04-100425 City of Federal Way
Community Development Services Electrical Permit #:04 - 100425 - 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: DENTAL OFFICE OF DR.JOHN HODGES
Project Address: 33301 9TH Suite125 Parcel Number: 926501 0130
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Project Description: Relocate(4)T-stats;Install(1)new T-stat.
Owner Applicant Contractor
FWTPI,LLC PACIFIC AIR CONTROL INC PACIFIC AIR CONTROL INC
1201 PACIFIC AVE SUITE 1400 11812 NORTH CREEK PKWY N 11812 NORTH CREEK PKWY N
TACOMA WA 98402 BOTHELL WA 98011 BOTHELL WA 98011
USAY (206)682-6393
Electrical Fixtures
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PERMIT EXPIRES August 3,2004.
Permit issued on February 5,2004
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 Way.
Owner or agent: G DS 4. ?T Date: 2- S' 0 r
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33530 FIRST WAY SOUTH•PO BOX 9718
Cory of 110111.4.or„i FEDERAL WAY,WA 98 063-9 718
Federal Way PERMIT APPLICATION FEB 0 5 2(o 661nIlltyS•n((FAX:rdernl253wnq-66Mmm129
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FW File Number: 0 ( ___1 .°
U ( 4 `1 - `-'BUJILSING DEPT/ /
The oliowin. is re•uired in ormation-an incom•fete a..lication will not be acce•ted. Please •rint le.ibl (in ink)or .
• PROPERTY INFORMATION ^
SITE ADDRESS: .; Z J 0 l( c Je q 4v, S Li I # 11" SUITE/APT# 5VI1 t- /2 5
ASSESSOR'S TAX/PARCEL#: - SQUARE FOOTAGE OF LOT:
E
LEGAL DESCRIPTION (eg:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT(This application): ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIO (Provide detailed description of work included on this permit only):
Re/oea-f-e_ ( /) T- 5Jtects i 1r15-i'a i i (1 ) "- SI-q 1.-
PROJECT NAME(Name 0 Business/Owner Last Name): )r- 1-10 ,e s
• PEOPLE INFORMATION
PROPERTY NAME: ` J PRIMARY PHONE:
OWNER F W T p i- 1 L (/t4 ) -
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
333o) q 4,..( S. redero I Oct y, ii
CONTRACTOR: NAME COMPANY OFFICE PHONE:
�gcr c- 1)Ir Cdn1-1c ) RAC /I.r (01.1-1-,,f)) ( za(D) (pet -G3,3
MAILING ADDRESS(STREET ADDRESS,): CITY,STATE,ZIP CELL PHONE:
i) S n_ N. Crew_ P kw A). #/09 6-T e ll' (,v,'} 9011 ( /)A-) -
CITY OF FEDERAL WAY BUSINESS LICENSE-NUMBER: EXPIRATION DATE: FAX NUMBER:
_ _ / / ( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
/ /
(coPy of card required with each application)
LENDER: NAME: DAYTIME PHONE.
(If Propos Value>$S,000) ( ) -
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME: COMPANY OFFICE PHONE:
( )
MAILING ADDRESS(STREET ADDRESS). CITY,STATE,ZIP EVENING PHONE:
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant o Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner ❑ Contractor ❑ Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION -
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 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(commermat) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
._COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS Irodct) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom smk 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 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 asoma part of this application.
NAME/TITLE:
' 4"y '` `et�rI V-X DATE: `_ S O�
/ (Signature) (Title)
RELATIONSHIP TO PROJECT: 0 Property Owner Applicant 0 Contractor 0 Architect 0
FOR OFFICE USE ONLY:
o NEW a ADDITION o ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? o YES o NO
ZONING DESIGNATION: CHANGE OF USE? 0 YES o NO
NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? a YES o NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES o NO
11 .r; , . .,
■ ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet. Seance or Feeder Each Add'n
(First 1300 ft2-$87 00;Each add'n 500 ft2-$28 00) LI 0 to 100 amp $ 94.50 $ 58.00
LI Detached outbuilding or garage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201 -400 amp 220.50 87.00
LI Detached outbuilding or garage LI 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) LI 801 - 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442 00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
1:1 201 -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 LI 0 to 200 amp $ 94.50
(Inspected separately from service) ❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
LI 0 to 200 amp $ 72.50 LI over 1000 amp 369.50
❑ 201 -600 amp 117.50
LI over 600 amp 177.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
LI #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58.00,Add'n circuits$6-00/ea)
LI 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
LI Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES TEMPORARY SERVICE
❑ Service or feeder only $58.00
LI Service and feeder $94.50 Commercial Residential
❑ 0- 100 $58.00 $51 00
MOBILE HOME/RV PARK
LI 101 -200 74.00 51.00
LI #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
C MISCELLANEOUS SERVICE/EQUIPMENT
XJ 4 of Thermostats LI #of Signs
(First-$43.50,add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit, if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $58 00
❑ Security Alarm System LI Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
El
(Per System(s). 1""2500 ft2-$51.00,
Each add'n 2500 ft2-13 50) *Per WAC 296-46-910(5)(b)(i&n)
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