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02-100162 City Community Development Services Federal Way Electrical Permit #:02 - 100162 - 00 - EL ' Communi 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: CHIROPRACTOR 32020 BUILDING Project Address: 32020 1ST S SUITE115 Parcel Number: Project Description: ELE-Add 2 switches and 2 outlets Owner Applicant Contractor ABC PACIFIC CORP LAZER ELECTRIC LAZER ELECTRIC 9523 19TH AVE E 9523 19TH AVE E TACOMA WA 98445 TACOMA WA 98445 (253)535-1900 Electrical Fixtures Description Quantity - - Description ' ' ; (Quantity Description jQuantity Circuits- Commercial Y I PE' IT EXPIRES July 13,2002,IF NO WORK IS STARTED. Permit issued on January 14,2002 I hereby certify :t the a•ove info .do, s ‘orrect and that the construction on the above described property and the occupancy an‘' the - I'll be in acc.i •a,04:1,14\a laws,rules and regulations of the tate o Washington and the City of Fede�%`�11). ''; . ';, +, 41)11111 ( ( Gl \ L �z Owner or agent: v� Date: t i l - --0 Z Ciiv caw, do (2w..- 7 'eke_ _ �ip i i --Z3— a)-- c e t i✓4N:y (moo e g, 01 " , t 1,--i_3 - D7--- 1Z oce fC, ff-1 f7a.1'c-,,9 G o 4,c, -- cp 1 - 911 91L (/► 1"1/4-L fic',L£), e ( -v't- Nfi 1 pi 1 !At 0 .- 69 2_( ,D 2 �i41'1L D 1<' /I) c 0 u , l l_— / C- m' 2- - F-, c.•« -sk or, CONSTRUCTION PERMIT APPLICATION � i- _ APPLICATION NUMBER: _- L 00 /�(,2, - 61?i JAN 1 4 200i APPLICATION NUMBER: - - _ APPLICATION NUMBER: - - 1 %..,I t yr' Ei- ./Li-ir,L WAY **The followeiJIL416101D€P1?formation—Please print(in ink)or type** Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. ' I, ■ PROPERTY INFORMATION • ..SITE ADDRESS: 3 2 vo..O 1 st a V e-. S, IL t Ib ASSESSOR'S TAX/PARCEL #: 1 1 2. L Q Y - g 0 s e LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): A 4-4-A-c I e r/l ' ■ PROJECT INFORMATION . TYPE OF PROJECT(This application): ❑ BUILDING 0 PLUMBING ❑ MECHANICAL ❑ DEMOLITION CiiitELECTRICAL ❑ ENGit IINEERING❑ FIRE PREVENTION SYSTEM PROJECTI DE CRI TION (Provide detailed description): AdCZ se,o ( siC-�. i c_a PROJECT NAME: (iV\ t i( -ei A-C . 1 ` .Z__© ao Ck.( (A(- •3 (� - ■ PEOPLE INFORMATION . PROPERTY OWNER: NAMEDAYME PHONE: f TIgC Nee Cr.sc� (,,253)Ca7 - /90"I. MAILING ADDRESS(STRICT ADDRESS,CM,STATE,ZIP). IS- I6 S. 3so-tL F. w - ( ) A 900(93 CONTRACTOR: NAME DAYTIME PHONE -A-Z e 5(e-c -1 c-- c_ (2s-s) s 13 - 6 9 MAIUNGIADDRESS(STREET ADDRESS.CITY,STATE,ZIP) EVENING PHONE• 9 'Z_ , I61 +c. (43 e_, t' 4 (0106) do -9‘/ 1 CITY OF FEDERAL WAY BOSINESS LICENSE NUr•1BER FAX NUMBER Dv - 1 013 `-f 4 - 8L (ac ) 5-73- i797 CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE L-,4- L F 2 j' 0 s t) F , / 6 ;2(.913:S (copy of card rc�TuaeC) APPLICANT: NAME DAYTIME PHONE S ikp e -- o t-- L.k I cte t-S 1 1-" e--. (253) 57 - 1b` MAILING A DRESS(STREET ADDRESS,CITY,STATE,ZIP) EVENING PHONE. AZ I 1 g (-e,AAet'- (0 S�}, TA( to . V0 I4 et$ e> `f Oct (a ) l6 4o - t I RELATIONSHIP 10 PROJECT I 6).34 - f FAX NUMBER. ❑ ARCHITECT Cl TENANT -OTHER( DESCRIBE): W•34t14C._TO I (2S3 ) s73-r7' 7. E-MAIL ADDRESS `R I(A ill CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT (1I CONTRACTOR S.cr't e'I°�tc C0 ' . • - _ - . . :■ DETAILED BUILDING INFORMATION - EXISTING USE: 0 1 Le EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ 10001 C)o n ti/ 'CC USE: �1 3 ce PROPOSED VALUATION FOR IMPROVEMENTS: $ 5-.0 &v SPRINKLERED BUILDING? CI YES 'NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES sti NO WATER SERVICE PROVIDER: KEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: ( LAKEI1AVEN 0 HIGIILINE O PRIVATE(SEPTIC) "NEW RESIDENTIAL CONSTRUCTION ONLY" . NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ .. • - - -.