09-100838 W
' Electrical
City of Federal Way Q
411 0
Community Development Services Permit #: 09-100838-00-EL
P.O Box 9718 Cgra I LE
Federal Way,WA 98063-9718 Inspection Request Line: (253)835-3050
Ph'(253)835-2607 Fax (253)835-2609 p q
Project Name: FRED MEYER GASOLINE FACILITY
Project Address: 33702 21ST AVE SW Parcel Number: 930100 0010
Project Description: Installation of low-voltage security alarm system inside clerk kiosk.
Owner Applicant Contractor
FRED MEYER STORES INC E C COMPANY E C COMPANY
3800 22ND AVE 3401 "C"ST NE SUITE 200 ECCOM**148BA(6/30/09)
PORTLAND OR 97202 AUBURN WA 98002 3401 "C"ST NE SUITE 200
AUBURN WA 98002
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Service greater than 1000 Amps? No
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Low Voltage-Burglar Alarm(Cor I
PERMIT EXPIRES Friday, March 5, 2010
Permit Issued on Thursday, March 5, 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
�f f/ , �annd ••a City of Federal Way. r�
Owner or agent: / -id ged p)C�C.,l% • Date:3 5 0 cl
FINALED
6 �
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C •
THIS CARD IS TIUEMAIN ON-SITE
•
CITY OF 411P 'ww Community Developaltnt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-100838-00-EL
Owner: FRED MEYER STORES INC
Address: 33702 21ST AVE SW
FEDERAL WAY, WA 98023-7762
This card is part of your required inspection documents. 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.
❑ UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
By Date 3'6 'C)7
For inspector reference only
O Rough Electrical 0 FINAL-Electrical
Approved Approved •
By Date By Date
CITY°,A 1 cyt _ i as132_
, FederalWay
COMWU TYDEVELOPMEN SERVICES PERMIT SF MF CO M LOPL DE EN FP
33325 8R+AVENUE SOUTH•PO BOX 9718
1 FEDERAL
2 FAX253 260 APPLICATION
iM.dv . 337oa -- VmIB
4 The following is required information-an incomplete application will not be , _- „ , , Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 2- t C+ 0 Li Sl t; F--(C_t-✓eQ(t.14 y t ( x1372 '�-� � SUITE/UNIT#_ 7
ASSESSOR'S TAX/PARCEL I - —— —— LOT SIZE(sl L 01) `'
/
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) I 1 (t t i"))(4-i)k-r F C k./ ( Jtt'-21-lc,-
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑PLUMBING ❑MECHANICAL
0 DEMOLITION.(ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION .^[(Proviide detailed`description of work included on this permit only)
C7-LL%rrI+ice} '- Vl.-.`\ 9L-1CL-v--- l.�i�JINA X7LC1LU r k ( �M p
in)4-1�\.-. -c�i-c i- 1- I.-616k k...).,„,4,,-,,.. _ j ' - i �,
PROJECT NAME(Name of Business or Owner Last Name) F)'ell 6'V 1 t c1 t-6 / Gic` c-j-zr 1 j,
• PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER H-C-Ck- 1.V\-tLJ C r' ("LS 3 )ct S'Z - ) t 00
MAILING ADDRESS CITY,STATE,ZIP c 0 2.3 E-MAIL ADDRESS
'31 2 o---; Z 1 S�- 4 i.-( 5(L t--e&fo'c- L,L:;(4`i iiw.,
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
k C.. Lc..>v."7-,..AA u1 p.-\t 1.9-1.9- L3 t 4�Si--E v----- (-z ) Z.y Z - 3� )D
MAILING ADDRESS STATE,ZIP CELL PHONE
31014 C- ,t- ,- c `r-u,) . ,\ LUt.,9:9»2 ( eolz, ) Citi L - cc,33
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
ZO - oD - /0/800- o:/' -JL. /e - �L7 - 2- > (zo(0) - .
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
"ECC=on , * 1iga8 c ..- 3, - ,,()
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
EL -L--p- \,J y"\.‘k,: ( f- ( , ( 2.0(c) 2Li2 - 3v )D
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
3io(-1 C cc-+ K)C-- At,1):--,,t + 1 • :0, `'t8:))2 (Z'1 ) L/L(r - (c'=;:S
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect a Tenant 0 Agent XOther C 0 L\b--y c.c 4-C. - ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT M ikl.ic <✓l.)Q•�}--C\ -- (2.?6) L(tl IG - 3ied3 iti\tiL -v 6-C--C0-��''
LENDER NAME Per RCW 19.27.093:
Lender irjonnation is required if project value exceeds 53,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORE $
SPRINELERED BUILDING? ci YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? to YES 0 NO
WATER SERVICE PROVIDER ❑LAEEHAVEN 0 HIGHLI NE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN o HIGHLI NE 0 PRIVATE(SEPTIC)
a PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST , •
c c l s/rm, (vs< 2 0o
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS �`�s r o� TOTAL TO�`ma71Oi, TOTAL MOM=Sr mrucer
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FLXTURES
Indicate number of each type of Jndure to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MSCHAIBCAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITHAPPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(c
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIO.SYSTEMS
PLUMBING
BATHTUBS torub/show c.vo s LAVS(Bathroom Maki URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Nam)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
•
SIGNATURE
I certify under penalty of perjury that I ane the property owner or authorised agent of the property owner.I certify that to the best of my
knowledge,the information submitted in support of this permit application is true and correct..1 certify that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorised by the issuance of a permit.I understand that the issuance of this permit
does not remove the owner's responsibilityfor compliance with local,state,or federal laws regulating construction or environneental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expanses, 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, 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.
