02-101379 Cr ity lei ederal Way Electrical Permit #:02 - 101379 - 00 - EL
Community Development Services
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: RILEY
Project Address: 31916 34TH SW Parcel Number: 698000 0480
Project Description: ELE-Replace 200 amp panel
Owner Applicant Contractor
CLAIRE RILEY ELECTRO SERVE LLC ELECTRO SERVE LLC
31916 34TH PL SW 13547 SE 27TH PL SUITE 3-D 13547 SE 27TH PL SUITE 3-D
FEDERAL WAY WA 98003 BELLEVUE WA 98005 BELLEVUE WA 98005
(425)451-3358
'
Electrical Fixtures
�: - �'Desciption'. ! , '{Quantity, : �: 0.ecription` , ,``;�'{Q
uanti� ';i._':_ Descri tion .
` r REGG RECEIVED CONSTRUC I ION PERMIT APPLICATIONC
• APPLICATION NUMBER: Dv2-
uv APR 032002 _ � �� s� l- QQ
APPLICATION NUMBER: -
CIN O FEDERAL WAY•
APPLICATION NUMBER: - -
Tt@lf QSteTruired information—Please print(ih ink)or type** •
Please note: Electrical,Fire Prevention stems and Engineering permits may require a separate application.
!'4 :-PROPERTY INFORMATION" - ' . - -
SITE ADDRESS: L \\ so 31\—cam 'Q. L S,USSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• °., .=- . PA . PRO]ECTINFORMATION . - , .
TYPE OF PROJECT(This application): ❑ UILDING ❑ PLUMBING ❑ MECHANICAL ID DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): �,J �� v�� ZCs-A- ( .Qz t 1)/LA
PROJECT NAME:
- . _ :. _. '74'.PEOPLE INFORMATION
PROPERTY OWNER: NAME' DAYTIME PHONE:
C 6,01c2�.1 e#PJ ) s71-4- SEA&
MAILING ADDRESS(STREET ADDRESS,CITY,STATE, ):
CONTRACTOR: NAME. DAYTIME PHONE:
CC Q .. .� \( t ) C/S-
MAILING ADDRESS(STREET ADDRESS,CITY,STATE,ZIP)- EVENING PHONE: 1
\'S L`-**) S 2r? lik_e")•• ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
)
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
° )
MAILING ADDRESS(STREET ADDRESS,CITY,STATE,ZIP) EVENING PHONE:
RELATIUNSH O P OJ E. �� _ L. ( )
FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
-: -• - .R DETAILED BUILDING INFORMATION ' -
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: - PROPOSED VALUATION •• • •ROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES *Mo..— RE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVI •• _ • •: ❑ LAKEHAVEN ❑ HIGHLINE ❑ T• • ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPT
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• • .. • - -- ■ PROTECT FLOOR AREAS •
•
FLOOR EXISTING SQ.FT. ` PROPOSED SQ.FT. TOTAL
•
• BASEMENT* •
F1
zz/-
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCR • )
DECK
GARAGE
HOW MANY FLOORS?
TOTAL
M FIXTURES
•
ndicate number • each type of fixture
MECHA •L
AIR HANDLING • (S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOI • ) FIREPLACE INSERT(S) RANGE(S) MISC.( )
•= 'PRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) •T SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ CTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SI K(S) WATER CLOSET(S) M )
INTERCEPTOR(S) S P(S)
: •'174 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(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information sup - to the city as a part of this application.
7
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
-FOR OFFICE USE ONLY:
_❑.NEW=-=`= =fl ADDITION ❑ ALTERATION_ - -❑ REPAIR ❑TENANTIMPROVEMENT - --
'CENSUSCODE: LOT SIZE: - . -
-ZONING DESIGNATION: BUILDING SHELL-ONLY? ❑YES ❑ NO
-COMP=PLAN DESIGNATION _ BASIC PLAN? = ❑ YES ❑ NO •
_ 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:253-661-4129
www.citvoffederalway.com
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-SII.SOca)
(First 1300 ft2475.00;Each add'n 500 Ill-$24.00) _Service and feeder $81.00 #of Low voltage fire or burglar alarms
• Square Feet: First 2500 ft2-S43.50;Each add'n 2500 ft2-$11.50
' . Each outbuilding or garage...... $31 00 MOBILE HOME/RV PARK Square Feet-
• (Inspected with service) _k of service or feeders ' I'cr WAC 296-46-910(5)(b)(i&ii)
_
Fad'outbuilding or garage . $50.00 (I irst service/feeder-$50 00,Add'n service/ __is of Signs(First sign-$37.50,add'n sign
(Inspected separately) feeder-$32 each) $17 50 each)
Swimming pool,hot tub,spa .575 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 am 101.00.... ...... 50.00 _Oto 100 ... ......... $ 81.00 . . .
P $ 50.00 601- 1000 284 50
_401-600 amp 138.00... . 68.50 _l01-200.......-... 101.00 63 50 _over 1000....................................317.00
_601-800 amp 176 50... .........94.50 _201 -400.......... .. . 189.00 75.00 _t#of circuits
_Over
800 amp 252.50.. ........ 189.00 _401-600 220.50.........88.50 (I-5 circuits-$63 50,Add'n circuits,$5 ea)
ALTERED SINGLE/MULTI FAMILY _601 -800... .-. 284.50....... 120.50
(When inspected separately from the services) _801 - 1000.. .. .........348.00.. .. 145 50 TEMPORARY SERVICE
Krvice or Feeder _Over 1000 . .... . . 379.00 . .202.50 Residential/Multi-Family/Commercial/Industrial
0 to 200 amp- .. .$ 68 50 _Over 600 volts surcharge ..........63 50 _0- 100- ..... .. ...- ........$ 50.00
_201-600 amp . 101 00 _Mast or meter repair......... . ... . ... 6850 _101 -200..... ... . . ..... ... ......63 50
over 600 amp.. .......... . - .. 151 50 _201 -400. .. ..... .. . ... . .. . 75 00
_Mast or meter repair.... 37.50 401-600
101 00
_k of circuits _over 600 .... 109 00
(1-4 circuits-$50.00,Add'n circuits$5 ca)
If service is greater than 200 amp.a plan review is req'd Fee is 35%of permit fee+$63 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
I
TOTAL COLUMN(D):
Total Column(D) i
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50 +( 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)
SE4CC Surcharge: (19) (21) (23)
Total (Pages one&Two>: Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)4(21)+(22)+(23) = (24)
Bulletin 11100—January 18, 2002