09-103093 4 _ • Electrical
City of Federal Way
Community Development Services Permit #: 09-103093-00-EL
PO.Box 9718
Federal Way,WA 98063-9718
Inspection Request Line: (253)835-3050
Ph (253)835-1/21 Fax (253)835-2609 p q
Project Name: FRED MEYER .AS
Project Address: 33702 21ST AVE SW Parcel Number: 930100 0010
Project Description: Alter up to(5)circuits for replacement of light fixture lenses and additional receptacles.
Owner Applicant Contractor
FRED MEYER INC. SOUTHGATE ELECTRIC INC SOUTHGATE ELECTRIC INC
P 0 BOX 42121 23444 30TH AVE S SOUTHEI366P1(8/30/09)
PORTLAND OR 97242 KENT WA 98032 23444 30TH AVE S
KENT WA 98032
Additional Permit Infortilatiori
Is Use Educational or Institutional? No Service greater than 1000 Amps? No
Electrical Fixtelts,.
Circuits-Commercial 5
PERMIT EXPIRES Wednesday, August 11, 2010
Permit Issued on Tuesday,August 11, 2009
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
an the City of Federal Way.
Owner or agent Date: //%/F
V Z4 0/
• THIS CARD IS T MAIN ON-SITE
r •
CITY OF • Construction I ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT #: 09-103093-00-EL _ Address: 33702 21ST AVE SW
Owner: FRED MEYER INC. FEDERAL WAY; WA 98023-7762
•
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as •
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
LIFER Ground (4295) Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved • Approved to place concrete
By Date By 'Date By Date
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Pool Bonding(4195) 0 Temporary Power(4275) Service(4235)
Approved . Approved Approved
By Date By Date By Date
- 0 Feeders/Sub-panels(4045) Rough Electrical(4225) Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
By
(-1-#‘ Date 6.-
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•
•
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For inspector reference only
0 Rough Electrical O FINAL-Electrical
Approved Approved •
By Date By Date
CUT OF iirak K C fia/`I V L SL i_ - 1 30 _0_5 3_
Federal Way R M I T OD
COMMUNITY DEVELOPMENT SERVICES j ( , MF C O ME®'L D E E N FP
33325 FEDERAL R WA SWATH•63 971 9714TIO N
53- 5- 07Y,WAFAX
93-8 3-26098 •� D
idarsairanAill
253-33w.dloo•FAX 253335-2609 CITY O Nii--)RkICAL
1'1,•J�
uauun.cituol]`edertihixiu.eam 1! � (('''��
The following is required informatioi[dincomplete application will not be accepte•. Please print legibly(in ink)or type.
rr�� !\ 9 A • PROPERTY INFORMATION
SITE ADDRESS s7 /7 OdZ /. i A`I E 50 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sn
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desoiption)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION X ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
.p I Ac..e Li et t+; �1Xu t_C--- LE-21.1 S G S I / .1� `-/ gCs2 i c��
S14-0G i2 i A1cj GAJ .LL ,
PROJECT NAME(Name of Business or Owner Last Name) / 71-1-Cy,E7 .
l
i PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER )2.-ep it-4--/-EA- ( ) _
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
-CuTG4-ice mix --2 « (zo. ) K7F(--„2810(#
MAILING ADDRESS ITY,STATE,ZIP CELL PHONE
a 4 LI )4U- S. �C>z�,� 9&22 (.2O ) 790 - 1,�96
CITY OF FED WAY BUSINESS LICENSE NUMBER EXPIRATION ATE FAX NUMBER
/9—Loy— 000004-00—13L REGISTRATION NUMBER EXPI TIO DATE E-MAIL ADDRESS 1;.2Z,3/ _02069 (A)6) S'2 -1. 5'0
COPY of card regaled CONTRACTOR'S
with each application //
S0 LA+L e) (OIP?) 7130 C:20// eCI4Q I @- Ot-/iiiil,9 , •CcN1
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE ✓
( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other ( ) -
PROJECT NAM�Ei PRIMARY PHONE / AD f SS
CONTACT Air L 1 ROSS (.20 6) �2Er-.7tr(&'6 —
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ /�O5''• OG
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO ,
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. SQ.FT. SQ.F�
BASEMENT ' •
OB
•
•
FIRST
•
SECOND
THIRD •
ADDITIONAL FLOORS(DESCRIBE) •
•
DECK(0 COVERED OR 0 UNCOVERED?)
