04-100371 City unity Development Services eveWay
Community Electrical Permit #:04 - 100371 - 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: FEDERAL WAY HEAD START DAYCARE
Project Address: 31455 28TH 6-kiiGS Parcel Number: 092104 9054
Project Description: Install to branch circuits to serve construction trailer and spider box.
Owner Applicant Contractor
FEDERAL WAY PUBLIC SCHOOL KELLY ELECTRIC KELLY ELECTRIC
31405 18TH AVE S PO BOX 2108 PO BOX 2108
FEDERAL WAY WA PO BOX 2108 PO BOX 2108
98003-5433 ISSAQUAH WA 98027 (425)454-2424
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits- Commercial 2
PERMIT EXPIRES August 1,2004.
Permit issued on February 3,2004
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_ � � k— Date: Fe_l, 3 2a.)y
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crrr of Ft�� 335305FIRSTDEVELOPMENTSOUTH• SERVICESX9718
OM FIRST WAY SOUTH• BOX
FEDERAL WAY,WA 98063-9718
Federal Way PERMIT APPLICATIONEc 253-661-4115•FAX.253-661-412911,111,111Wah
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For Office Use Only FW File Number: gLR[��„ L - D TD
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The oilourin• is re•uired in ormation- rrt. e a••Iication uriIl not be acce•ted. Please .rint Ie•ibi (in ink)or .
■ PROPERTY INFORMATION
SITE ADDRESS: 3 MSS." a-844. 't'. So. SUITE/APT#
ASSESSOR'S TAX/PARCEL#: - I Srfr'.rjr SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (e.g.:Acme Estates, Lot 1) ek r SciAa,A
(Attach separate page for lengthy legal description)
• ■ PROJECT INFORMATION
TYPE OF PERMIT(This application): ❑ BUILDING 0 PLUMBING O MECHANICAL 0 DEMOLITION
, ELECTRICAL 0 ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT4ESCRIPTION(Provide detailled description of work included on this permit only):
5?`alter- b�
PROJECT NAME(Name of Business/Owner Last Name): Q.(12-r C V)C"-\ \ 9 I rN 1 .
■ PEOPLE INFORMATION
PROPERTY NAME: PRIMARY P-•NE:
OWNER . S, . s ..1./(� . 0-95-). .1-1 i �
QtAILI0 ADDRESS(ST�EE �D'RDES,S,,�: ,. CITYtu r I'ZItP"1.00r\ 1 ^�1 ��
CONTRACTOR NAME ��r j. Com'J� 0 PPJ1 Cwt/j OFFICE PHONE:
M.JO O� STRI ADDRESS;): CITY.STA .ZIP'�� LA 9, � (9CELc)PHO?LI 0(0
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:
pr Prod vane>$5,0001
( ) _
1
MAILING ADDRESS(STREET ADDRESS;):j CITY,STATE,ZIP
APPLICANT: NAME: . ) , COMPANY OFFICE PHONE: -
MAILING ADDRESS(STREET ADDRESS) CITY,STATE,ZIP EVENING PHONE:
( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER'
❑ Architect 0 Tenant ❑ Other(Describe): ( ) -
)(CONTACT PERSON FOR THIS PROJECT: 0 Property Owner Contractor ❑ Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION
EXISTING USE: NOAH PROPOSED USE: iiiill S �- &Aft,I
EXISTING ASSESSED/APPRAISED VALUE $ y/ VALUE OF PROPOSED WORK: $ )(001)
SPRINKLERED BUILDING? 0 YES NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
'
• ■ PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL 1
BASEMEN"I'
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(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Descnbe)
_COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower CorntxiSHOWERS WATER CLOSETS(Toll<t} MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS _ RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom sulk 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 th ' vestigation and defense of such claim), which may be made by any person, including the
undersigned, and filed agp.inst t e City of Federal Way, but only where such claim arises out of the reliance of the city,
including its officersand emp //s upon the accuracy of the information supplied to the city as a//part
l of this application.
NAME/TITLE: // Cce-S 1 OttA. DATE: l./c�I W L 0t-
(Signature) (Title) l
RELATIONSHIP TO PROJECT: ❑ Property Owner 0 Applicant Contractor 0 Architect ❑
FOR OFFICE USE ONLY:
' ❑ NEW ❑ADDITION a ALTERATION a REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES ❑ NO BASIC PLAN? 0 YES ❑ NO
ZONING DESIGNATION: CHANGE OF USE? 0 YES I i NO
NEW ADDRESS REQUIRED? 0 YES a NO UP/SEPA/SU? c YES n NO
---- - - -------------- - - ---- -- --------PLATTED LOT? c YES - NO 1 DEMO PERMIT REQUIRED? n YES p NO
■ ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
•
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet: Service or Feeder Each Add'n
(First 1300 ft.,-$87 00,Each add'n 500 ft,-528 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 U 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
O 401 - 600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110 00 ALTERED COMMERCIAL/INDUSTRIAL
LI Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
(Inspected separately from service) 0 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332 00
U 0 to 200 amp $ 72.50 U over 1000 amp 369.50
❑ 201 -600 amp 117.50 `�
❑ over 600 amp 177.00 ❑ CT- # of circuits to be added/altered
(1-5 circuits-$74 00,Add'n circuits,$6.00/ea)
❑ # of circuits to be added/altered
(1-4 circuits-$58 00;Add'n circuits$6 00/ea) COMMERCIAL/INDUSTRIAL PLAN REVIEW
❑ 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
U 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 U 201 -400 87.00 n/a
(First service/feeder-$58 00;each add'n-$37 50)
❑ 401 -600 117 50 n/a
U over 600 127 00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ _ # of Thermostats ❑ # of Signs
(First-$43 50;add'n-$13 50/ca) (First sign-$43.50, add'n sign $20 50/ca)
❑ Low Voltage U Swimming pool/hot tub. .. .... . . $87 00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alain Si stern ❑ Yard Pole meter loops. .. ... . . .. .. $58 00
O Security Alarm System U Additional Plan Review S87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling, !h
❑ 'L
(Per System(s) 1,,2500 ft'-$51 00,
Each add'n 2500 ft,-13 50) •fir ll'.1r'256 41,-Q!nt�fih!5,4 u/