04-100254 City of Federal Way
Community Development Services Electrical Permit #:04 - 100254 - 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: HAGSTROM 5)(
Project Address: 3001 S 288THiSpace335 Parcel Number: 042104 9155
Project Description: Provide electrical service and feeder for mobile home in mobile home park.
Owner Applicant Contractor
Charlotte Hagstrom WASHINGTON HOME CENTER WASHINGTON HOME CENTER
3001 S 288TH ST UNIT 335 PO BOX 176 PO BOX 176
FEDERAL WAY WA 98003 CHEHALIS WA 98532 CHEHALIS WA 98532
(360)748-6049
Electrical Fixtures
Description [Quantity Description Quantity Description 1Quantity
Service and Feeder-Manu./Mobile 13 1
PERMIT EXPIRES July 24,2004.
Permit issued on January 26,2004
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. �`/ Date: �''Z,L-
—� Is_
Loc .Ba CodC
'alftQQATMUNITY DEVELOPMENT
} E RECFIV FIRST AY SOUTH
9d BOrtt718
Federalcrry PERMIT APPLICATION 253-661-4115.FAX:253-661-1129
Way !mow atwffederahuaq mm
JAN 2 6 2004
j TD.
For Office Uwoar FW File Number: Q 4 - 4 Q 0 9- (rt F€ €RAL WAY /
G DEPT.
The ollourin• is re•uired in ormation-an incom•/ete a••lication will not be acce•tot4UILIN
ase •not ie•ibl (in ink)or
/ ■ PROPERTY INFORMATION
SITE ADDRESS: 3 C D [ ,SD, 2-OO iQ-/< S El•. • # 3
"31—
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): ❑13.11H,DING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION
ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
II
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlcl):
/1404,/, /,„.I,., t 5{/VICE 61✓YJ4, l/ //i (el,-
PROJECT NAME(Name of Business/Owner Last Name): W g 5-4„,3-Lfr, 4644 i C?h 75.6.-- 1:,, .
• PEOPLE INFORMATION
PROPERTY NAME: �� PRIMARY PHONE:
OWNER C4,1.-le L' U'�t6ri, ( ) -
MAILING ADDRESS(STREET ADDRESS;. CITY,STATE,iIP
3da/ Se, 2-ff /CI;d1{.4 11/0)/ '/✓A ?r'oc2J
CONTRACTOR NAME COMPANY OFFICE PHONE:
/1't1/Z_ "lit in/d,, // Lor ,;, ol 11 7�2
e GAlifi, ( ) 75,x'` -.6-H. _
MAI ING ADDRESS(STREET ADDRESS;): CITY,SATE.ZIP CELL PHONE:
Dn /16 C�tAJ c VA 9g ( 6 ) 2W -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: T. '(3Z XPIRATION DATE: FAX NUMBER.
- - (362)yc 07L
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(coPy of card required with each application) / /
LENDER NAME: DAYTIME PHONE:
(If P,oposed value>$5,000) ( ) -
MAILING ADDRESS(STREET ADDRESS,): CITY,STATE,ZIP
APPLICANT: NAME: COMPANY OFFICE PHONE:
NAME:,.....
of Cain--b"et e4_ ( )
MAILING ADDRESS(STREET ADDRESS). CITY,STATE,ZIP EVENING PHONE.
( )
RELATIONSHIP TO PROJECT. FAX NUMBER.
❑ Architect ❑ 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:
IEXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
i rt
• 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(commercial) 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 fro.kt) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sime 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 as a part of this application.
NAME/TITLE: 4,i IA • i
DATE: / r Z 11''&
^(Slgn.ture� ' (Title)
RELATIONSHIP TO PROJECT: ❑ Property Owner ❑ Applicant .e'C-ontractor ❑ Architect ❑
FOR OFFICE USE ONLY:
a NEW a ADDITION o ALTERATION o REPAIR o 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? o YES o NO UP/SEPA/SU? D YES a NO
PLATTED LOT? a YES ❑NO DEMO PERMIT REQUIRED? o YES a NO
!;u-.tl.-t t:U:• Page 2
• 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) CI 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 U 0 to 200 amp $ 94.50
(Inspected separately from service) ❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 amp $ 72.50 ❑ 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)
❑ it 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
❑, Se�rvi a or feeder only $58.00
Lf 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 ❑ #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 ❑ Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
O Data Cabling
0
(Per System(s): ls,2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) •Per WAC 296-46-910(5)(6)0&U)
1 Page 3
This is an overview of possible fees associated with the issuanc. of perltnits and is not intended to be inclusive.
PERMIT FEES
Building,mechanical,and fire prevention system fees are based on the following schedule.
**Electrical and plumbing fees are calculated separately**
TOTAL PROJECT VALUATION INCREMENTAL FEE FACTOR
(1)$1 00 to$500.00 (1)$30.50
(2)$501 00 to$2,000.00 (2)$30.50 for the first$500.00 plus$4 00 for each additional$100 00 or fraction thereof,to and
including $2,000.00
(3)$2,001.00 to$25,000 00 (3)$90.50 for the first$2,000.00 plus$18 00 for each additional$1,000 OO or fraction thereof,to and
including$25,000 00
(4)$25,001.00 to$50,000 00 (4)$504.50 for the first$25,000.00 plus$13 00 for each additional$1,000 00 or fraction thereof,to
and including$50,000.00
(5)$50,001.00 to$100,000.00 (5)$829.50 for the first$50,000.00 plus$9.00 for each additional$1,000.00 or fraction th cof,to
and including$100,000.00
(6)$100,001.00 to$500,000.00 (6)$1,279.50 for the first$100,000.00 plus$7.50 for each additional$1,000 00 or f.ction thereof,
to and including$500,000.00
(7)$500,001.00 to$1,000,000.00 (7)$4,279.50 for the fist$500,000.00 plus$6 00 for each additional$1,000 0r .r fraction thereof,to
and including$1,000,000 00
(8)$1,000,001.00 and up (8)$7,279.50 for the first$1,000,000.00 plus$4.50 for each additional . 000.00 or fraction thereof.
Table A
PLAN REVIEW FEES
• Building Permit 65% of Building Permit Fees
-__ • Mechanical Permit 25% of Mechanical Permit Fees-_
• Plumbing Permit 65% of Plumbing Permit Fees
• Additional Review $61.00/hour
PLUMBING PERMIT FEES
• $26.50 Permit Fee plus $9.50 per fixture
OTHER FEES (Vary according to project type and s .pe)
• WA State Building Code Council (SBBC) Sur, arge $4.50/issued permit;
• Fire District #39 review fees (commercial o y) 15%of Building Permit Fees
• Public Works review fees Hourly/varies by project
• School District Impact Fees (new resid- tial only) $3,269.00/single family residence
$ 940.00/multi-family unit
• Demolition Permit Fees
• Required Bond(s)/Deposits
If you need assistanc- completing the permit application form, or have questions
conce ing the application process, please contact:
Community I-velopment Customer Service Counter at (253) 661-4115
8:00 am to 5:00 pm, Monday through Friday
I;
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