05-102443 City of Federal Way Electrical Permit #: 05 - 102443 - 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) 835-30511
Project Name: TIME OUT TAVERN
Project Address: 34525 16TH s ptvi. S Parcel Number: 889700 0060
Project Description: Install low-voltage security alarm.
Owner Applicant Contractor
TIME OUT INN TAVERN CHUBB SECURITY NW.,INC dba SECURE S CHUBB SECURITY NW.,INC dba SECURE S
34525 16TH AVE S 150 12TH AVE 150 12TH AVE
FEDERAL WAY,WA SEATTLE WA 98122 SEATTLE WA 98122
98003 (206)521-5678
Electrical Fixtures
Description Quantity Description [Quantity Description Quantity
Low Voltage Burglar Alarm -Comme 5552
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 5)and must comply with FWCC,Chapter 22,
Article XIV"Critical Areas" and fill out a Hazardous Materials Inventory Statement,if applicable.
PERMIT EXPIRES November 20,2005.
Permit issued on May 24,2005
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: %�"""•401 � i �� Date: 6-/2. / 2 Cc
F I
NAKED
0
</C.071
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community-Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-102443-00-EL
Owner: TIME OUT INN TAVERN
Address: 34525 16TH AVE S
FEDERAL WAY, WA 98003-6802
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) 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) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
O Rough Electrical(4225) .❑ Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved Approved
By Date By Date G] Date
❑ Under-slab groundwork(4295)
Approved
By Date
RECEIVED
Federal Way MAY 2 4 2005 PERMIT • F
OOUMTJmrnevEWPMExr SF MF COM ,L DE EN FP
JJ34F FEDERAL WAY,WA7H•M3�Y OF FNDF LI CATI O N
53432607'FAX
98063-9718 BUDDING _
45JJJ5-?607•TAX 453-035-4609
wpm.yityatier_ y.an
The ollowi • is re• iced in ormation-an Inco •fete • ••iication will not be acce•ted. Please • • •1 in or
IN PROPERTY INFORMATION
SITE ADDRESS 3215 2 3 o 9 5�+, /40-1-)+ '1 A JE- 5, SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# o -7v O- 0 0 () 0 LOT SIZE(sfl
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(AMA spa ate Pegs far Imes&kW,d ,
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
Loy) 1)01.--TA(r>. ALA Rt-1 , 5 y-3-re.ril -
PROJECT NAME(Name of Business or Owner Last Name) '77.--,c o Lki- 10,1 JLia 9
` Ni PEOPLE INFORMATION
PROPERTY NAME'
-rAPRIMARY PHONE
OWNER I ,;ne c),-.-.- vk.g..� ( z,.. ) ` 3g - Ocg(O
MAILING ADDRESS CITY,STATE,ZIP -
34S2_S` ( (o`— e._ S F6.6
I CONTRACTOR COMPANY NAME APPLICANT NAME
OFFICE PHONE
CI-10 Be �cc,J,Z-: (4'4', ) z, - ‘3‘10.
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
15C• 1 2:r4 Ad£ ,S'k.A,-rt..k. I.JA, 581zz ( ) )
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER J EXPIRATION DATE FAX NUMBER
20 - 00 - 1 0 3 2 Se2-B L / I ( Io� ) 5"Z- - 5310
CONTRACTORS REGISTRATION NUMBER(copy of card rogaind with each applicatioal EXPIRATION DATE
I /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
6-00-�AcT oGZ ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
a Architect a Tenant a Agent a Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE (v. $2(-5‘.1g E-MAIL ADDRESS
Rt.)(.. p .s tit-4-7m .5-r nansK4 ( :sat, ) 7 s . -7,./:;‘, -
LENDER
MAILING ADDRESS lip• ,STATE,ZIP
Aliggilliiihh....
• ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? O YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? O YES 0 NO
WATER SERVICE PROVIDER O LAKEHAVEN a HIGHLINE 0 TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER O LAKEHAVEN a HIGULINE 0 PRIVATE(SEPTIC) •
•
-
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT. _
BASEMENT
FIRST •
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
•
NUMBER OF FLOORS cXIsruo PROPOSED Toru f1 _--rtR ;s
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture 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 comm.
rciso 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 Romp MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
I.AVS(Bathroom sinks' 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 5 L fgpiL DATE ,•••-......5!d1/4Acia5---
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ wner a Agent ❑ Contractor a Architect a Other
' <PPl'!. . :aOLP.r'(c)4 Ai,,k)_•)4.‘10.04 TM--.
