04-100459 City of Federal Way
Community Development Services Electrical Permit #:04 - 100459 - 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: GRISSOM ek
Project Address: 35339 10TH SW Parcel Number: 502860 1810
Project Description: Adding 1 circuit for new A/C unit
Owner Applicant Contractor
Karen L Grissom WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
35339 10TH PL SW 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98023-6955 (206)272-4700
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits-Residential 1
PERMIT EXPIRES August 11,2004.
Permit issued on February 13,2004
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 cordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: 2/
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Federal Way �,i, P IIT APPLICATION t_1_mAre L?S,i�pwt99
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Par oaa Um Oar FW File Number. L - 1 (2 0._ 4. -
The ollowin• is •aired I orntation-an Inca •tete a• .Uicatlon wilt not be avec.tied. Please •rint • •l in in or . •
• PROPERTY 1NFORNLATION
SITE ADDRESS: 3532 pJO I [�C...o SUITE/APT t
ASSESSOR'S TAX/PARCEL II: 5C c 1F4e6/Erb_ SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
•
TYPE OF PERMIT(This application': O BUILDING O PLUMBING O MECHANICAL 0 DEMOLITION
'ELECTRICAL o ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed escriptlon of work Included on this permit onlyj:
Avd( nd I G! riC q- 04 w�f 2-VQ I/ r ' /C_
PROJECT NAME(Name of Business/Owner Last Name): 6 V( •Su v r
• PEOPLE EIFORMATION
PROPERTY NAME:
v�e,/ PRIMARY PHONE:
k e vPRIMARYnt
► vi S M.' (Z r).f 7
MAIL ADDRESS(STREET ADDRESS•: ....;;STATE.VP
33 7 t 0 lo� A...) 10).rz a C4)y 4-l
CONTRACTOR COMPANY r OFFICE PHONE:
.1- (Zig& tid— CO7
MMLINO ApD �D .WT CELL PHONE:
-Zne.b LIcrry OP wEXPIRATION DATE:
FAX NUMBER
O L6_f2, V _boaI / -- /or
CONTRACTOR'S REGISTRATION NUMBER: EXPIRTION DTE
. (copy et erne rantred..ith.,'01.a>ltte.u..) LOP- .. .f 7 L__ / A- A/ d S--'
LENDER: -NAME:
DAYTIME PHONE:
IItra pa..4v.w a a.000) ( ) -
MAILING ADDRESS(STREET ADDRESS•: CITY.STATE.VP
APPLICANT: NAME:c__ ( lzne..._ COMPANY OFFICE PHONE -
MAILING ADDRESS(STREET ADORES.% CRY,STATE.ZIP EVENING PHONE
(
REIATIONSHIr Td PROJECT: FAX NUMBER:
0 Architect O Tenant 0 Other(Desolbek ( ) -
r CONTACT PERSON FOR THIS PROJECT: 0 Property Owner kContractor 0 Applicant E MAILADDRESS
M DETAILED SUILDLIG INFORMATION
EXISTING USE: PROPOSED USE: •
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OP PROPOSED WORK S
SPRINKLERED BUILDING? O YEN O NO FIRS SUPPRESSION SYSTEM PROPOSED/REQUIRED?: O YES O NI)
WATER SERVICE PROVIDER t]LAKEHAVEN 0 HIOHLIME 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 NIGHLINE a PRIVATE(SEPTIC)
FEB-9-2004 08: 14 FROM: TO:12536614129 P.8
k- tSSS- 3533 1 !O -9( Com)
■ ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE - NEW COMMERCIAL/INDUSTRIAL SERVICE
Ci Single Family Square Feet service or Feeder Each addyt
(First 1300 IP-$87.00;Each odd%S00 fit-$28.00) CI 0 to 100 amp S 94.50 $ 58.00
O Detached outbuilding or garage 0 101-200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201-400 amp 220.50 87.00
❑ Detached outbuilding or garage 0 401-600 amp 256.50 103.00
(Insilected separately) $58.00 0 601-800 amp 332.00 140.50
NEW MULTI-FAMIJ (three units or more) ❑ 801- 1000 amp 405.50 169.50
NEW
Service Feeder 0 Over 1000 amp 442.00 236.00
❑ Up to 200 amp S 94.50 $ 28.00
❑ 201 -400 amp 117.50 58.00 0 Over 600 volts surcharge $74.00
O 401 -600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110.00 ALTERep.CQMMERCJAL/1NDUSTRJAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
/ALTERED SINGLE/MULTI FAMILY 0 0 to 200 amp $ 94.50
(inspected separately from service) 0 201-600 amp 220.50
Service or Feeder 0 601- 1000 amp 332.00
❑ 0 to 200 amp $ 72.50 0 over 1000 amp 369.50
❑ 201-600 amp 117.50
❑ over 600 amp 177.00 0 I of circuits to be added/altered
\� (1-5 circuits-4174.00; n 74.00;Add' circuits,56.00/eat
' 1__r tr circuiu to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-358.00;Add'n circui4 s6A0/pJ
0 Service over 200 amps
(] Mast or meter repair $43.50 0 Medical/Educational/Institutional Facility
$74.00 plus 35%of Permit Fee
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Scrvice Over 400 amps
$74.00 pitim 35%of Permit Fee
MOBILE ROMPS TEMPORARY SERVICE
❑ Service or feeder only $58.00
CI Service and feeder S 94.50 Commercial Residential
0 0-100 $58.00 $51.00 .
