02-101857corm of Federal me Electrical Permit #: 02 -101857 - 00 - EL
Y
y Conmfr �[y Development Services
33530 f4t Way S
Federal tMay, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: FARMER'S INSURANCE
Project Address: 500 S 336TH Parcel Number: 926500 0370
Project Description: ELE - Relocate 6 outlets and 3 switches for TI
Owner
Applicant
Contractor
Co -Op U.s.a. Inter III
GRIFFIN ELECTIC INC
GRIFFIN ELECTIC INC
3650 131ST AVE SE #205
1427 SW 306TH ST
1427 SW 306TH ST
BEL.LEVUE WA
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
98006-1334
(253)529-2923
Electrical Fixtures
'5N "3escrlption Quanti
Circuits - Commercial
PERMIT EXPIRES November 2, 2002, IF NO WORK IS STARTED.
Permit issued on May 6, 2002
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 W y.
Owner or agent: Date:
�--%� OZ JKouy4/- l/v ItppG'U�a
L��S 19h7
RECEIVED CONSTRUCTION PERMIT APPLICATION
uV Ay PPLICATION NUMBER: - CJ L_ 7 - _
MAY 0 6 2002 PPLICATION NUMBER: _ _ - _ _ _ _ - - - - -
PRLICATION NUMBER:
CITY OF FEDERAL.WAY.
--- --
**The followiruR J#Lq9qy4"rmation - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY•. •
SITE ADDRESS: _ Don � 3�Cn� ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
•• •• •.
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
X ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): %�00( lQ �iL! �p 1j
3
PROJECT NAME:
PEOPLE•• •
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME: DAYTIME PHONE:
Fou -"r5 ins .0 (-.63) -
MAILING ADDRESS (STREET ADDRESS; CITY. STATE ZIP): 2,01
ADO � Z� �•
NAME: -
C t I�-r n1
l Erp c
DAYTIME PHONE:
(z.53) S2q
- 2qZ.,?
MAILING ADDRESS (STREET ADDRESS; Cif Y, STATE, P):
a -3o(?t F
EVENING PHONE:
�)s
- zgzF.
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
o a
(2-�3) 52q
- 7-4o9
CONTRACTORS REGISTRATION NUMBER:
(coWofcardreWkeo
C -a e L..FE E, y 6 q
EXPIRATION DATE:
/ /5
/ Zoe
eF I N Lc -h'( (US 2,) ��' - 2Kz3
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, IIP): EVENING PHONE:
Fr ( ) - 247Z-5
RELATIONSHIP TO PROJECT: FAX NUMBER:
11ARCHITECT ❑ TENANT VOTHER ( DESCRIBE). ! I � Of (2-53).52-q - zy-,cf7
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE:
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER.
PROPOSED VALUATION FOR IMPROVEMENTS: $
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE 11 PRIVATE (SEPTIC)
**NEW 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'
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACEINSERT(S) RANGE(S) MISC.( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
1MCLAIMER/SIGNATURE RLC
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
MISC.( )
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 s plied to the city as a of this application.
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANT , CONTRACTOR
OOMMUNTTY DEWW MENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FMERAI. WAY, WA 98063-9718.253661-4000 • FAX: 253.661-4129
www.dtvoffedmkvay.com
TABLE B
NEW RESIDENTIAL SERVICES
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
-Single Family =
_ Service or feeder only .........................
$50.00
_ # of Thermostats (First -537.50; add'n-$11.50ea)
t 1300 ft ' -S75.00; Each add'n 500 ft=
-$24.00)
_ Service and feeder ...............................
$81.00
_ # of Low voltage fire or burglar alarms
Squ:S'4 cet:
First 250011=-543.50; 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 29646-910(5)(b)(i & ii)
_ Each outbuildingor garage ...........................
$50.00
(First service/feeder-$50.00; Add'n service/
_ # of Signs (First sign -537.50; add'n sign
(Inspected separately)
feeder -$32 each)
$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
ver 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 ............................................... S 50.00
......
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)
it a new or airerea commercial service is zvv amps or greater, or a new or aiterea resiaenuai service is greater man 4vu amps, a pian review is requirV. Fee 1s 351/o of
permit fee +$63.50. Add'l plan review for other submissions is $75.00/hr.
Estimated Permit Fee: (12)
Total Column (D)
Estimated Permit Fee from ane 12
Estimated Plan Review Fee: $63.50 + ( X.35) = (13)
I ■ DEMOLITION
Estimated Permit Fee: (14)
Bond Amount: (15)
Estimated Permit Fee: (16)
Bond Amount: (17)
Mbtfgatlon Fee: (18)
SBOC Surcharge: (19)
■ OTHER FEES
(20) (22)
(21) (23)
Total (Pagesonea,T.): Une(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100 - February 19, 2002