02-101361 C nu Development Services or tyDe Way
Community Electrical Permit #:02 - 101361 - 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: PACIFIC DENTURE CLINIC
Project Address: 33505 PACIFIC S Parcel Number: 926503 0010
Project Description: ELE-Change out 125 amp panel,install new lighting and outlets for TI
Owner Applicant Contractor
DU SIK JUNG GOLD ELECTRIC GOLD ELECTRIC
1402 U CT NW GOLD ELECTRIC GOLD ELECTRIC
AUBURN WA 98001 5121 GALLEON DR NE 5121 GALLEON DR NE
TACOMA WA 98422 (253)227-7712
Electrical Fixtures
-Quantify '== `t7escription :: ;: Quantity ` ":.Description .° Quarit
Alt.Serv./Feeder up to 200 amps-Co 1
PERMIT EXPIRES September 29,2002,IF NO WORK IS STARTED.
III
Permit issued on April 2,2002
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: - �A C Z Date: Z/d
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RECEIVED CONSTRUC I ION PERMIT APPLICATION
• FnE_i ZRL_ APPLICATION NUMBER: Q 2- Q IL
_ _ i
uv Flv OF
0 2 2002 - -
APPLICATION NUMBER: - -
CITY OFFEDERAL WAY APPLICATION NUMBER: - -
BUILDING 0**The following is required un��pp nation-Please print(ih ink)or type** •
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
•-•';-- _-.::-':.--.•: :.--'••'-:'-':'----".--..e:1', II!PROPERTY-INFORMATION. ' ' . -- - - -,-
SITE ADDRESS: b,505 -Pat )1•13S ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY ATTACH SEPARATE DESCRIPTION IF LENGTHY):
.-"''.1:i. i --'-'•:-'7.• . • -.:'--3.1:i:3•:-:..-:'•-•-'. .:-;-a. PRO3ECTINFORMATION 1-. - : ' . . .. .: • :
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING El MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): .,- �� - a
,,!' moi- -›9 r
iall
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PROJECT NAME: V
-., --- --.:• .,...-._,,,_.,:,:-,i.=..PEOPLE INFORMATION -= --- .:.-.--= - - - --
PROPERTY OWNER: NAME: DAYTIME PHONE
) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP)
CONTRACTOR: NAME/' /'� DAYTIME PHONE:
'/G/ c 7 /C os-j) 2Zf- 06.9
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP). // EVENING PHONE:
— ��`
cITY
/ wAC•,I�/?�O2'7U� je/ - T74eaa1i9 9C7 ( )
OF FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER: �C� ,/. I D EXPIRATION DATE: /�D//''//''
(copy of card required) Lr7'�JF''fr 6 }�
APPLICANT: NAME /
DAYTIME PHONE
68/1/641_(1947 ( )
MAILING ADDRESS(STREET ADDRESS,CITY,STATE,ZIP) EVENING PHONE.
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT El CONTRACTOR
' - - :. • - -T ' •_■ -DETAILED BUILDING INFORMATION.'• 7 ':•' L'.' .'
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 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• -• ■ PROSECT 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) - WOOpSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) •RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC e ❑ 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 •
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 claim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied t• the city as a part of this . ., 'cation
NAME/TITLE:
DATE:
❑ PROPERTY OWNER ❑ • '' ' NT ❑ 'I NT 74,CTOR
-FOR OFFICE USE ONLY:
❑,NEWT _=_,--Cl-ADDITION ❑ ALTERATION - ❑-REPAIR ❑TENANT IMPROVEMENT
'CENSUS CODE:- _ • LOT SIZE: T. - -
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
-COMP-PLAN DESIGNATION • -BASIC PLAN? = ❑ YES ❑NO
SECTION: 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.cityoffederalway.com
- • ELECTRICAL
TABLE B
•
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family
_Service or fccdcr only - $50.00 _
#of Thermostats(First-$37.50;add'n-$l I.SOca)
(First 1300 112475.00;Each add'n 500 ft'-$24.00) _Service and feeder $81.00 #of Low voltage fire or burglar alarms
- Square Feet: First 2500 ft'-543.50;Each add'n 2500 112411.50
- _Each outbuildingor garage. . .. . ..$31.00 MOBILE HOME/RV PARK Square Feet:
• (Inspected with service) k of service or feeders *Per\1'AC 296-46-910(5)(h)(i&ii)
_Each outbuilding or garage $50 00 (First service/fccdcr-550 00,Add-n service/ - _gof Signs(First sign-537 50,add'n sign
(Inspected separately) fccdcr-$32 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 ... .. $ 81 00- $ 24 00 Feeder / 201 -600. . ......... ....... . ..189 00
_201 -400 amp 101.00 . . 50 00 _0 to 100.. . ....... ..$ 81 00 ..5 50 00 _601 - 1000 ...284.50
_401-600 amp 138.00.... ........ 68.50 _101 -200. ... 101.00.........63.50 _over 1000 317.00
_601-800 amp 176.50. . 94.50 _201 -400 189.00... ....75.00 _d 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
Service or Feeder _Over 1000 ... . .....379 00-- 202.50 Residential/Multi-Family/Commercial/Industrial
_0 to 200 amp . . ....5 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.._ . 101 00
_
It 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+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) TOTA).(D)
TOTAL COLUMN(D):
Total Column(0)
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)
SBCC Surcharge:(19) (21) (23)
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Total (Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
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Bulletin k 100—January 18, 2002