02-101628 City of Federal Way
Commur�ty Development Services Electrical Permit #:02 - 101628 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.C.1 4129 Inspection request line: 253.835.3050
Project Name: NEO DENTAL INTERNATIONAL
Project Address: 2505 S 320TH Suite250 Parcel Number: 797820 0535
Project Description: ELE-Alteration of up to(5)circuits for relocation of electrical outlets and switches for Minor tenant
improvement work.
Owner Applicant Contractor
PRIMESTAR INVESTMENT CORP*Mr NIZA CORNERSTONE ELECTRIC INC CORNERSTONE ELECTRIC INC
PRIMESTAR INVESTMENT CORP 8425 25TH ST E 8425 25TH ST E
2505 S 320TH ST SUITE 101 PUYALLUP WA 98371 PUYALLUP WA 98371
FEDERAL WAY WA 98003 (253)922-1191
Electrical Fixtures
`�escriptaon-: :-:,:�, �Qual iti y, rt �escript1on '- Quaintity „ ; Description { ‘, (Quantity
Circuits- Commercial 5
PERMIT EXPIRES October 14,2002,IF NO WORK IS STARTED.
Permit issued on April 17,2002
•I hereby •-rtify at the above informati,, is • . that the construction on the above described property and
the occupa.cy an. he use will be in acc dan•- laws,rules and regulations of the State of Washington and
the City of F-'eral \ ay. 1
Owner or agent: I,
%V•• �- Date:
riser'
•
4- 19- o z wwdv-eD
- 2-- o 7 Fil-IAA tilt°NI-ED
72
•
J
� _°� GCONSTRUCT l ION PERMIT APPLICATION
\W FIv EcEtVED APPLICATION NUMBER:6 Z-ld/�i 28_
APPLICATION NUMBER: -
APR 1 6 2002 APPLICATION NUMBER: - - -
cri-Ver-Freeiniwroluired information—Please print(Ih ink)or type** •
Please note: ElectrIM409APnTion Systems and Engineering permits may require a separate application.
- ; -::---.---:•-• - - _ ■;:PROPERTY INFORMATION -
SITE ADDRESS:gf S2 S?j�0 0R5C7 ASSESSOR'S TAX/PARCEL #: 79.7t2o_ _ - dr3cr
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
;'_-a -.:':-.•;-' -. -= --.3-/. PROJECT INFORMATION _ . . . - . . . -
TYPE OF PROJECT(This application): El . ILDING ❑ PLUMBING El MECHANICAL El DEMOLITION
// ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PR JECT DESCR N(Provide detailed description): (Q -e_
LSCA /i� P
PROJECT NAME: N L-.`1 De.. . J A- L_ „v-7 L1Lt- eiJ t o- j-e_c__Atrt:c....ak 0(4A2 OS
oL
.,' -' - ` . - ----■'PEOPLE INFORMATION =_ .• �: --.:•:-•- _ - _ - _.
PROPERTY OWNER: NAME: t DAYTIME PHONE:
/NA STA i -. ( )
MAILING ADD ESS STREET ADDRESS;CITY,STATE,ZIP)
CONTRACTOR: NAME.
DAYTIME PHONE:
rrOdVer Cee ( ) -
MAILING ADDRESS(STREET ADO S//S;CITY,STATE,ZIP): EVENING PHONE:
SG1.." ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER- FAX NUMBER:
( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required)�l// • 7r...(40_7;04.4.0 / /
APPLICANT: NA - DAYTIME PHONE:
_ * _ ► - 24-04 - - L.E z Tc__,. 253) ago- �s/o
M'i Amp 55(STREET ADDRESS,CRY,ST. :_ P- nn EVENING PHONE:
RE�iNS IFcC PRO .i2.4 OC LliC9e ,---4---CS-L-9- --_/191
��
FAX NUMBER:
❑ ARCHITECT ❑ TENANT El OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: El PROPERTY OWNER El APPLICANT ❑ CONTRACTOR
:,-:•: :' :'•- - - ' - =- - `•■ "DETAILED BUILDING INFORMATION ' - '-'-'1 ::- -.- - -.' ,
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES El NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 111 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** `-
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
. _ -• ■ PRO]ECT FLOOR AREAS •
•
- FLOOR EXISTING SQ.FT. ' PROPOSED SQ.FT. TOTAL
• BASEMENT- -
' FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS? .