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GARAGE 0 CARPORT 0
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!1
NUMBER OF FLOORS STUO 55050855 TOTAL TOTAL aam do SP TOTAL TR PoesD Al TOTAL$7
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""NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
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1111 FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL •
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(eommereid)
COMPRESSORS FURNACES RANGES '
DUCTS GAS LOG SETS REFRIG.SYSTEMS
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PLUMBING
BATHTUBS)orTub/show.rcombo) LAVS(Bathroom sink.) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
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SIGNATURE
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 authorised 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 supplied to the city as a part of
this application. �v �y
NAME/TITLE Zit�i1,,� T/�i4 7�/� DATE fJ ////
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent 0 Contractor 0 Architect 0 Other
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES n NO
ZONING DESIGNATION CHANGE OF.USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? a YES o NO
Bulletin#100—April 2,2007 Page 2 of4 k\Handouts\Permit Application
1 '' -i .
'= ,, .. -.L...CTRICAL PERMIT INFORMh�A.�N `: , :_.
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RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE • NEW COMMERCIAL/INDUSTRIAL SERVICE
0 Single Family.Square Feet Service or'Feeder Each Add'n
' (Fiist 1300 ft2-'$111.00;Each add'n 500 ft2-$35.50) 0 0 to 100 amp $120.50 $74.00 .
❑ Detached outbuilding or garage ❑ 101-200 amp 149.50 94.50
(Inspected with service) $47.00 ❑ 201-400 amp 280.00 111.00.
❑ Detached outbuilding or garage ❑ 401-600 ainp '327.00 131.00
(Inspected separately) $74.00 0 601-800 amp 423.00 179.00
0 801 - 1000 amp 516.50 216.00 •
NEW MULTI-FAMILY(three units•or more) ❑ Over 1000 amp 563.00 300.00
Service Feeder-
❑ Up to 200 amp $120.50 $35.50 ❑ Over 600 volts surcharge $94.50
O 201 -400 amp 149.50 74.00 0 Maat or meter repair $102.00 •
❑ 401 600 amp 205.00 102.00 • ALTERED COMMERCIAL/INDUSTRIAL
0 601 -800 amp 262.00 140.50
❑ Over 800 amp 375.50 280.50 Service or Feeders
❑ 0 to 200 amp $120.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 280.50
❑ 601 - 1000 amp 423.00
Service or Feeder ❑ ver 1000 amp 471.00 •
❑ Oto 200 amp $92.50
❑ 201 -600 amp 149.50 5 #of circuits to be added/altered
❑ over 600 amp 225.50 11-5 circuits-$94.50;Add'n circuits,$7.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$74.00;Add'n circuits$7.00/ea) $94.50 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $55.00 • 0 Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $74.00
O Service and feeder $120.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residentia
I/Multi•Famiiy $65.00
❑ # of service or feeders
(First service/feeder-$74.00;each add'n-$48.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $74.00
❑ 101-200 amps 94.50
• ❑ 201-400 amps 111.00
❑ 401-600 amps 149.50
❑ over 600 amps 162.00
t
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signs
(First-$55.00;add'n-$17.00/ea) (First sign-$55.00;add'n sign$26.00/ea)
O Low Voltage ❑ Swimming pool/hot tub $111.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System 0 Yard Pole meter loops $74.00 •
❑ Security Alarm System 0 Additional Plan Review $111.00/hour
❑ Voice Cabling (for modified submittals) ,
•
laData Cabling
O ❑ Automation Fee on all Permits $5.00
1"2500 ft2-$65.00;
Each add'n.2500 ft2-•17.00) *Per WAC 296.46-910(5)/6)fi&ii) I
Bulletin#100-April 2,2007 Page 3 of 4 k\Handouts\Permit Application