02-100551 City of re:leral Way ` t Electrical Permit #:02 - 100551 - 00 - EL
Community Development Services
3 +0 Way
Fe35deral W1stay,WSA 98003-6210
Ph:253.661.4000 Fax:251661.4129 Inspecti quest line. .835.3050
Project Name: NORTHWEST CHURCH
Project Address: 34800 21ST SW cel Num 0 0630
Project Description: ELE-Install 1200amp new service,panels,transformers,o ,&light' a church facility
Owner Applicant ontractor
NORTHWEST CHURCH BROADVIEW ELECTRIC CO BROAD IEW :C4tRIC CO
POB 4065 7821 FRE T AVE N FREMO E N
FEDERAL WAY,WA SEATTLE W 103-4736 E EWA 98103-4736
98063 0 789-6900
Xki
lectrical Fixt s
Descript a uantity Description Quantit Description Quantity
Service/' ,er: 0-100 a -Comm. 5 Service/Feeder: 101-200 amps-Comr{ 4 Service/Feeder:over1000 amps-Con- 1 1
- eeder:201-400 am. omr Jl II
• PERMIT EXPIRES September 15,2002,IF NO WORK IS STARTED.
Permit issued on March 19,2002
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. r
Owner or agent: e ¢C,c.�K- Date: •-3M12. Z
" Its 1, Ms /4 '1► ti 6.,�j
C v t ( �-5 — T. 04-1 k;iet-
11 � 40z oK —
�
4(2 / o Z woo-f- o/s w E P (b l c D 1c —
o -�- v— -t-e, e� v I (\ v tk c
r-i co�V
epzs
aS4- o_es,r �vY C•et, ,• ofG eoV Y ��'
— —VL 24SEMIT ( %1- Ft-. Ge, T - itev -c K,4-0p € L D killif Cc vee, Er
CQ , L�-uy- ; cam, r cku 1- /'ri - B N •
• (,- 1 - 1 D2 Ca e. LiA 1`92 7't Ff,-1( ?t
G- - 61, A ", ` "47`^.k e cit - z( .}c tv.se, vQv« o C—,-- /�-�
7- (_ c) 2' LOhreCI ON Xit yf N5 u./G Lo.vNe l 7r BQ 7`7.,e f G'oci/z-x..
VVk(r frw) 6119 . —
.7- 2- 02 C�i‘4 rti6 Gpv �� 't�P.
W ,--.. cvi ---- C\
o— n cO
� , � 7 -�
t—' ik; 7 L_ g. fit st'i.---ri - \?' € * Z
'-- -; - ( . 4:
4 rrN )• t 1
I. 4, . ., Cit kn Z
7 k- 1 Z7
-t —1 4) s
--. 7?, . . cr ' r V
li 1 aii ; iiN A . --. .;, ril itt L.4 .4. . . ;) 4 4
wi �` c '11 1 rho ZI �.
7° 1 �" +.:_z , z.„ f a
,. I. \rc" . tssx s, e %8
„ ,,, 'N
VI tt,
c' _
k ' ,► P . , ?,t( , \ .
c
1 ? N 4 V, .-"41* 1' i.— Z N
,_,-. r .g (..... t./ i
�,, i 1 0 ,.. • ( ' A
h n
a r x
-e 4 ^-' c\
'<' e 1 S'b ‘`.' i L — 1
„it, , 1.. Ct. 11 g i ql (6—'1
Ir--P* -sip iti (It \f' i
..1__-- *)t. , 4: r. N r11 ' h:0 • )W
•
BROADVIEW ELECTRIC CO., INC.
August 1, 2002
City of Federal Way
Attn:Electrical Department/Rd Parlova
P.O.Box 9718
Federal Way, WA 98063-9718
RE:Northwest Church-Permit#01-104139-00-EL
To Whom it May Concern,
The Uffer Ground and Ground Rods were installed on 10/29/01 in accordance with the NECA and
Washingtong State Administrative Code.
Sincerely,
William R.Koski,
President
411111rr
•4e Mik
. l ,r.;/
• pplicant's si nature
State of Washington )
County of King ) L
Signed and sworn to before me this ! Day of- 0 F,2002.