c ,._ •/ ,.0.3
e}i,lfe=: :c�l,r e) li :s' 1 .� j : i (c, i',5.:..i.)( -t4 1 M�"
ti4
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za ! ; Y ;n I . �(0) :'' :4,,W,'t. 1 ' ' -''t�D: ;ick
+ Bulletin#100-January 7,2005 Page 2 of 4 kU Iandouts\I'ermit Application
V V/ .V/ V V 14 V 1 1 V i ♦a W V a a a V• .4S#u.u.a. It 455 W,JU V 1
BUILDING DIVISION
oe =I No �� fAu j+ p, 33530 First Way South
Federal Way WA 98003
(253)661-4000
Fax(253)6614129
ELECTRICAL PERMIT APPLICATION
***Federal Way Business License number: 2 0-O D 1(nZ641 ELE 00 -'1L
lab Address 31.151 S l�o 5 Job Site Phone 253 --m$ ob$(o
Pared No Lot No Subdivision Name
Owner/arrant Mall Address Phone
� _ C `'CEVk•ea-e.•l 15 Z 5 kbdll• ZA_t- S Z53-W38 -Ob8(c
Electrical Contractor Address/phone 19::0 !Z 1 h *AL Q. Electrical contractor license number (•7r r.f.4
wA- 48 t2Z- C' Mcjgel 3 2
. C •gb SC.e -i 7.0(0) 2b0(0) 51.1. 534.0 Expiration Date: 04/ / t
Uao amaino SF Res Carom 0 Other Multi DChurddScbaol Glue olWoric a New )Alteration 0 Addition 0 Repair
Description of work
Lw vottAilt, Ak 5/54e,‘"^-
NEW RESIDENTIAL SERVICES MOBILE HOMES
If service is greater than 200 amp, a -Single Family -Service or feeder only .... $44.25
plan review is req'd. Fee is 35% of (Fun th 7 oo;g add o goo a=421s3) -Servicer and feeder $72.25
permitSquare Feet:
fee+$56.25. Add'1plan review
Each outbuilding or garage . S2E.00 MOBILE HOMEIRV PARK
for other submissions is $67.00/hr. ^(mspected with service) #of service or feedersEach outbuilding or garage. .544.25 -(gust ravicelfeedet444.25'Add'n service/
(Inspected separately) feede.528 each)
MISC EQUIPMENT/TEMP SERVICES NEW MULTifAMILY COMMERC$ALIINDU$TRIAL
. ((ndudo1liee units cc awe)
-#of Thermostats(Fust 433.50;sdd'n.Slosoea) Service Feeder Amps Service or Add'n
-0 of Low voltage fire or burglar alarms -tip to 200 amp S 72.25 . S 21.50 Feeder
0rust 2500�43s.75,Each m14'112500 ttlS10.5o _201-400 amp . 89.75 . .. 44.25 - 1 do 0 S 72.25 . 44.25
*Par WAC 296. . . .
44.910(5)ib)(i&ii) _401-600 amp 123.25 .61.50 -I01--2 200 89.75 . .. 56.25
4 of Signs(First sign-S33.50;add'n sign _601-800 amp 158.00 . ._ 84.25 -201-400 . ... 169.00 . . 67.00
S16.00 each) -Over 800 amp . . 225.25 .. 169.00 -401-600 . . . . 197.00 . . 78.75
_Progress inspection per 4 hr.... $33.50 -601 -800 .. .. ?54.50 . 107.25
Swimming pool,hot tub,spa .... 67.00 -801 -1000 . . . 310.75 . 129.75
339.00
_Temporary Pole(up to 60 amp) . . 38.75 -Over 1000 •••• charge . 181.00
Yard Pole meter loops 44.25 Over 600 volts surchargelrarge .. 56.25
- Mast or meter repair 61.50
ALTERED SINGLE/MULTI FAMILY COMMERCIAL/INDUSTRIAL
Inspections requested before 3:30pm will be (When inspected separately from the Altered Service or Feeders
made the following work day,253.661.4140. services.) _0 to 200 S 7215
_201-600 169.00
Thereby certify that 1 em the owner(or authorized Service or Feed= ......
601-1000 254.50
agent)of the above named property,ora licensed 0 to 200 amp S 61.50 over 1000 282.75
contractor(or firm's authorized agent)and em 201-600 amp 89.75 _#of circuits
making the installation or alteration is _over 600 135.25 (1-5 circuits-S56.25;Add'n circuits,55 ea)
compliance with all applicable city,county, _Mast or meter repair 33.50
and/or state laws. _4 of circuits Temporary Service
(1-4 drruits-544.25;Md'acircuits S5 ea) 0 to 60 538.75
Applicant's Signature: _61-100 44.25
_101-200 56.25
_201-400 67.00
_401-600 89.75
Date: over 600 97.75
J,_
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nom.WINO
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
CI Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$104.50;Each add'n 500 ft2-$33.50) ❑ 0 to 100 amp $113.50 $69.50
❑ Detached outbuilding or garage ❑ 101-200 amp 141.00 89.00
(Inspected with service) $44.00 0 201-400 amp 264.50 104.00
❑ Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50
(Inspected separately) $69.50 ❑ 601-800 amp 398.50 168.50
❑ 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 530.50 283.00
Service Feeder
❑ Up to 200 amp $113.50 $33.50 ❑ Over 600 volts surcharge $89.00
❑ 201 -400 amp 141.00 69.50 ❑ Mast or meter repair $96.00
0 401 -600 amp 193.00 96.00
❑ 601 -800 amp 247.00 132.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ 0 to 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY 0 201-600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
❑ Oto 200 amp $87.00
❑ 201 -600 amp 141.00 ❑ #of circuits to be added/altered
❑ over 600 amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$69.50;Add'n circuits$7.00/ea) $89.00 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $52.00 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $69.50
❑ Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $61.00
❑ #of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0-100 amps _ $69.50
❑ 101-200 amps 89.00
❑ 201-400 amps 104.50
❑ 401-600 amps - 141.00
❑ over 600 amps 152.50
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signs
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea)
li Low Voltage ❑ Swimming pool/hot tub $87.00
iSquare Feet to be served by system(s) 55 (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $104.50
) 0 Security Alarm System ❑ Additional Plan Review
❑ Voice Cabling $104.50/hour
(for modified submittals)
0 Data Cabling
CI Automation Fee on all Permits .. $5.00
(Per System(s)•la 2500 ft2-$61.00; _
Each add'n 2500 ft2-16.00) •Per WAC 29646-910(5)(h/(&til
1
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Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application