SIGNATURE: `77/Z Z6LeG " Oi/ /t17- Al
J� , � DATE n f�(
petty
or and/or Authorized Agent
•
a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a.NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/STJ? a YES a NO
PLATTED LOT? a YES a NO _DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application
• le
ELECTRICAL PERMIT INFORMATION
*NOTE: an automation fee of$6.00 will be charged for all permits.
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet ❑ 0 to 100 amp 1300 LP-$121.00;Each addn 500 112-$39.001 $131.50 $80.00
❑ 101-200 amp 163.00 103.00
(3 Detached outbuilding or garage(w/service) $51.00 0 201-400 amp 305.50 120.50
❑ Detached outbuilding or garage(inspected separately) $80.00 0 401-600 amp 356.00 142.50
❑ Swimming pool(w/service) $80.00
O 601-800 amp 460.50
10 Swimming pool(inspected separately) $120.50
CI Hot tub/spa/sauna(w/service) $51.00 la 801-1000 amp 562.50 235.50
O Hot tub/spa/sauna(inspected separately) $80.00 0 Over 1000 amp 613.00 327.00
El Septicpumping system(w/service) $51.00 0 Over 600 volts
CI Septic pumping system(inspected separately) $80.00 195.00
surcharge $103.00
❑ Mast or meter repair $111.00
NEW MULTI-FAMILY(three units or more) ALTERED COM ERCIAL/IIIDUSTRIAL
Service Feeder (Does not include circuits.)
Service or Feeders
❑ Up to 200 amp $131.50 $39.00 0 0 to 200 amp $131.50
CI 201-400 amp 163.00 80.00 0 201-600 amp 305.50
❑ 401-600 amp 223.00 111.00
O 601 - 1000 amp 460.50
❑ 601 -800 amp 285.50 152.50 ❑ over 1000 amp 513.00
❑ Over 800 amp 408.50 305.50
❑ #of circuits to be added/altered
ALTERED SINGLE/MULTI FAMILY (1-5 circuits-$103.00;Add'ncircuits,$8.00/es)
Service or Feeder COMMERCIAL/INDUSTRIAL PLAN REVIEW
0 0 to 200 amp $100.50 $103.00 plus 35%of Permit Fee
laService- 1,000 amps or greater
CI 201 -600 amp 163.00
❑ over 600 amp 245.50 0 Medical/Educational/Institutional Facility
❑ Additional plan review for
❑ #of circuits to be added/altered modified submittals $115.00/per hour
(1-4 circuits-$80.00;Add'n circuits$8.00/ea)
❑ Mast or meter repair $60.50 TEMPORARY SERVICE
Service or Feeder Each Add'n
MANUFACTURED HOMES ❑ 0 to 60 amp $ 71.00 $32.00
❑ Service or feeder only $80.00 0 61-100 amp 80.00 39.00
❑ Service and feeder $131.50 0 101-200 amp 103.50 51.00
O 201-400 amp 120.00 60.50
MOBILE HOME/RV PARR 0 401-600 amp 163.50 80.00
❑ #of service or feeders 0 Over 600 amp 183.00 92.00
(First service/feeder-$80.00;each add'n-$52.50)
MISCELLANEOUS SERVICE/EQUIPMENT
o #of Thermostats
(First-$60.50;add'n-$18.50/ea) 0 #of Signs
Low Vol �1/,', (First sign-$60.50;add'n sign$28.50/ea) '
Square Feet to be served by system(s) C 1- 3 ❑ Yard Pole/meter loops/pedestal $80.00
❑_Fire Alarm System 0 Portable Generator(transfer equipment) $100.50
Security Alarm Sy' laDitch cover/inspection only $120.50
❑ Voice Cabling
❑ Data Cabling
❑l a 2500 m-$71.00; For fees not listed,contact the Permit Center at
Each addn 2500 dn-$18.50) 253-835-2607
Bulletin#100-January 1,2009 Page 3 of 4 k\Handouts\Pemfit Application