04-100518 1r •
City of Federal Way
Community Development Services Electrical Permit #:04 - 100518 - 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: BELTRAN .ri!4
Project Address: 30146 16TH' W Parcel Number: 515320 0397
Project Description: Service for 407 square foot living room addition and 60 square foot porch addition.
Owner Applicant Contractor
Emesto D Beltran &Adelaida P Beltran Ernesto D Beltran Adelaida P Beltran
30146 16TH AVE S 30146 16TH AVE S 30146 16TH AVE S
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003 98003
Electrical Fixtures
, * IVri ks;:44:f 10640 Wit'` P001 41.04:: FR: �Y 0escn t 1t " " Quantity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES August 15,2004.
Permit issued on February 17,2004
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 accordance with the laws,rules and regulations of the State of Washington and
the City of Federal ay.
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Owner or agent: 1&O gDate: .0---11 -0*
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FINALED
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RECEIVED
COMMUNITY DEVELOPMENT SERVICES
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33530
FEDERST RAL WAY,WA 98063DO-97X189718
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CITY of� F C° 1 �7 2 O Z53.661-I 115•FAX 253b61-1129
Federal Way 1 HERMIT APPLICATION www ceuofederalwag corn
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For Oiko U.r Only. K.V1�4e'ill 7 �,.0 U - L (2 C` T L X _ C O T o I I 1 /'1I J _
The ollowin• is re•uired inVVollrrnation-an11inco •lete a.•lication will not be acce•ted. Please V•rint le.ibl (in ink)or .
R PROPERTY INFORMATAON
SITE ADDRESS: 0 I L1/4 T 'f • VILL SUITE/APT#
ASSESSOR'S TAX/PARCEL#: - 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): 0 BUILDING 0 PLUMBING ❑ MECHANICAL o DEMOLITION
O ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT D CRIPTI r(Proyide detailed description of work ' deal hthis permit maul:
(v k V �01NAK
PROJECT NAME(Name of Business/Owner Last Name): egPVCLV\
• PEOPLE INFORMATION
PROPERTY NAM i
,,//J� We-r--- PR`I�MAARY PHOr_31-
N�E 2OWNER Ct1 r C tc `.') tl-3 l- 0 3P
MA I A (STR ADDR SS;': ; 1 CITY'}-STOAT IP f(� A
67 4)79
CONTRACTOR: NAME COMPANY OFFICE PHONE:
5 PCWP e- IP*S ow X - l- ( )
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP CELL PHONE:
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: /FAX NUMBER:(
- - - I / )
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required with each application) / /
LENDER NAME: /� DAYTIME PHONE:
(If Proposed Value o$5,0001 s,ry M e. 1 TG7 cx. -/\ ( ) -
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME: /�,,�� COMPANY OFFICE PHONE:
ISN Y A.S. A5 .-N. ( )
MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE.
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 Architect O Tenant ❑ Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: 0 Property Owner 0 Contractor 0 Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ❑ YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: O YES ❑ NO
WATER SERVICE PROVIDER ❑LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE a PRIVATE(SEPTIC)
■ 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? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ FIXTURES
Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
- AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commudal) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/showercombo) SHOWERS WATER CLOSETS(roikt) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom sink VACUUM BREAKERS ELECTRIC WATER HEATERS
•
• DISCLAIMER/SIGNATURE BLOCK
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 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 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 led against the City of Federal Way,but only where such claim arises out of the reliance of the city,
including its of • d e< •ioye• upon y ccu •'1 y •,,t e information supplied to the city as a part of this application.
NAME/TITLE: ���` (� ' I 1 o I) / WI DATE: 2�1
1-6 Li---
Signature)
(Title) V
RELATIONSHIP TO PROJECT: 0 Property Owner o Applicant o Contractor 0 Architect 0
FOR.OFFICE:USE ONLY:
a NEW a ADDITION o ALTERATION a REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION: CHANGE OF USE? ❑YES o NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? o YES a NO
PLATTED LOT? a YES ❑NO DEMO PERMIT REQUIRED? a YES ❑NO
IiuLcuil `'IiIC' -.,<t.-,I„ 1. .--:()I Page 2
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• ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet: Service or Feeder Each Add'n
(First 1300 ft2-$87.00,Each add'n 500 ft2-$28 00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201 -400 amp 220.50 87.00
❑ Detached outbuilding or garage ❑ 401 -600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601 -800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) ❑ 801 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201 -400 amp 117.50 58.00 ❑ Over 600 volts surcharge $74.00
❑ 401 -600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
(I ected separately from service) CI 201 600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
0 to 200 amp $ 72.50 CI over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ over 600 amp 177.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58.00;Add'n circuits$6.00/ea)
❑ Service over 200 amps
❑ Mast or meter repair $43.50 ❑ Medical/Educational/Institutional Facility
$74.00 plus 35%of Permit Fee
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES TEMPORARY SERVICE
❑ Service or feeder only $58.00
❑ Service and feeder $94.50 Commercial Residential
❑ 0- 100 $58.00 $51.00
MOBILE HOME/RV PARK ❑ 101 -200 74.00 51.00
❑ #of service or feeders ❑ 201 -400 87.00 n/a
(First service/feeder-$58.00;each add'n-$37.50) ❑ 401 600 117.50
n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats U #of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
LI Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s): (Includes additional circuit,if required)
❑ Fire Alarm System U Yard Pole meter loops $58.00
❑ Security Alarm System U Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
(Per System(s): 1•,2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) •Per WAC 296-46-910(5)(b/(i&ii)
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