05-102146 City of Federal Way Electrical Permit#: 05 - 102146 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA -9718
Ph:(253 8350009 8F x:(253)835-2609 Inspection request line: (253) 835-305C
Project Name: MILLER
Project Address: 29845 24TH OW ME SW Parcel Number: 893750 0300
Project Description: Low voltage security and stereo prewire
Owner Applicant Contractor
TERRY JENSEN CONSTRUCTION CORP*T] A S D SYSTEMS INC A S D SYSTEMS INC
PO BOX 1326 314 182ND AVE E SUITE B 314 182ND AVE E SUITE B
ISSAQUAH WA 98027 SUMNER WA 98390 SUMNER WA 98390
(253)826-1990
Electrical Fixtures
. � zIQuantifyi _- ,a":` "�::tfpinr w i t stir n .f Quai'i Ity
Low Voltage Burgler Alarm-Residen 3800
PERMIT EXPIRES November 5,2005.
Permit issued on May 9,2005
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.
p l / /
Owner or agent: ,cer, 1IPPLIC'TIQI&i Date: S (
vkl\11\1-
/t6
THIS CARD IS TO REMAIN ON-SITE
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE# (253) 835-3050 .
PERMIT#: 05-102146-00-EL
Owner: TERRY JENSEN
Address: 29845 24TH 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.
❑ Slab/Concrete Floor(4255) 0 Ditch cover(4030) ❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
ElTemporary 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 By iS Date//
❑ Under-slab groundwork(4295)
Approved
By Date
ury of 444111 RECEIVED B�COMMUNITYDEVELOPMENT SERVICES
3530 FIRSTTWAY SOUTH•PO DOX 9718
�/ ,WA 063-
FeeleraI Way PERMIT APPLICA' ' ,DEVELOPMENT DEPAr ' YF
to AX 75398-6619-412718 9
mww ntunlfrdernlnnq mm
y..� — ///''' — MAY 0 6 20135
" For OlLce Use Only
FW File Number: /yam/} T 5- , 0.___LI
L( to — .40TD /
/
The ollowin• is re•uired in ormation-an incom•iete a.•iication will not be acce•ted. Please .rint le•ibl (in ink)or -.
■ PROPERTY'INFORMATION
SITE ADDRESS: r) i 14 ) rr44 alK, SU) SUITE/APT#
ASSESSOR'S TAX/PARCEL #: - SQUARE FOOTAGE OF LOT: -5g0 l
LEGAL DESCRIPTION (eg:Acme Estates, Lot 1) l
(Attach separate page for lengthy legal description)
: -- ■ PROJECT INFORMATION
TYPE OF PERMIT(This application): 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
'piELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only): Lch,3 VIS 1'-(ic Se c u i If
--1- C�.C-U-r..' 7v"r- t r -
PROJECT NAME(Name 0 Business/Owner Last Name):
■ PEOPLE INFORMATION .
PROPERTY NAME: /+ ( PRIMARY PHONE:
OWNER: 1114 j'e C
°tSC'1 V'\ �t_C.lS -l(> (act-0) „ (t,+ -c4c5S
MAILING ADDRESS(STREET ADDRESS,): CITY,STATE,ZIP
Oa Jt 13,-Le iSSi' L3 Ldµ 'kc,17
CONTRACTOR: NAME `` COMPANY OFFICE PHONE.
YA-S D S
I,S�VIS1 1 I'l C. (J=Y)) L.5 C - 10 -1-2
MAILING ADDRESS
EE SSZIP
CELL PHONE:
agI .ut ac-C.. �' F LJ- < �lLl�l V�� LU} 1S3�L�
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER.
- V L� I. (2 L Ti - 14 0b o E L ID- / 3 I /0 S_ ( .2-5 3) t (.� - ICI Ci_
CONTRACTOR'S REGISTRATION NUMBER: y�" C EXPIRATION DATE:
(copy of cud required with each application( . r� S V 1e h( LM 3 / ( / ('i
LENDER: NAME: DAYTIME PHONE:
(If s.oposet Value>$5,000) ( ) -
MAILING ADDRESS(STREET ADDRESS,(- CITY,STATE,ZIP
APPLICANT: NAME: COMPANY OFFICE PHONE:
( )
MAILING ADDRESS(STREET ADDRESS) CITY,STATE,ZIP EVENING PHONE:
( )
RELATIONSHIP TO PROJECT FAX NUMBER.
0 Architect 0 Tenant ❑ Other (Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: 0 Property Owner Contractor 0 Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION - ' - - -
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: 0 YES 0 NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN U HIGHLINE 0 PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
"NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
- • FIXTURES
Indicate number of each type of fixture that is 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(commerdat) 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 tro,hq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(BathroomSmk 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 o cers and employees, upon the accuracy of the information supplied to the city as a part of this application.
NAME/TITLE: ( / )7 t) DATE: jl`S/Q`C
(Signature) (Ti e)
RELATIONSHIP TO PROJECT: 0 Property Owner 0 Applicant Contractor 0 Architect ❑
FOR OFFICE USE ONLY:
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION: CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES o NO
Pa;.-,c 2
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ 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 ❑ 201-400 amp 264.50 104.00
❑ Detached outbuilding or garage U 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
❑ 401 -600 amp 193.00 96.00 ALTERED COMMERCIAL/INDUSTRIAL
0 601 -800 amp 247.00 132.00
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ Oto 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
❑ 0 to 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/ca)
❑ #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-569.50;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)
Low Voltage - -1) ❑ Swimming pool/hot tub • $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $104.50
❑ Security Alarm System ❑ Additional Plan Review
❑ Voice Cabling $104.50/hour
(for modified submittals)
❑ Data Cabling CC? ❑ Automation Fee on all Permits $5.00'
(Per❑ 7-.System(s) 1K 2500 ft2-$61.00; -7-7
Each add'n 2500 ft2-16.00) •Per WAC 296-46-910(5)(b)fi di ii)
•
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application •