MOBILE ROME/RV PARK 0 101 -200 74.00 51.00
❑ it of service or feeders ❑ 201 -400 87.00
{first service/feeder-558.00;each add'n-$37.501 „/a
' 0 401-600 117.50 a/a
❑ over 600 127.00 n/■
MISCELLANEOUS SERVICE/EQUIPMENT
Q ti of Thermostats ❑ I of Signs
(First-$43.50;add'n-513.50/ea) (First sign-$43.50;add't sign$20.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s): (Includes additional circuit,tr required)
O Fire Alarm System 0 Yard Pole meter loops 958.00
O Security Alarm System 0 Additional Plan Review 587.00/hour
O Voice Ceb1in6 (for modified submittals)
❑ Data Cabling
0
(Per System(s): 1.12500 ft3-$51.00;
Each riders 2500 IV-13.50)'Per WAG 29d. 6-9Irnt3xb*i A MJ
Iltlil.i t 1,1(10 J.=::u..'N I. -WO t Page 3
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. �r c�SO " 355.5 cul
■ PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. _ TOTAL
BASEMENT
FIRST ' ' `
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOW.DinTIMO ToroJeoross0 TOM.=ITEM Ida rsow•eo
I
••NEW HOMES ONLY" NUMBER OF BEDROOMS:.__ ESTIMATED SELLING PRICE: $
IIIIIMIIIIIIIIIIMIIMIIIIIIEIEZIIMMIIIIIIIIIIIIMIMIIMIII
Indicate number of each type of fixture that is to be installed or relocated as part oI tlas project. Do not include existing fixtures to remain.
MECHANICAL r /1 0 ---
Value of Mechanical Work $ l Y ' S
1 --MR HANDUNO UNITS EVAPORATIVE COOLERS GAS LOOSREPRIO.SYSTEMS
13EQg FANSHOODSr........a4 WOODSTOVES I
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS i FURNACES 0613 WATER HEATERS
DUCTS OAS PIPE OU'LETS
PLUMBING
BATHTUBS(•••vi.m•••••c+hM SHOWERS WATER CLOSETS Iraq MISC(Deaeribe)
DISHWASHERS SINKSDRINKING FOUNTAINS
GAS-PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE SIRES
LAVS iarr... sink VACUUM BREAKERS n.ICYRIC WATER HEATERS
• DISCLAIMER/SIGNATURE BLOCK
t certify under penalty of pe that the irforrmt tion furnished by,.—is tree and correct to the best of my
knowledge,and further,that I am authorised by the owner of the above'preTnises to perform the work for which the perm and
t
application is made. I further agree to hold harmless the City of Federal Way as to any claim(including costs,expo
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 e • es,u,•n the accuracy of the information supplied to the city as a partof application.
2/9'
NAME/TITLE: T . i! —/ DATE: Cid/
(Signature) iro 1
RELATIONSHIP TO PROJECT: 0 Property 6,0 er O Applicant • .• tractor -*D Architect O
LF2 S 7 76
•FOR 04$sFICK 134E•ONLY-. .,
n NEW. ' ' • d ADDITION a ALTERATION a REPAIR D TENANT IMPROVEMENT
BUILDING SHELL ONLY? G YES D NOBASIC PLAN? a YES p NO
Z'OItNG DESIGNATION: CHANGE OF um? a YES o NO
NEW ADDRESS REQUIRED? a YES a NO UP/ /ASPS SU? a YES o NO
PLATTED LOT? a YES a NO DEMORMITPE REQUIRED? co YES a NO
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