04-105241 •City of Federal Way Electrical Permit #: 04 - 105241 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-30513
Project Name: ZALUSKA
Project Address: 5320 SW 316TH el Parcel Number:321020 0351
Project Description: Change out 100-amp panel.
Owner Applicant Contractor
Henryk Zaluska &Wieslawa Zaluska L&D ELECTRIC L&D ELECTRIC
5320 SW 316TH PL 14811 16TH AVENUE CT S 14811 16TH AVENUE CT S
FEDERAL WAY WA SPANAWAY WA 98387 SPANAWAY WA 98387
98023-2039 (253)208-6582
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES June 27,2005.
Permit issued on December 29,2004
I hereby certify that the above information i correct and that the construction on the above described property and
the occupancy and the use will'in acc ce with the laws,rules and regulations of the State of Washington and
the City of Federal Wray) - / l
Owner or agent f - / Date: /2 -2 cf— O c/
1 \
THIS CARD IS TO REMAIN ON-SITE t
. A
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-105241-00-EL
Owner: HENRYK ZALUSKA
Address: 5320 SW 316TH PL
FEDERAL WAY, WA 98023-2039
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.
0 Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date • By Date
•
❑ Temporary Power(4275) 0 Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) Final-Electrical(4055)
Approved Approved Approved
By Date By Date B \'k\S Date (ZIAPkt.k
I-
❑ Under-slab groundwork(4295)
Approved
By Date
a"ef.4.. • RECEIVED O - 7 S 2. (4 i
Federal Way PERMIT
COMMUNITY DEVELOPMENT SERVICES DEC 2 9 0 SF MF CO M L L DE EN FP
3332 FR L O SOUTH.PO 97I8 PLICATION r°
FEDERAL WAY,WA 98063-9718
/ /
w.th u.
253835.2607'FAX 2s383s-2 .NTY OF FEDERAL WAy o ederalwacom BUILDING DEPT,
The oliowing is required information-an incomplete a.•lication will not be acce•ted. Please •rint legibly(in ink)or type.
/`� I ,/ al PROP/ERTY INFORMATION
ITE ADDRESS !? ' 2 V 3 A , 3/(O /ii, / SUITE/UNIT#
SSESSOR'S TAX/PARCEL# - _ LOT SIZE(sf)
/// LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) / () A o fl 1Gia f c124 k C
(Attach separate page for lengthy legal description) .l
■ PROJECT INFORMATION •
r--TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
..p' L
.-_T OJE T DFSCRIPTIO (Provide detailed description of work included on this permit on1U)
,m 19 2 ncl Chc,q.Se_
%----1/PROJECT NAME(Name of Business or Owner Last Name) 119 CS`..4 (.v1 l
is PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER 1., (2.5.1;IA Vi1t /l,N-/
_ MAILIN7s
CITY,STATE,ZIP �� _
5-3 24 L5 k1 3/G � iedERm J_ /4)c.
CONTRACTOR COMPANY N ME AP NT NAME OFFICE PHONE
d-- b 1zedr-c_ t /1 IiciV;4 ( ) 5'-3i 0200
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
—B L / / ( ) -
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
I /
APPLICANT COMPANY NA APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT • FAX NUMBER
❑Architect 0 Tenant a Agent 0 Other(Describe) ( ) -
I
CONTACT NAME ! PRIMARY PHONE E-MAIL ADDRESS
1, ( ) -
t LENDER ' '<P CW '9. 7.095: Lende-ir4(ormationis. • NAME
eguire4 prpject value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
- - ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
• EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ •
1
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ,❑YES 0 NO
i WATER SERVICE PROVIDER 0 LAKEHAVEN ❑HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
. AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DES '• BE) •
DECK(COVERED?)
GARAGE/CARPORT N\
HOW MANY FLOORS? ` To• EXISTING TOTAL PROPOSED TOTAL UaSTDIG AND PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS \N ESTIMATED SELLING PRICE $
FIXTURES _ = .
Indicate number of each type off xture to be ',.tailed or'elocated as part of this project. Do not include existing fixtures to remain.
MECIIANICAL \
Value of Mechanical Work $
•
• AIR HANDLING UNITS EVAPORATIVE COOLER 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 rTub/Shower Combo) SHOWERS WATER CLOSETS Ir•acq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS tI oomsinky VACUUM BREAKERS ELECTRIC WATER HEATERS
- _ 1,-:- _:`" -' -- , _.: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 • to any taim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim),which mag'1e masi'e by •ny p so including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the r Ianc4l oftlte ci ,inc ud its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. _ O
•
_-,_
.,
•
NAME/TITLE` / DATE /2 zLT
4Signature( (Title)
! R9 A IONSHIP TO PROJECT 0 Owner o Agent ❑ Contractor ❑ Architect 0 Other
E
( 'FOR OFFICE USE ONLY
• o NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
1 BUILDING SHELL ONLY? o YES a NO BASIC PLAN? o YES a NO
1 I ZONING DESIGNATION CHANGE OF USE? a YES a NO
t NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a NO
• F
t
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Bulletin#100—March 30,2004 — Page 2 of 4 k\Handouts—Revised\Permit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(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 U 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
i ❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
1 ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
0 to 200 amp $ 72.50 ❑ over 1000 amp 369.50
❑ 1 -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) $74.00 plus 35%of Permit Fee
❑ Mast or meter repair $43.50 ❑ Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES
❑ Service or feeder only $58.00 TEMPORARY SERVICE
❑ Service and feeder $94.50
I Commercial Residential
MOBILE HOME/RV PARK ❑ 0- 100 $58.00 $51.00
❑ #of service or feeders ❑ 101 -200 74.00 51.00
(First service/feeder-$58.00;each add'n-$37.50) 0 201 -400 87.00 n/a
❑ 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 U 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)
❑ Data Cabling
(Per• System(s) 1•,2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) 'Per WAC 29646-91 o/Sl fblti&ill
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Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Rcvised\Permit Application