04-100885 •
• City of Federal Way
Community Development Services Electrical Permit #:04 — 100885 — 00 — EL
33530 ist Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: LARSEN
Project Address: 841 SW 306TH St Parcel Number: 178870 0165
Project Description: 100-amp service change.
Owner Applicant Contractor
Barbara J Larsen LANDER ELECTRIC SERVICE LLC LANDER ELECTRIC SERVICE LLC
12126 SE 160TH ST 13359 NE 16TH ST 13359 NE 16TH ST
RENTON WA BELLEVUE WA 98005 BELLEVUE WA 98005
98058-5312 (800)794-4321
Electrical Fixtures
Description IQuantity Description Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Res.i 1
PERMIT EXPIRES September 11,2004.
Permit issued on March 15,2004
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. See Application _ o
Owner or agent: Date: 3 —'t '
c-0(-)e
� L
RECEIVED BY COMA W,p DE CEOPMD 8 OM DEVELOPMENT MH9;TOERVICE
,OF , 'fMUNITY DEVELOPMENT DEPARTMENT
�� Y,WA 063-97]8
aderal Way c8 2 7 2004 PERMIT APPLICATIONAR 1 5 zoo u coin
4 253w lea:25,-661.4129
4 - I 0 0 8 8 c - E_ (---- TD
For Office Use Only. FW File Number: / /
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
El PROPERTY INFORMATION
SITE ADDRESS: pH cm/ JDb rA ( ASSESSOR'S TAX/PARCEL#: I O p
S 3 b - 1 5-
LEGAL DESCRIPTION (eg:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
SQUARE FOOTAGE OF LOT:
, . • PROJECT INFORMATION
TYPE OF PERMIT (This application): ❑ BUILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION
,LECTRICAL .7", ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DES PTION(Provide detailed description of work included on this permit onlq):
/d amp c/Jrv/(e 0,(A Q
PROJECT NAME(Name 0 Business/Owner Last Name:
II PEOPLE INFORMATION
PROPERTY NAME ` v/� n j� PRIMARY PHONE:,z //,, !_
OWNER: ?/ bar/7 L! M2J? (y-10. ) .255 - /f��1�
MAILING ADDRESS(STREET ADDRESS;): CITY,.STATE,ZIP / ��- �����
/L/2 0 OF / 9/--A Vt. Re fan
CONTRACTOR: 1 NAME OMPANY OFFICE PHONE:
i kAr(A fri11 a1' �L?/�Cr1/�/77Q cj-1..1.5(01 -177/
MAJLINGpESS(ST T ADDRESS;):�� CITY,STATE,ZIP C—LL PHONE: -
N
10/fA 1,Vi c 1/ue/ ur 7 q�a�,3 ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER:
.02,3_ - . 00_ 007 - a Q 12 /3/ / Of- (*..�),3rr2 -ltbb
CONTRACTO S REGIST TION NUMBER: i / 4 D /^ q EXPIRATION DATE:
(copy of card required with each application) N V l / C / / 3 / 0_5
:.ENDER: NAME. DAYTIME PHONE:
If Proposed Value>$5,000) ( ) —
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
3PPLICANT: NAME. COMPANY OFFICE PHONE:
LOW CaArmol r ( ) -
MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 Architect ❑ Tenant 0 Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner [Contractor a Applicant E-MAIL ADDRESS:
U DETAILED BUILDING INFORMATION
EXISTING USE:(yilyzC' / I Ly PROPOSED USE: ,
EXISTING ASSESSED/APPRAISED/AVALUE $ VALUE OF PROPOSED WORK: $
•
iPRINKLERED BUILDING? a YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES 0 NO
VATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
;EWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
•
II PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED2)
GARAGE/CARPORT -
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
. ■ FIXTURES
ndicate 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(commercial( WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
RAT?-ITRv IOi Tuij 3i4w2,combo) SHOWERS WATER!`TT (Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
-WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sunk 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;go art of this application.
,, 1r
NAME/TITLE: 41ai#L J4 /1���_ V�' P/ ,"-- •
DATE: ✓ w� O
f gnature) ( tie)
RELATIONSHIP TO PROJECT: 0 Property Owner 0 Applicant 0 Contractor 0 Architect 0
FOR OFFICE USE ONLY:
n NEW o ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES ❑NO
ZONING DESIGNATION: CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? a YES o NO
PLATTED LOT? ❑YES a NO DEMO PERMIT REQUIRED? ❑YES ❑NO
• . 1.3r .€; f:? Page 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-$87.00; Each add'n 500 ft2-$28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101-200 amp 117.50 74:00
(Inspected with service) $36.50 ❑ 201-400 amp 220.50 87.00
❑ Detached outbuilding or garage ❑ 401-600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601-800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) 0 801 - 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00 .
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201 -400 amp 117.50 58.00 0 Over 600 volts surcharge $74.00
❑ 401 - 600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 - 800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
(Inspected separately from service) ❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
X0 to 200 amp $ 72.50 ❑ over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ over 600 amp 177.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
❑ # of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58.00,Add'n circuits$6.00/ea)
❑ Service over 200 amps
❑ Mast or meter repair $43.50 ❑ Medical/Educational/Institutional Facility
.ty
$74.00 plus 35%of Permit Fee
SINGLE/MULTI FAMILY PLAN REVIEW
❑. Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES TEMPORARY SERVICE
❑ Service or feeder only $58.00
❑ Service and feeder $94.50 Commercial Residential
❑ 0- 100 $58.00 $51.00
MOBILE HOME/RV PARK 0 101 -200 74.00 51.00
❑ # of service or feeders ❑ 201 -400 87.00 n/a
(First service/feeder-$58.00,each add'n-$37.50)
❑ 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats ❑ #of Signs
(First-$43.50; add'n-$13.50/ea) (First sign-$43.50; add'n sign$20.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s): (Includes additional circuit,if required)
O Fire Alarm System ❑ Yard Pole meter loops $58.00
O Security Alarm System ❑ Additional Plan Review $87.00/hour
0 Voice Cabling (for modified submittals)
0 Data Cabling
0
(Per System(s): 1•t 2500 ft2-$51.00;
•
Each add'n 2500 ft2-13 50) •Per WAC 296-46-910(5)(b)(i&it)
■ FEES
This is an overview of possible fees associated with the issuance of permits and is not intended to be inclusive.
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