TOTAL:
- - ■ FIXTURES •
Indicate number of each type of fixture -
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) '
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) - WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) _ MISC.( )
INTERCEPTOR(S) SUMP(S)
. .. .. ' .•■ 'DISCLAIMER/SIGNATURE BLOCK ' .• • - V . - -
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
fu . a• ee to hold harmless the City of Fed,-11 Way as to any claim(induding costs,expenses,and attorneys'fees incurred in the
Inv,- :gatio, and defense of such d ,wh••• ••ay be made by any person,induding the undersigned,and filed against the City of
Fed- -I Way, •ut only where such •aim a . ' •fy'of the reliance of the city,induding its officers and employees,upon the accuracy
of the forma••n supplied to thea., as a .: .• • is application.
NAME/ , : !. / Mm DATE:
1/s
Il► ._ , : iii
❑ PROP • ►M ❑ APPLICANT ❑ CONTRACTOR
-FOR US 4 ONLY:
=❑_NEWF`z _f=ADDITION ❑ ALTERATION - II REPAIR 0 TENANT IMPROVEMENT -
'CENSUS CODE: - LOT SIZE: -
_ZONING DESIGNATION: BUILDING SHELL ONLY? 9 YES ❑ NO
-COMP.PLAN DESIGNATION BASIC PLAN? ' ❑ YES ❑ NO -
-SE'CTION_ .. TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
-PLATTED,LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718-253-661-4000•FAX:253-6661-4129
www atyoffederaiway.com
•
■ ELECTRICAL
TABLE B ,
•
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only - $50.00 _#of Thermostats(First-$37.50;add'n-S 1 I.Soca)
(First 1300 ft2-$75.00;Each add'n 500 111-$24.00) _Service:and feeder S81.00 #of Low voltage fire or burglar alarms •
• Square Feet: First 2500 ft2-543.50;Each add'n 2500 ft2-S 11.50
• - _Each outbuildingor garage.... • ...S3I 00 MOBILE HOME/RV PARK Square Feet:
• (Inspected with service) _k of service or feeders • Per WAC 296-46-910(5)(b)(i K ii)
_Eaeh outbuildingor garage 550 00 (I list service/feeder-550.00,Addh service/ _I:of Signs(I list sign-537.50,add"n sign
(Inspected separately) feeder-532 each) $17 50 each)
Swimming pool,hot tub,spa ... . $75 00
_Yard Pole meter loops... .. .. ....$50 00
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or more) Altered Service or Feeders
Service Feeder Amps Service or Add'n 0 to 200 ............... ......... ...$ 81 00
_Up to 200 amp S 81.00- $ 24 00 Feeder —201 -600. . ...... ........... ...189 00
_201 -400 amp 101.00... ............50.00 _0 to 100 - . . .5 81 00 - . $ 50.00 _601 - 1000... ..... ................ 284.50
_401-600 amp I38.00..... ...........68 50 _101-200 101 00 63.50cr 1000 317.00
_601-800 amp 176 50...............94.50 _201 -400 189.00.... .. 75.00 #of circuits
_Over 800 amp 252.50 ......... 189.00 401-600 220.50..........88.50 (1-5 circuits-563.50,Add'n circuits,55 ea)
ALTERED SINGLE/MULTI FAMILY _601-800.................284 50........120.50
(When inspected separately from the services.) _801 -1000.............. .348.00.. . . 145.50 TEMPORARY SERVICE
Service or Feeder _Over 1000. ...............379 00.... 202.50 Residential/Multi-Family/Commercial/Industrial
_0 to 200 amp ... - ....S 68 50 _Over 600 volts surcharge. 63.50 0- 100 $ 50 00
_201-600 amp .. 101.00 _Mast or meter repair 68 50 _101 -200..... ... ..... ................63.50
_over 600 amp............... .... . 151 50 _201-400. .. . - .............. ..75 00
_Mast or meter repair........ .. .. . 37 50 _401 -600.
10100
_N of circuits over 600 .. . . . .. .. . . . 109 00
_
(1-4 circuits-550.00,Add'n circuits$5 ea)
If service is greater than 200 amp.a plan review is rcq'd Fee is 35%of permit fee+563 50.Add'I plan review for other submissions is$75.00/hr.
FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D)
I
TOTAL COLUMN(D):
Total Column(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50 +( X.35) = (13)
" " - " . - • DEMOLITION . . • . . - .-
1
Estimated Permit Fee: (14)
Bond Amount:(15)
•• ENGINEERING . . -. . . . .
Estimated Permit Fee:(16)
Bond Amount: (17)
.... " - - ■ OTHER FEES -• - - . " - -- - -
Mitigation Fee:(18) (20) (22) 1
SBCC Surcharge: (19) (21) (23)
Total (Pages One&Two): Line(s)(11)+(12)+(13)+(19)+(1S)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin x 100-January 18, 2002