• . • - ■ .PROTECT FLOOR AREAS - . FLOOR EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL BASEMENT FIRST SECOND THIRD l l FOURTH OTHER FLOORS (DESCRIBE) DECK • GARAGE HOW MANY FLOORS? __ _ -- TOTAL: fl 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 BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATEk(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 .erju that the information furnished by me is true and correct to the best of my knowledge, and further, that I .:m authorized by th own,r of-the above premises to perform the work for which the permit application is made. I further agree to hold harmless the ity o' Federal Way as to any claim (including costs, expenses, and attorneys'fees incurred in the investigation ark. defe e of such .laim), vhich may be made by any person, including the undersigned, and filed against the City of Federal Way, b • ly h re such ,lain ises out of the reliance of the city, including its officers and(i 'i'7' mploye s, upon the accuracy of the informati,, kis •.. tot e c ty.IT ,.f.8.`.' application. 7 NAME/TITLE: ,\ `�� ' L�� A-cy I N DATE: 1 `' L/ ❑ PROPERTY ON.�R ❑ APPLICANT ❑ CONTRACTOR FOR OFFICE USE ONLY: I ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT CENSUS CODE: l LOT SIZE: ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO COMP PLAN DESIGNATION _� BASIC PLAN? ❑ YES ❑ NO SECTION TOWNSHIP RANGE —1 NEW ADDRESS REQUIRED? ❑ YES ❑ NO -- --- ---- PLATTED LOT? ❑ YES L) NO 1 CHANGE OF USE? ❑ YES ❑ NO _ rv. .r ,,.,+,. ,,,.,.i,.r ;, ,I\I(1'•. 71'..'IIIC• 7 \'.t' a i,,,. t•n l„i. l+,v .11 . .'J 1'.•. \'..1 'l`.,,a1l7l' . '.\l(.1 .. k✓i.I ' + , , r,• •■ ELECTRICAL • TABLE B w NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES _Sin_Ic Family _Service or feeder only . . . 544 25 _#of Thermostats(First-S33 50,add'n-S10.50ca) (first 1300 ft2-567.00,Each add'n 500 ft'-521 50) _Scn•ice and feeder . S72 25 First o2f I.ms00 voltage 75fire Each burglar ur8ld'n 2500lafts-SIO 50 Square ac foul 528 00 Square feet _Each outbuilding or garage MOBILE HOME/RV PARK • I'ur\VAC 296-4G')IU(5)(h)(i 8:ii) (Inspected with service) _Sr of service or feeders C (First service/feeder-$44 25,Add'n ser rcc! _a:of Sans(First sign-S33 50,add'n sign _ rack nutbwldingor garage.. 544 25 5.10 OU each) (Inspected separately) feeder-528 each) _Progress inspection per Yr hr .....$33 50 _S„'miningpool.hot tub.spa . ... .67.00 Yard Pole meter loops . .. ....44 25 NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL (Includes three units or more) _ Altered`-,c1\ice or I ceders Service feeder Amps Sen ice or Add'n U to 200 . S 72 25 _Up to 200 amp . S 72 25 S 21 50 feeder 201 -600 .169 00 _201 -400 amp 89 75 44 25 _Oto 100 5 72 25 5 44 25 _601 - 1000 254 50 _401 -600 amp 123 25 61 50 _ 101 -200. 89 75 56 25 r,‘et 1000282 75 _601 -800 amp 158 00 84 25 _201 -400 I69 00 07 00 f 5 of cm.rnt. _Over 800 amp 225 25 109 00 _401 -000 197 00 78 75 (I-s cucuit;-556 25 Add'n circuits.$5 ca) ALTERED SINGLE/MULTI FAMILY _(01 -800 254 50 107 25 (When inspected separate!) front the sen ices) _801 - 1000 310 75 129 75 1 emp,rr:rn Seryice Service or Feeder _O%er 1000 339 00 181 00 _01,00 . 538 75 _0 to 200 amp S 01 50 _O%er 600%olts surcharge 56 25 _61 • 100 . 