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02-102974 City of Federal Way CUmmunity Dl:velopment Services Electrical Permit #:02 - 102974 - 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: INSTITUTE FOR FAMILY DEVELOPMENT Project Address: 34004 16TH S Suite200 Parcel Number: 390380 0160 Project Description: ELE-Low vlotage voice and data cabling Owner Applicant Contractor Rickney D Brown CUSTOM COMMUNICATIONS INC CUSTOM COMMUNICATIONS INC 34004 16TH AVE S#200 PO BOX 42067 PO BOX 42067 FEDERAL WAY WA TACOMA WA 98442 TACOMA WA 98442 98003-8951 (253)536-9183 Electrical Fixtures Description �Qutar� r --„vDescription 1Quanfh ”, Description Quantity Low Voltage-Other Commercial 4100 PERMIT EXPIRES January 11,2003,IF NO WORK IS STARTED. Permit issued on July 15,2002 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 Way. Owner or agent: `� e....._... ..„ /� -- Date: 7-- / s - d 1- 17—v `2- Wft( Gvf/ -tZ Ire pita V a3, — tV V 0) & (>. uAjf MVO, = CONSTRUCTION PERMIT APPLICATION An L' APPLICATION NUMBER: OL - L QLg.- IL - L APPLICATION NUMBER: - - APPLICATION NUMBER: - - **The following Is required Information-Please print(In Ink)or type** Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. ■ PROPERTY INFORMATION LoySITE ADDRESS: i... �O eisO©3 ASSESSOR'S TAX/PARCEL St: - LEGAL DESCRIPTION-6F SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): • PROJECT INFORMATION TYPE OF PROJECT(This application): 0 BUILDING ❑PLUMBING 0 MECHANICAL ❑DEMOLITION o ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM i OJ€ T PR CT DESCRIPTION(Provide detailed ription): " 11 .tom 1 4 _ _ O l CO _ 4-b _a , n CI e e PROJECT NAME: 31\s4---(-4-,ui-e_ 4 (VIII }-4 k ' • PEOPLE INFORMATION * c PROPERTY OWNER: n\s....rt--4.4a r brvi:iI -- „ - Aq y�� _ 1J-nILIIJ�,ApDR _( REET ADDRE : TAE 'ir ,1P rt ui y ` a+ M )6/ $ 0 0 3 CONTRACTOR: NAME: \ C—N i-C--, D( L 0 ;51.1_ T (.5 0 MAILING STREET DRE STATE,ZIP): -},;;;'i— 0 ENING PHONE: - CIN OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBEI`R: ' - - (copy�CcMORd re�R�E�RATION NUMBER: • L � Di 7o° EXPIRATION/DATE: I APPLICANT: NA I . Ozntin on 6 :� 9j� sDCAMPH - ` p 3 M,i ADD' SS R TN,STA� 41266 EVENING PHONE: O + . #. I \ i - RELA IONSHIPTO PROJECT: ( �� NUM: -: ❑ARCHITECT ❑TENANT `OTHImo' sw hi ER(DESCRIBE): r7ito t, / E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER . APPLICANT 0 CONTRACTOR �(,p �� • DETAILED BUILDING INFORMATION f ti.�( EXISTING USE: OFAT-52 EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: 49 r r / PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? o YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES ❑ NO WATER SERVICE PROVIDER: o LAKEHAVEN ❑HIGHLINE ❑TACOMA o PRIVATE(WELL) SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o PRIVATE(SEPTIC) • 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 ftr-575.00;Each add'n 500 f-$24.00) _Service and feeder $81.00 g4 of Low voltage fire or burglar alarms Square Feet: First 2500 ft-543.50;Each add'n 2500 ft=-511.50 -Each outbuilding or garage $31.00 MOBILE HOME/RV PARK Square Feet: C i Q c9 (Inspected with service) _ &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) $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 FeederOver 1000 379.00 202.50 Residential/Multi-Family/Commercial/Industrial _0 to 200 amp $ 68.50 r 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 (1-4 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+563.50.Add=1 plan review for other submissions is$75.00/hr. FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D) TOTAL COLUMN(D): Total Column(D) Estimated Permit Fee: (12) Estimated Permit Fee from line 12 Estimated Plan Review Fee: $63.50+( X 35)=(13) • DEMOLITION Estimated Permit Fee: (14) Bond Amount:(15) • ENGINEERING Estimated Permit Fee:(16) Bond Amount: (17) ■ OTHER FEES Mitigation Fee:(18) (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) Bulletin#100-February 19,2002 **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: ■ FIXTURES Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLERS) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC o GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC o GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) ■ DISCIAIMER/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 mads 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 informatkmsu d to the city as a of this application. 2/is7o NE/ REDATE: o PROPERTY OWNER APPLICANT o CONTRACTOR Xi FOR OFFICE USE ONLY: 0 NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION: BUILDING SHELL ONLY? 0 YES o NO COMP PLAN DESIGNATION BASIC PLAN? 0 YES o NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? o YES o NO PLATTED LOT? o YES o NO CHANGE OF USE? o YES o NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.citvoffederalway.corn