S it(G ell 1• grwt4!'Gc�
���ti /�. Not s Name(Print)
�oN r ti '
�_ `� ��' ', Notary's Signature
g f N NOTARY PUBLIC in and for the
v �p . St to of Washington,residing at
3 t o's _ I?�{ County. /o ,
�i S = My C mission expires: 3/i.
Y 4 • •
akar G RECEIVE) BY CONSTRUCTION PERMIT APPLICATION
jr-IEr1F1L.. COMMUNITY DEVELOPMENT DEPARTMEN�PPLICATION NUMBER: 0 22- L 1?0551 - 019
FEB 0 5 2002 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 �1
SITE ADDRESS: 34800 21"Ave.S.W. ASSESSOR'S F 3V TAX/PARCEL*:J _w`3()
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑PLUMBING o MECHANICAL ❑DEMOLITION
X ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): INSTALL 1200A NEW SERVICE, PANELS,
TRANSFORMERS, OUTLETS AND LIGHTING IN NEW CHURCH FACILITY.
PROJECT NAME: 001 111 ii atureV i
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
NORTHWEST CHURCH ( 253 ) 838-6321
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
34800 21sT AVE.S.W.FEDERAL WAY,WA 98023
CONTRACTOR: NAME: DAYTIME PHONE:
BROADVIEW ELECTRIC CO.,INC, ( 206 ) 789-6900
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
7821 FREMONT AVE.N. SEATTLE,WA 98103 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
20-01-101784-00-BL ( 206 ) 784- 2766
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) BROADEC312K6 03/31/02
APPLICANT: NAME: DAYTIME PHONE:
DROADVIEW ELECTRIC CO..INC, ( 206 ) 789 - 6900
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
7821 FREMONT AVE.N. SEATTLE,WA 98103 ( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT o TENANT XOTHER(DESCRIBE):ELECTRICAL CONTRACTOR ( 206) 784 - 2766
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER XAPPLICANT ❑CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES ❑ NO
N f
SEWER$ERVICE 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) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ELECTRIC ❑GAS
PLUMBING
BATHTUBS) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ELECTRIC o GAS
DRINKING FOUNTAINS) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.I )
INTERCEPTOR(S) SUMP(S7
E' DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury , t 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 daim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,induding 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 supplied to the city as a part of this application.
NAME/TITLE: ljtJ(•�� £ - 6 05/�l'/.uv J DATE: 2.-/5l/s/Zd 621
❑ PROPERTY OWNER ❑APPLICANT CONTRACTOR
FOR OFFICE USE ONLY:
❑NEW ❑ADDITION o ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑YES ❑NO
COMP PLAN DESIGNATION BASIC PLAN? ❑YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑YES 0 NO
n�*TR" "re,/ ..%RC .. iun /.tJAI III"r Ar■MOMS Vel. .-, MP%
J .
Miscellaneous Fixture Charge:(10)
•SUb Total (Page One): Une(s)(1)+(2)+(3)+(4)+(5)+(6)+ 7)+(8)+(9)+(10)= (11)
X 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-$11.00ea)
(First 1300 ftZ-$72.00;Each add'n 500 ftZ-$23.00) _Service and feeder $78.00 _#of Low voltage fire or burglar alarms
Square Feet: First 25001t2-$42.00;Each add'n 2500 ftZ-$11.00
_Each outbuilding or garage $30.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _#of service or feeders *Per WAC 296-46-910(5XbXi&ii)
_Each outbuilding or garage $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 AmpsService or Add'n _0 to 200 $ 78.00
Up to 200 amp $ 78.00 $ 23.00 / 5' Feeder _201-600 182.00
_201-400 amp 97.00 48.00 S 0 to 100 $ 78.00 $ 48.00 _601-1000 274.00
_401-600 amp 133.00 66.00 /101-2001 . . 97.00 61.00 _over 1000 305.00
_601-800 amp 170.00 91.00 01-400 182.00 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 .7.„Over 1000 365.00 195.00 Residential/Multi-Family/Commercial/Industrial
_0 to 200 amp $66.00 _Over 600 volts surcharge 61.00 _0-100 48.00
201-600 amp 97.00 _Mast or meter repay 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.
FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B)- NUMBER OF URITIS(C) TOTAL(0)
r„,Al/4-0(/I'L
TOTAL COLUMN(D):
Total Column(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $61.00+( 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)