02-102166City or Federal Way
Community Development Services Electrical Permit #: 02 -102166 - 00 - EL
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: BELMOR MOBILE HOME PARK SPACE 18, SHOP
Project Address: 2101 S 324TH Parcel Number: 162104 9037
Project Description: ELE - Replace meter pedestal for mobile homes - SPACE 18, SHOP
Owner
Applicant
Contractor
BELMOR HOLDINGS LTD
SHEPPARD & NELSON ELECTRIC
SHEPPARD & NELSON ELECTRIC
1571 BELLEVUE AVE W SUITE 210
PO BOX 3630
PO BOX 3630
VANCOUVER CN
KENT WA 98032-0210
KENT WA 98032-0210
(206) 878-7333
Electrical Fixtures
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: See "!" Nl1Catlon Date: a,
et, 0 Z t2o&e7A/ Y'- 0G 111P®o4a lid. �
CONSTRUCTION PERMIT APPLICATION
�L- RECEIVE[
uV �y PPLICATION NUMBER: _ _ _T6 -Z 7 _ _EL
APPLICATION NUMBER: _ _ -
APPLICATION NUMBER:—
* Oie�fQj�IIonfp+N�gl�j�A information - Please print (in ink) or type**
Please note: Electrical, FR�Tr� AIV'ACWWSTystems and Engineering permits may require a separate application.
SITE ADDRESS:�' 3(� K ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
P( ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): o12
v- !/lf� IV
.,e b4n) et --t -e
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
6e i `GZ DAYTIME PHONE: -
MAILING (STREET ADDRESS; CITY, ATE, ZIP):
� � I
S '�'"7!/' c / e Doi
WON
NAME:
DAYTIME�) PHONE:
-73 33
MAULING ADO (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMB
Q-1
18iti --7
0Q
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)
CONTRACTORS REGISTRATION NUMBER:
ccvYa )a d
E L P N_ �� S G �- 9
EXPIRATION DATE:
U / 3
/ 3
NAME: (`DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: ONE: -
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT 11OTHER ( DESCRIBE): FAX
NUM _
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANTCONTRACTOR I
AbTAILEV UiILDIAG IRFORNATION
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: 11 LAKEHAVEN ❑ HIGHLINE 11 PRIVATE (SEPTIC)
L
I
PIF
.. 1
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT _
FANS)
HOOD(S)
WOODSTOVE(S)
FIRST
FIREPLACE INSERTS)
RANGE(S)
MIsc ( )
SECOND
FURNACE(S)
THIRD
GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
FOURTH
PLUMBING
OTHER FLOORS (DESCRIBE)
LAVATORY(S)
URINAL(S)
WATER HEATER(S)
DECK
RAIN WATER SYS.
VACUUM BREAKER(S)
❑ ELECTRIC ❑ GAS
GARAGE
HOW MANY FLOORS?
SHOWER(S)
WASH MACHINE OUTLET
TOTAL.
SINKS)
WATER CLOSET(S)
MISC. ( )
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S)
EVAPORATIVE COOLER(S)
GAS LOG(S)
REFRIG. SYSTEM(S)
BBQ(S)
FANS)
HOOD(S)
WOODSTOVE(S)
BOILERS)
FIREPLACE INSERTS)
RANGE(S)
MIsc ( )
COMPRESSOR(S)
FURNACE(S)
DUCT(S)
GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
PLUMBING
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)
SINKS)
WATER CLOSET(S)
MISC. ( )
INTERCEPTOR(S)
SUMP(S)
•
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 sypp(ied to the city as abart of this application.
NAME/TITLE: L���J1 /,/ �i-71i'-�fOL " DATE:�—
❑ PROPERTYOWNER 06PPLICANT ❑ CONTRACTOR
QOMMUNRY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTTI • PO BOX 9718 • FEDERAL WAY, WA 98063.9718 • 253.661-4000 • FAX: 253-661-4129
W W W.CKWffCdM1-aV-00rn
■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
Single Family
_ Service or feeder only .........................
$50.00
_ # of Thermostats (First -$37.50; add'n-$11.50ea)
(First 1300 ftZ-$75.00; Each add'n 500 ft' -$24.00)
_ Service and feeder ...............................
$81.00_
# of Low voltage fire or burglar alarms
Square Feet:
First 2500 ftZ-$43.50; Each add'n 2500 ft2-$11.50
Each outbuilding or garage ...........................
$31.00
MOBILE HOME/RV PARK
Square Feet:
(Inspected with service)
# of service or feeders
' Per WAC 296-46-910(5)(b)(i & ii)
_ Each outbuilding or garage ...........................
$50.00
(First service/feeder-$50.00; Add'n
service/
_ # of Signs (First sign -$37.50; add'n sign
(Inspected separately)
feeder -$32 each) C, ®
$17.50 each)
_ Swimming pool, hot tub, spa...............$75.00
Yard Pole meter loops .........................$50.00
NEW MULTI -FAMILY
COMMERCIAL/INDUSTRIAL
COMMERCIAL/INDUSTRIAL
(Includes three units or more)
Altered Service or Feeders
Service
Feeder
Amps Service or
Add'n
0 to 200 ..............................................$ 81.00
_ Up to 200 amp .............. $ 81.00................
$ 24.00
Feeder
_
_ 201-600 .............................................. 189.00
_ 201 - 400 amp ................ 101.00 ....................
50.00
_ 0 to 100.........................$ 81.00.......
$ 50.00
_ 601-1000 ............................................ 284.50
_ 401 - 600 amp ................ 138.00 ....................
68.50
_ 101-200 ........................ 101.00 ...........
63.50
_ over 1000.............................................317.00
_ 601 - 800 amp ................ 176.50 ....................
94.50
_ 201-400 ........................ 189.00...........
75.00
# of circuits
_ Over 800 amp ................. 252.50..................
189.00
_ 401-600 ........................ 220.50...........
88.50
_
(1-5 circuits -$63.50; Add'n circuits, $5 ea)
ALTERED SINGLE/MULTI FAMILY
_ 601-800 ........................ 284.50.........
120.50
(When inspected separately from the services.)
_ 801-1000 ...................... 348.00.........
145.50
TEMPORARY SERVICE
Service or Feeder
-Over 1000 ...................... 379.00.........
202.50
Residential/Multi-Family/Commercial/Industrial
_ 0 to 200 amp ...............................................
$ 68.50
_ Over 600 volts surcharge ......................
63.50
0-100 ................................................ $ 50.00
_ 201 - 600 amp ..............................................
101.00
_ Mast or meter repair..............................
68.50
_
_ 101-200 .................................. !...........63.50
over 600 amp ................................................
151.50
_ 201-400 ................................................ 75.00
Mast or meter repair .......................................
37.50
_ 401-600 .............................................. 101.00
_ # of circuits
over 600 ...............................................109.00
(14 circuits -$50.00; Add'n circuits $5 ea)
_
If a new or altered commercial service is 200 amps or greater, or a new or altered residential service is greater than 400 amps, a plan review is required. Fee is 35% of
permit fee +$63.50. Add'I plan review for other submissions is $75.00/hr.
Estimated Permit Fee:
Total Column (D)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50 + ( X .35) = (13)
Estimated Permit Fee: (14)
Bond Amount: (15)
Estimated Permit Fee: (16)
Bond Amount: (17)
Mitigation Fee: (18)
SBCC Surcharge: (19)
■ DEMOLITION
■ OTHER FEES
(20)
(21) (23)
Total (pages one&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100 - February 19, 2002