44 25 201 -600 amp 59 75 _Matt or meter repair 61 50 _ 101 -220(1 56 25 o%cr 600 amp 135'_5 _201 -40(1 .. 67 89.00 _Mast or meter repair 33 50 _401 -600 75 —k of circuits _o%cr 600 97.75 (1-4 circuits-544 25.Add'n circuits S5 ca) It service is greater than 200 amp,a plan res re%% is rcq'd I ee is 35%01 permit Ice+556 25 Add]plan re%is%% for other,ubmnsions is 507 00/hr FIXTURE DESCRIPTION (A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(0) • i TOTAL COLUMN (D)J Tota'Column(D) Estimated Permit Fee: (12) Esiimatc5 Pc'r 't rev 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 (Pe,?csonet.Two): Line(s)(11)+(12)4(13)4(1+)+(15)4(16)+(17)+(1S)+(19)+(20)+(21)+(72)+(23) _ (24) Lluiietin 100 - January 3, 2001 Construction Permit Fee Calculation Sheet *******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT. CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!******* Building, mechanical,and fire prevention system fees are based on the following schedule. TABLE A TOTAL VALUATION FEE FACTOR (1)51 00 10 5500 00 (1)$24.25 (2)5501 00 to 52,000 00 (2)$24.25 for the first$500.00 plus 5327 for e.xh,gld,Lmal5100 00a fraction thereof,to and rnclud,ng 52,000 00 (3)52,001 00 to 525,000 00 (3)571.46 for the first$2,000.00 plus 515 00 Qr cath addvrpnt l 0(X7 00 or fraction thereof,to and vxludmg 525,000 00 (4)525,001 00 to 550,000 00 (4)$403 61 for the first$25,000.00 plus 110 52 IC,each ni,l,anal 5.1.000_ 0a fracte,n thereof,to and mclud, 550,000 00 (5)550,001 00 to 5100,000 00 (5)$664.35 for the first$50,000.00 plus 57 50 for cxh a,1,112Qc2a/51.000 00a]radion thereof,to a • luding 5100,000 00 (L)1100,0.1 UG to 550,000(hI (G)11,025.55 for the first 1300,000.00 plus 5EO ., .':h'�f�t�n,3 51�(7pa hactK,n U,col,to ar,d lndudilul 5500,000 00 (1)5500,001 00 to 51,000,000 00 (7)53,337.23 for the fist 1500,000 00 taus 5512_,S_ch_k$th2Q,3/1l 70.0pa fr •'Or,thereof,to and including 51,030,030 D0 (F)51,0.:0,501 UO ant)up (F)15,788.23 for the first$1,000,000.00 plus 5,3,2/Icrf_xh a,75L a 51 0r QQa Iracaon thereof Bold number is the base fee for the specrfied increment Italicized underlined number is the lee per additional specified i. rcmen PLUS: Add 65 percent of the base building permit fee for plan review fee. Add 25 percent of the base mechanical permit fee for mechanical plan review fee. Add 15 percent of the base building permit fee for Fire District o39 surcharge, co r ercial only. Add $150 for 1VA State Building Code Council, plus$2.00 per unit for duplex& save. ** Electrical, plumbing, and mechanical f are calculated separately ** - . . . . - . • - - • • BUILDING • - •. - PROPOSED VALUATION: FEE FACTOR FROM TABLE A: Number: (a) Base Fr : (b)Add onal Increment Fee: Estimated Permit Fee: (1) Estimated Plan Review Fee: (2) Estimated FW Fire Department Surcharge: 3) (COMI:LRCI%.L Ot7LY) . - . • _ • • ■•MECHANICAL • • PROPOSED VALUATION: FEE FACTOR FROM TABLE A: Nu firer: (a) Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (' Estimated Plan Revie Fee: (5) - - - ' - - - ■ FIRE PREVENTION SYSTEM -• •- PROPOSED VAL TION: FEE FACTOR FROM TABLE A: Number: (a) Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (6) Estimated Plan Review Fee: (7) ,. ■ PWMBINO Base Fee numt,,'r of fnlures $21.00 f• ( X $7,00/fixture) = (8) Estimated Permit Fee E:tintiatnd r„m,t lee X l.`, -___ __-_— (5) Estimated Plan Review Fee Miscellaneous Fixture Char ge: (10) _ __ ';1 111 Fnt:r l ,, ,...,._,• t..,, /.1 (t 1,/ r 1.1 11.1:\.r'.\.1..1,(/N.00.0;1.11(11 - (lit