05-102153 •
r
a City of Federal Way Electrical Permit #: 05 - 102153 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: THIERER
Project Address: 28616 13TH$ AV ly.S Parcel Number: 720300 0595
Project Description: Alter circuit for dishwasher.
Owner Applicant Contractor
Alan F Thierer &Janet Thierer ELECTRO SERVE LLC ELECTRO SERVE LLC
28616 13TH AVE S 13547 SE 27TH PL SUITE 3-D 13547 SE 27TH PL SUITE 3-D
FEDERAL WAY WA BELLEVUE WA 98005 BELLEVUE WA 98005
98003-3150 (425)451-3358
Electrical Fixtures
Description Quantity Description Quantity r Description (Quantity
Circuits-Residential 1
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 FedeMb
E 3 � � 11Vir
I—0
S.-
Owner r agent.
Date:
v-\t>s
FINALED
67 /0(71/77/7
r s
THIS CARD IS TO REMAIN ON—SITE
CITY OF A- - - Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-102153-00-EL
Owner: ALAN F THIERER
Address: 28616 13TH AVE S
FEDERAL WAY, WA 98003-3150
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.
0 Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) �❑ Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
0 Rough Electrical(4225) El Ceiling Cover(4020) .
❑ Final-Electrical(4055)
Approved Approved Approved
By Date `By Date l �s Date G— 7—c
❑ Under-slab groundwork(4295) '
Approved
By Date
' • sk , RECEIVED BY DJ 1 c
��„
Federal Way PERM
� ITY DEVELOPMEN RRfi1+AENT—
COMMUNITY DEVELOPMENT SERVICES �/ O 9 r� F CO moil"- D E EN FP
ili
3332FEDERAENUE SOUTH•�B718 APPLICATION L
FEDERAL WAY,WA 98063-9718 / /
253-835-2607•FAX 253-835-2609
unuu+atvoffederalwatl com
The following is required information-an incomplete ap•lication will not be accepted. Please print legibly(in ink)or type.
c',._ • > • . . ' -. , • . -.{- " -. III,PROPERTY INFORMATION - - -
SITE ADDRESS /72-51>5l//p(L I b- A-Vf S • SUITE/UNIT# .---
ASSESSOR'S TAX/PARCEL# - LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page far lengthy legal desorption)
., . . 7. . , . -; ." : - - . -. .- I.• PROJECT INFORMATION° - - - .. •• . - .
TYPE OF PERMIT 0 BUILDING D PLUMBING D�tl FGHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
-.'• Ola. / � Pi.I-...1A w. v .!�i1 $-
PROJECT NAME(Name of Business or Owner Last Name) --"Ll 1 t �=-�-
. .- + - : - III PEOPLE INFORMATION - - • _ , - - - . . •- - -
PROPERTY NAME • PRIMARY PHONE
OWNER '1 (25b) 54(( - S
MAILING ADDRE CITY,STATE ZIP
G2510((4P. 1 b= Ai/6-5 ( rc l t�A `8w3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
J d Q 11Llleit-t L MA. (Ltv) 66'3 - togZ
MA13L!�t, DDRESSS� f� .��F/ CITY, ,,ATE,ZIPS /� CELL PHONE
CITY o3 FEDERAL05 W Y BUSINESS LICENSE V I kt [QS �j.L1 RA/y.4 EXPIRATION
DATE (IAA tNUMBERI `{ -S-161-1
0-1)(2-1 V Q - B L /I 61 / o✓ (kzs-f.gi? z. '
CONTRACTORS REGISTRATION NUMBER(copy of card required with each applications EXPIRATION DATE
f L, S _c _Tbl' a Hama 4 l O(o
APPLICANT COMPANY NAME APPLICANT NAME -� OFFICE PHONE
ciQZ fa ¢-- 'Y) NAME .r...-------
•
/ ham_ (`I ti s 3- �o S2
MAILING ADDRESS CI STATE,ZIP CELL PHONE
71(
/3300 56 S-= sr ‘ft /D S - 6Avc&,(AJPf- q; ooS ( 4 2g 8loq - 51(0%4
RELATIONSHIP TO PROJECT FAX NUMBS q
0 Architect 0 Tenant ❑Agent Other(Describe) (f,4,1.-g-d .;-e `
CONTACT NAME /�////� PRIMARY PHONE E-MAIL ADDRESS
• • J.! r ' Yom_ PRIMARY
453- ub X52.
LENDER - per RCW 19.27.095:'Lender information is NAME
required if project value exceea_s$5,000
MAILING ADDRESS CITY,STATE,ZIP
a
•-.;.::.' . .- -,1•-". , .-. -.■ DETAILED BUILDING INFORMATION - - - , . • - - , .
EXISTING USE PROPOSED USE
- EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
i WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE a TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 BIGHLINE ❑ 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
TOTAL EXLSTIKG TOTAL morose') TOTAL EXISTING AND morose:.HOW MANY FLOORS?
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
- _ _ ;��: TURES•-.:1' ...-,. ..;..1:_!:::*" _ .. -
_ ,. . - °-FIX
Indicate number of each type'of fixture 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
BATHTUBS(or Tub/showtrcombol SHOWERS WATER CLOSETS rroa,q MISC(Describe
)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
= F:: ,-: . - ;DISCLAIiii-R/SIGNATUREBLOC . ...
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 a part of
this application.
NAME/TITLE �� ?IflLtf DATE yb(oc
Cii-t-
(Signature) (�' /
RELATIONSHIP TO PROJECT 0 Owner 0 Agent Contractor O Architect 0 Other
,F
OR OFFICE USE ONLY '
a NEW a ADDITION a ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? o YES 0 NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? o YES o NO
,I
j Bulletin#100—March 30,2004 — Page 2 of 4 k\I-Iandouts—Rcvised\Permit Application-
! :
l : .
. = . ... : - .' .. ' - - ELECTRICAL PERMIT INFORMATION - - - . -
RESIDENTIAL COMMERCIAL
//NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
9Servar ingle Family Square Feet
ice or Feeder Each Add'n
(First 1300 f12-$87.00,Each add'n 500 ft2-$28 00) 0 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 0 201 -400 amp 220.50 87.00
❑ Detached outbuilding or garage 0 401 -600 amp 256.50 103.00
(Inspected separately) $58.00 0 601-800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) ❑ 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 ❑ Over 600 volts surcharge $74.00
❑ 401 -600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
O 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
O Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY 0 0 to 200 amp $ 94.50
❑ 201 -600 amp 220.50
Service or Feeder 0 601 - 1000 amp 332.00
O 0 to 200 amp $ 72.50 ❑ over 1000 amp 369.50
O 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)
$74.00 plus 35%of Permit Fee
O Mast or meter repair $43.50 ❑ Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES
❑ Service or feeder only $58.00 TEMPORARY SERVICE
❑ Service and feeder $94.50
Commercial Residential
MOBILE HOME/RV PARK ❑ 0- 100 $58.00 $51.00
❑ # of service or feeders 0 101 -200 74.00 51.00
(First service/feeder-$58 00;each add'n-$37.50) 0 201 -400 87.00 n/a
O 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
O #of Thermostats ❑ 4 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)
❑ Fire Alarm System ❑ Yard Pole meter loops $58.00
•
❑ Security Alarm System ❑ Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
0
(Per System(s) 1•,2500 ft2-$51.00,
Each add'n 2500 ft2-13.50) •Per WAC 296-46-910(5)(L)4&h )
Bulletin 11100-March 30,2004 P.: of 4 k\Handouts-Revised\Pennit Application .
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