATION NUMBER: MAY 0 7 2002 PPLICATiON NUMBER.- * IT4Yf information - Please print (in ink) or type C * UI- ^^Ir nnEPT. Please note: Electrical, 1W11�flElon Systems and Engineering permits may require a separate application. PROPERTY / INFORM. //ll SITE ADDRESS: (�' �CJ �:1 - / g J ASSESSOR'S TAX/PARCEL #: � � 5 1 L V -00 3 O LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): PROTECT INFORMATION TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): PROJECT NAME: PROPERTYOWNER: CONTRACTOR: J-oo 'air -Si5c, s V3 d F9 5 ■ PEOPLE INFORMATION N M DAYTIME PHONE: MAILIN r- `AG � Il�1a IS3 7jr) j� / ` /� /') s 9 -�'J6 (y l o YJ ADDRESS Cl �V P / STATE, ZIP/ �V l r� lu y , WsI • l �Cd v N ` k /� f� b DAYTIME PHO 9 LIbG ADrDrET ��F CITY, STATE, ZIP): if /� n ' ! Q EVENING ONE: - QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER :^ `, - I - y,(� F U BER: \EEXPIRAT19N - ©p kU-r4 BER: Q �2 DATE: / APPLICANT: NAME: DAYTIME PHONE: MAILING ADDRESS (STREET ADDRESS; QTY, STATE, ZIP): EVENING PHONE: RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: P(PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR . . . • 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) n1� �V *,*MEW RESIDENTIAL CONSTRUCTION ONLY* NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: ■ PROJECT FLOOR AREAS FLOOR EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS (DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC. COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS IJi<If FWII c BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( ) INTERCEPTORS) SUMP(S) DISCLAIMER/SIGNATURE BLOCK ' 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 application. NAME/TITLE:�r'1j kin I) — CUJ hlnzl Jlf'o iC6 DATE:V-6Leu ❑ PROPERTY OWNER ❑ APPLICANT X CONTRACTOR COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253-661-4000 - FAX: 2S3-661-4129 V , TABLE B NEW RESIDENT L SER CES MOBILE HOMES $48.00 MISC EQUIPMENT/TEMP SERVICES # of Thermostats (First -$36.00; add'n-$ I I.00ca) Single Family2 _ Service or feeder only ......................... _ _ (First 1300 ft' -$7 Each add'n 500 ft -$23.00) _ Service and feeder ............................... $78.00 _ # of Low voltage fire or burglar alarms i First 2500 ft'-$ O�:Each add'n 2500 ft2-$11.00 Square Feet: _ Each outbuil ' g or garage.... $30.00 MOBILE HOME/RV PARK # of service or feeders Square Feet: • Per W C 296-46-910(5)(b)(i & ii) (Inspectedth service) -Each outbfiildingor garage..... _........... $48.00 _ (First service/feeder-$48.00; Add'n service/ 1 Signs (First sign -$36.00; add'n sign _ # $of $ each) (Inspector separately) feeder -$31 each) Swimming pool, hot tub, spa .................72.00 Yard Pole meter loops ...........................48.00 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 ....................... ....................... S 78.00 Up to 200 amp .............. $ 78.00 ................ $ 23.00 Feeder _ 201-600 .............................................. 182.00 _ 201 - 400 amp .................. 97.00 .................... 48.00 _ 0 to 100....------ ..............$ 78.00.---... $ 48.00 _ 601-1000 ............................................ 274-00 _ - 600 amp ................ 133.00.................... 66.00 _ 101-200 .......................... 97.00 ........... 61.00 _over 1000 ............................................. 305.00 _401 601 - 800 amp ................ 170.00 .................... 91.00 _ 201-400 ........................ 182.00 ........... 72.00 _ # of circuits _ Over 800 amp ................. 243.00 .................. 182.00 _ 401-600 ........................ 212.00 ........... 85.00 (1-5 circuits -$61.00; Add'n circuits, $5 ea) ALTERED SINGLE/MULTI FAMILY _ 601-800 ........................ 274.00......... 116.00 (When inspected separately from the services.) _ 801-1000 ...................... 335.00......... 140.00 TEMPORARY SERVICE Service or Feeder -Over 1000 ...................... 365.00......... 195.00 Residential/Multi-Family/Commercial/Industiral 0 to 200 amp ................................................ $ 66.00 _ Over 600 volts surcharge ...................... 61.00 _ 0-100 .................................................... 48.00 _ 201 - 600 amp ................................................ 97.00 _ Mast or meter repair.............................. 66.00 _ 101-200 ................................................ 61.00 _ over 600 amp ................................................ 146.00 _ 201-400 ................................................ 72.00 _ Mast or meter repair ....................................... 36.00 _ 401-600 ..... ..........................................97.00 _ # of circuits _ over 600 ...............................................105.00 _ (1-4 circuits -$48.00; Add'n circuits $5 ea) It service is greater tuan cuu arup, a p.m..e...a....- -i . r ......._- --. - --- - --- Total Column (D) Estimated Permit Fee: Estimated Permit Fee from fine 12 Estimated Plan Review Fee: $56.25 + X .35 = (13) DEMOLITION Estimated Permit Fee: (14) Bond Amount: (15) N ENGINEERING Estimated Permit Fee: (16) Bond Amount: (17) Mitigation Fee: (18) ■ OTHER FEES (20) (22) SBCC Surcharge: (19) (21) (23) Total (pages one &Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24) � ' Gb Bulletin # 100 - August 20, 2001