02-102524 City of Federal Way
Community Development Services Electrical Permit #:02 - 102524 - 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: MILLER
Project Address: 3819 SW 339TH Parcel Number: 921151 0900
Project Description: ELE-Replace existing panel with 200amp panel and electrical outlet(2)circuits.
Owner Applicant Contractor
Jerry W Miller ALL SEASONS INC-ELECTRICAL ALL SEASONS INC-ELECTRICAL
3819 SW 339TH ST ALL SEASONS INC ALL SEASONS INC
FEDERAL WAY WA
98023-2973 (253)879-9144
Electrical Fixtures
,,Description Quarititt Quantity _Description' Quantity
Alt.Serv./Feeder:0 to 200 amps-Res.11 1 I Circuits-Residential 2
PERMIT EXPIRES December 14,2002,IF NO WORK IS STARTED.
Permit issued on June 17,2002
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: pnw��xN�-> Date: Cig.—(r pZ
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CONSTRUCTION PERMIT APPLICATION
**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
SITE ADDRESS: ,-2-,e)1c1 5uJ 33944' Sr ASSESSOR'S TAX/PARCEL d:: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING ❑ PLUMBING ❑ MECHANICAL ❑DEMOLITION
(LECTRICAL ❑ ENGINEERING ❑FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
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PROJECT NAME: N\\L- ...
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
849
41
MAILING ADDRESS ADDRESS;Cfll� (/-53 ) - �'
STATE,ZIP),
`)S I°l Su.) 3i4 s-� rd A f , qC6
CONTRACTOR: NAME: DAYTIME PHONE:
e*k b /AIG (2s3 )S 4 9 -q144
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
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CITY
t94 6CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
(2s3) 8 49 - \k 49
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(ropy of card required) A L L- S , 1. Y C 3 Li 5 / 25 /
APPLICANT: NAME: DAYTIME PHONE:
Se Sa ti s /►.1c_ (253) E -9 -moi lief
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT ❑TENANT ❑OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑APPLICANT C/NTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 950.06
SPRINKLERED BUILDING? ❑YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE ❑ 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:
■ FIXTURES
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)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) 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.( )
INTERCEPTOR(S) 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 ch claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supplie ,e city as aAil„ rt of thi application. .
NAME/TITLE: 4111PPi '•I � DATE: C _ T C7z--
13 PROPERTY OWNER ❑APPLI? �NTRACTOR
. FOR:OFfiCE:USE ONL.Y:::
ci NEW.: :: :.:: c:ADDITiON::. ti ALTERATION CF:REPAIR .-:::.:[1 TENNEANTT IMPROVEMENT:• ...
CENSUS:•CODEi :: :!'.:::: -:: .. ..::!:::;:::..:::•• :LOT"SIZEm::::.::. .. . .....:::` :: ::.::<:: • .::.
.:EOt4INGDES GNA :3::'.::: ::-: `. .: ::::.. :'::..:...... ::.:: :BUILEDING•SH.L•ONLY? : o:YES:..::::o`.?I :•:..:.:. .::•. ::
iCOMP:PIAN:DESIGNOtte ly.':.':• •.... BASIC PLAN? :>::t3•:3iE5:::::::z :Nlf :°•:•::::.:: :.:••::
•SECTION:"::::'•:::. TOWNSHIP.:•:.:;::::::RANGE:::-• ::::-:: INEW:ADDRESS•REQUIRED'f:::-°•!::"`:: i:k:YES..:. ::i :NO::::::
• 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-S11.50ea)
(First 1300 ft=-575.00;Each add'n 500 ft2-$24.00) _Service and feeder $81.00 _#of Low voltage fire or burglar alarms
Square Feet: First 2500112-S43.50;Each add'n 2500112-$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(5XbXi&ii)
Each outbuilding or garage $50.00 (First service/feeder-$50.00;Add'n service/ _#of Signs(First sign-$37.50;add'n sign
-
( tea y) feeder-$32 each) $17.50 each
telSwimming 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-563.50;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
I 0 to 200 amp S 68.50 _Over 600 volts surcharge 63.50 _0-100 S 50.00
_201-600 amp 101.00 __Mast or meter repair 68.50 _101-200 63.50
151.50 201-400 75.00
_over 600 amp -
Mast or meter repair 37.50 _401-600 101.00
-L#of circuits _over 600 109.00
(1-4 circuits-550.00;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'!plan review for other submissions is$75.00/hr.
OIM y :»:':;:::NUMBED:VOMIS <::;:::::-:-::•:::z<:•::.:::;;:•;:;:•MA::{ I::::;:::>:-> :<:s>s;:;::;•:...
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
L
Mitigation Fee:(18) (20) (22)
SBCC Surcharge:(19) (21) (23) -
Tota I (Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)= (24)