02-100557 r
t
City of Federal Way
Community Development Services Electrical Permit #:02 - 100557 - 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: ALBERTSON'S PHARMACY
Project Address: 31009 PACIFIC S Parcel Number: 0 04 9062
Project Description: ELE-Install low voltage burglar alarm for pharmacy onl
Owner App Contractor
ALBERTSONS FOOD CENTER#424 S&S SECURITY SYSTEMS INC S&S SECURITY SYSTEMS INC
POB 20 . . - RITY SYSTEMS INC S&S SECURITY SYSTEMS INC
BOISE,ID 118 23RD 118 23RD ST SE
83726 PUYALLUP WA ' 72 (253)845-8665
Electric- ixtures
Demist() � `I . . - •tion : ; -;E:' Qt'aanti A (,, 'j;s ,,;,x: *ascription 4'_ IQuantity1
Low Voltage Burglar Alarm Immc 1200
• 'ERMIT E \)02,IF NO WORK IS STARTED.
• ued on February 5,2002
I he by certify that the abo uiformatio ' c t d that the construction on the above described property and
the upancy and the u '11 be in accor c 'th e laws,rules and regulations of the State of Washington and
the C of Federal
Owner or agent: Ole , 44/92‘eataagiiiDate: ,2,-77,,
Z — Z!9 — az NO nvv-u.,..•4- v►', s,ti-C. _
III
•
«�►« CONSTRUCTION PERMIT APPLICATION 1
=INS_ APPLICATIONNUMB- E ' ::. • : - ��,. ,
uV RV.
APP11C!TION NUMBER ..:. ..
API?11CAfl N: l€MB ...... ..� ��::_: ............
::
**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: _3/00 9 1 7'/I'�')'`/ 5 ASSESSOR'S TAX/PARCEL#t: 6g 2 J a t - gQ& cz,
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL a ENGINEERING ❑ FIRE PREVENTION SYSTEM
LOW voce 6
PROJECT DESCRIPTION(Provide detailed description):
/els fDW VOL TttEE ,3,u,eh 5A.7011
//1/
PI/40r 4 C
m4C /
PROJECT NAME:
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
erCiailAS 1/9(, X55 15a9 -«€3
MAR IN ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHO`N�E�::�
MAILS .5' sEenf.dNG ADDRESS(STREET �.STATE,5 ✓/P .9/ /,5 i'� (053 )): EVENING PHONE: 5 - [A
BOA 9 i! 31
Y BUSINESS LICENSE NP1J V P W i1
CITY OF FEI FAX NUMBER:
919 - Ql¢ 355 - a0_ (zmi!5
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) 55
o o_
APPLICANT:• NAME: DAYTIME PHONE:
MAILING KESS(STREET AD)ESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
a ARCHITECT ❑TENANT a OTHER(DESCRIBE):
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER 0 APPLICANT '• CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES 0 NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ 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) FURNACES)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o 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 such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information upplied to the . ty as/'a part of is application. •
NAME/TITLE: /ur / 1'.4 f /Off ',, 50/10 g6".. DATE: /.11.,9Z.
o PROPERTY OWNER / PPL NT NTRACTOR
FOR OFFICE USE ONLY:
;❑ NEW ..._ :a ADDITION ..a•ALTERATION :- :: :❑REPAIR:i:.:: a':TENANT IMPROVEMENT:: ::. .
. :, LOT SIZE: .:: . ::.. :....:.:. . :. ....
CENSUS CODE:: ..• : ::-. -:. :: . : ::: .._
ZONING DESIGNATION: :::• :. ... • > ` ::- .BUILDINGSHELL:ONLY7:: :O.YES.......❑:NO:::..: -
COMP PLAN DESIGNATION . :. • '
:::: ::::.:. :::._: :BASK:PLAN?:':'::''-i3::yE5,,.._L#:NO:: :...: ::::....:::'.. . ....
SECTION TOWNSHIP .. RANGE:: .:;= '.;__NEW:ADDRESS;REQUIRED? :..:. ci€YES:::;::zINO'.: ::: .
PLATTED LOT'?:= -:❑"YES -: 2.NO .:. •:CHANGEOF USE?:::: .•:`'C1.Y£ :: CT.NO::..:":::.i..i ::..`.:: :
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
• ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $48.00 _#of Thermostats(First-$36.00;add'n-S 11.00ea)
(First 1300 ft2-$72.00;Each add'n 500 ft2-$23.00) _Service and feeder $78.00 L#of Low voltage fire or burglar alarms
Square Feet: First 2500 ft2-$42.00;Each add'n 2500 2 11.00
Each outbuilding or garage $30.00 MOBILE HOME/RV PARK Square Feet: 1 2.00 2•db
(Inspected with service) _#of service or feeders *Per WAC 296-46-910(5)(bXi&ii)
_Each outbuilding or garage $48.00 (First service/feeder-$48.00;Add'n service/ _#of Signs(First sign-$36.00;add'n sign
(Inspected separately) feeder-$31 each) $17.00 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 $ 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
_401-600 amp 133.00 66.00 _101-200 97.00 61.00 _over 1000 305.00
_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/CommerciaVIndustiral
_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)
If service is greater than 200 amp,a plan review is req'd.Fee is 35%of permit fee+$61.00.Add'l plan review for other submissions is$72.00/hr.
::: Fi[XTuRli~pEscRlPtroN 4A)... ._4IIXruRCFl:E:FRoVs t,>1Bt.E:BIB?><.< ::;:;..:.HrAMBER.:oF:E>al>yrsIDW:>;<:::: ::::::.>:::.::.::.:-.;:>:; AL:Tti)' :<.M:» -:>°'�
Total Column(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $56.25+ 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-August 20,2001