04-102677 City of
nits DevelopmentelFederalWay
Services
Community Electrical Permit #:04 - 102677 - 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: ROLLINS
Project Address: 29349 2ND SW Parcel Number: 119600 1305
Project Description: Security sy temV
iL
Owner Applicant Contractor
Robert Rollins &Sharon Rollins SECURITY SYSTEMS SECURITY SYSTEMS
27901 21ST AVE S 23416 SE 216TH WAY 23416 SE 216TH WAY
FEDERAL WAY WA MAPLE VALLEY WA 98038 MAPLE VALLEY WA 98038
98003-6949 \ (425)413-9244
Electrical Fixtures
Description Quantity Description Quantity i Description Quantity
Low Voltage Burgler Alarm-Residen 5720
PERMIT EXPIRES January 3,2005.
Permit issued on July 7,2004
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: ,%� � .7.---
��' Date: - / cV S'
FINALE
6 1-)
o
THIS CARD IS TO REMAIN ON-SITE
CITY OF 11111 Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-102677-00-EL
Owner: ROBERT ROLLINS
Address: 29349 2ND AVE SW
FEDERAL WAY, WA
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.
O Slab/Concrete Floor(4255) l'' Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date B Date 9,—Z-7_04\ By Date
❑ Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
‘10 Rough Electrical(4225) ❑ Ceiling Cover(4020) ,❑ Final-Electrical(4055)
Approved Approved Approved
By s Date y_1S �_ k By Date t G Date, — --p
❑ Under-slab groundwork(4295)
Approved
By Date
c
es
RECEIVED CONSTRUCTION PERMIT APPUCATION
CITY OF :
kitAtIONINUMBSti
Federal Way : -
EDL-RAL WAY �- - :
. �.._...
**The folliyAggh iisAtlnformation-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
Of
SITE ADDRESS: .2935/9 0? /9:4-e SST/ ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT_PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑BUILDING ❑PLUMBING ❑MECHANICAL ❑DEMOLITION
>sr ELECTRICAL ❑ENGINEERING ❑FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
t°7sf�// /w fro/.pie 44 4---
PROJECT NAME:
• PROJECT INFORMATION
PROPERTY OWNER: NAME:ac
/c / 47, DAYTIME PHONE:
(e2S ) 36 7 - Sys
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
S'
CONTRACTOR: S e- • f -/�'£ �- (Y, y/2 - y s�
�,�
MAILING ADDRESS(S�y ADDRESS;CITY,STATE,ZIP): q ;g EVENING PHONE:
�3 y/C se' .2/e' 41' Z/•- / 1`, l/.�/�s J 4//7- (f-.r ) S//.3 - y-2Jis�
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: 1 / FAX NUMBER:
9 - 99 L o b T - as-y/3 - Y.J
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) Se C cl 'f -s 2L= .L 3 ..6 .1)4-'. 3 /--- 1
APPLICANT: NAME: DAYTIME PHONE:
PCS n'/f J�, P/zi./ (f'�-r) Y/3 -9-?
MAILING ADDRESS(SI4EFADDREa CITY,STATE,ZIP): / / J EVENING PHONE:
RELA3R Pro Ea:.2/6 ''r Gri�i'i //�j 6 (/.�`� (f/.2f ) y/3 -
/' c% FAX NUMBER:
❑ARCHITECT ❑TENANT (OTHER(DESCRIBE): G������"'- (f x21 ) V/3
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER ❑APPLICANT ❑CONTRACTOR 4,44,4/7-2 .
■ PROJECT INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES ❑NO
WATER SERVICE PROVIDER: ❑LAKEHAVEN ❑HIGHLINE ❑TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑LAKEHAVEN ❑HIGHLINE ❑PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DEO(
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOtER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOODS) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKERS) n ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ 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 daim(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(Sty of
Federal Way,but only where such claim arises out of the reliance of the city,inducting its officers and employees,upon the accuracy
of the information supplied to the city as a part oft this application.
NAME/TITLE: Vii' O4„� — DATE: 7 _ 7 — U Sr
a PROPERTY OWNER a APPLICANT )if CONTRACTOR
NEW 3 ADDMON:-.-:;:::1:1ALTERATION_-::::-o_REPAIR_: :-_::_altleAtirlikWRQM1110 _::__ =
CENSIIS COD&r::..: . :.::..:::::::.:`; >:LOT SU&:: :: :-::_ ::.:-:.:::.: :
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COMPa AN DESIGNATIOt::-;:.:.::_:.;:::: -- ::;.: :B SIC mart 7. O Y :. '
NO
SECTION .. -:„ :TOSA IP:- :RANGE.. ..: tEWS RE4UIC ? 04ES--- _a 40 -.'IPL :..
:: o:YES : rf:N� >: :: : .: 01AMIGE ?: a YES'-'11 _ ::
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718.253-661-4000•FAX:253-661-4129
■ ELECTRICAL
TABLE B
. NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
-Single Family _Service or feeder only $57.00 _#of Thermostats(First-$43.00;add'n-S13.00ea)
(First 1300 f12-$85.50;Each add'n 500 R2-$27.50) _Service and feeder $93.00 _#of Low voltage fire or burglar alarms
Square Feet: First 2500 f12-5 0;Each add'n 2500 ft2-$13.00
-Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _#of service or feeders *Per WAC 96-46-910(5XbXi&ri)
-Each outbuilding or garage $57.00 (First service/feeder-$57.00;Add'n service/ #of Signs(First sign-$43.00;add'n sign
(Inspected separately) feeder-537 each) $20.00 each)
_Swimming pool,hot tub,spa $85.50
-Yard Pole meter loops $57.00
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or more) Altered Service or Feeders
Service Feeder Amps Service or Add'n _0 to 200 $ 93.00
-Up to 200 amp $93.00 $ 27.50 Feeder _201-600 216.50
_201-400 amp 115.50 57.00 _0 to 100 $ 93.00 $ 57.00 601-1000 326.50
_401-600 amp 158.50 78.50 101-200 115.50 72.50 _over 1000 363.00
_601-800 amp 202.50 108.50 _______201-400 216.50 85.50 _#of circuits
_Over 800 amp 289.50 216.50 _401-600 252.50 101.00 (1-5 circuits-$72.50;Add'n circuits,$6 ea)
ALTERED SINGLE/MULTI FAMILY _601-800 326.50 138.00
(When inspected separately from the services.) _801-1000 399.00 166.50 TEMPORARY SERVICE
Service or Feeder _Over 1000 434.50 232.00 Residential/Multi-Family/Commercial/Industrial
_0 to 200 amp $ 71.50 Over 600 volts surcharge 72.50 _0-100 $ 57.00
-201-600 amp 115.50 _Mast or meter repair 78.50 _101-200 72.50
_over 600 amp 174.00 _
201-400 85.50
-Mast or meter repair 43.00 _401-600 115.50
-(1-4 circuits-$57.00;Add'n circuits$6 ea) -
If a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps,a plan review is required.Fee is 35%of
permit fee+572.50.Add'l plan review for other submissions is$85.50/hr.
Total Colum(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from rine 12
Estimated Plan Review Fee: $72.50+( X.35)=(13)
• DEMOLITION
Estimated Permit Fee: (14)
Bond Amount(15)
• ENGINEERING
Estimated Permit Fee:(16)
Bond Amount (17)
• OTHER FEES
Mitigation Fee:(18) (20) (22)
SBCC Surcharge:(19) (21) (23)
Total(Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)=(24)
,