05-105813 t '› J
City of Federal Way Electrical Permit #: 05 - 105813 - 00 - EL
Community Development Services FILE
PO.Box 9718
Federal Way,WA 98063-9718
Ph (253)835-7000 Fax.(253)835-2609 Inspection request line: (253) 835-3050
Project Name: DENTAL CENTER OF FEDERAL WAY BUILDING B
Project Address: 34704 11THtSPrr Parcel Number: 215470 0030
Project Description: Installation of 600 AMP 120/208 3 phase 4 wire service switchboard with 8 each 100 AMP feeders and 1
each 200 AMP feeder,including all branch circuits.
Owner Applicant Contractor
Van H Vuong &Cindy H Vuong SHEPPARD&NELSON ELECTRIC SHEPPARD&NELSON ELECTRIC
2101 SE 2ND PL PO BOX 3630 PO BOX 3630
RENTON WA KENT WA 98032-0210 KENT WA 98032-0210
98056-8864 (206)878-7333
Electrical Fixtures
Description Quantity Description jQuantityl` Description Quantityl
Service/Feeder: 0-100 amps-Comm. 8 I Service/Feeder: 101-200 amps-Comrr 1 -II r Service/Feeder:401-600 amps-Com1
PERMIT EXPIRES May 9,2006.
Permit issued on November 10,2005
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.
Owner or agent: l{c tic•'-��`�' Date: 1! /C) — 017
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THIS CARD IS TO REMAIN ON-SITE t
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-105813-00-EL ilk--b 3' ��� ,
Owner: VAN H VUONG41i
Address: 34704 11TH PL S
FEDERAL WAY, WA 98003-6715
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) Il Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete . Approved Approved
Al,
By DateBy''�W ,./ Date 12. 1(Q\bS By Date
S `
El Temporary Power(4275) '� Service(4235) IJ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By &___.. Date b(p By ,�I�� Date (( kcy
❑ Rough Electrical(4225) 123 Ceiling Cover(4020) ` .0 Final-Electrical(4055) ,
Approved Approved Approved
t
By Date B• y ‘ t` Date it �yN B 1'4;'1 Date C{,
❑ Under-slab groundwork(4295)
Approved
By Date ,
' �A � 5 - _LO 5 13
Federal Way PERMIT SF MF CO M 1� •L DE EN FP
COMIAUVITY DEYELOIMENTSERYXEs
33325 dm AVENUE SOUTH•PO BOX 9718err 1
MURAL WAY,WA 980634718 APPLICATION
TD �
• 2534354607•PAX 2534352609 `,-.
The ottowi , is • road in ormatton-an i •• ,•tete •44./,lication will not bs ' -- ,• ,.• Phase • nt : b• in i or -_.,• -.
• PROPERTY INFORMATION
SITE ADDRESS 3 L 70 ` I i 1" + -c"'E- S, SUITE/UNIT•
ASSESSOR'S TAX/PARCEL M - _ — _ LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
r4Nrhe•Pmd•Palle J r km0041WW1 description)
MI PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION *ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
- PROJECT DESCRIPTION(Provide detailed description of work incite/Eng-lie permit only) IL
b on A-INE p i r9-o/a-o( 3 l w if .e S' e r t t c_e, s' e., ii-d, bot vd
(A.} l t1 i3 ..aI O p F-e ,ed vv27 c'Alp ci_ ( �c., eit P--Oc-3 A-4-44-/:'
-fl -e-c 4._,e-v,) /rc c_Lcc 1 c -0 •-.0.,- cfi c-r r ccc i7-S ,
PROJECT NAME(Name of Business or Owner Last Name) DU Ct.Ci(114.11111 rfid L,1 •i3
PROPERTY NAME PRIMARY PHONE
OWNER V 0 0..M.? '.e'Att../ G L t n•LI"c. L ct ` ( ) -
`tD0lc3 I/ PL S� CITY,
d "kisZIP w / q
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
(9-06).97e -
SI\ v d n 1,.e.Lc c v..c. C�04vy
MAIL! ADDRESS
Cr,STATE,ZIP CELL PHONE
1l d, 130v. r C30 i wry-/ cv# WOC:" ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
A. 9_--1 Q-1 o2 8 1. �- B L 19-' 3 ) / 05 ( 0,6 1578 - 1807
CONTRACTORS REGISTRATION NUMBER(copy of card required with melt eppBeet ) EXPIRATION DATE
� ttE E BE 51- CztV a7 / 3/ / o '7
APPLICANTJcodvt4i
NAME APPLICANT NAME OFFICE PHONE
r, ( ) -
ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect 0 Tenant 0 Agent ❑ Other(Describe) ( ) -
CONTACTN PRIMARY PHONE E-MAIL ADDRESS
t!:: ei✓L ,— ( ) -
LENDER i, ..f',-- ,, :1>,;.,,.,;.sy.z, .a;,C:a....,exits€y"^ NAME L`
tF,- :ice APHMpp
MAILING ADDRESS CITY,STATE,ZIP
III DETAILED BUILDING INFORMATION
EXISTING USE - PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ . , •F PRO•'• : • • - : $
SPRINKLERED BUILDING? Cl YES - • FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ - - Cl NO
t a
WATER SERVICE PROVIDER ❑ LAX/MAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
- SEWER SERVICE PROVIDER ❑LAKEHAVEIU 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED •
•
SQ.PT. SQ. PT. •.PT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
taoraso rearm= It. Y u6<yt ,r : � �? ° =.• ; :w `itP-,:';NUMBER OF FLOORS .'' ., ' ,4:7. ; .1 ;1 -.i
"NEW HOMES ONLY" NUMBER OF BEDROOMS �STIMATED SELLING PRICE $_
FIXTURES
Indicate number of each type of fixture • be installed or relocated as •• • this project. Do not include existing fixtures to remain.
IirECIMIBCAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(caem erdso WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES SAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATIR'U or Tub/Shower Combo) SHOWERS WATER CLOSETS clomp MI a--••be)
DIS SHERS SINKS DRINKING FOUNTAINS
GA PE OUTLI;ta SUMPS RAINWATER SYST
W HMG MACHINES URINALS HOSE BIBBS
LAYS paaenoom sinks) VACUUM BREAKERS IQiCTRIC 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 mg knowledge,and fturther,that I am
authorised by the owner of the abuse premises to perform the work for which the permit application is made. I farther agree to hold harmless toe City
of Inderal Way as to any claim(inebading costs,expenses,and attorneys'f es 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 Wary but only where such claim arises oat of the reliance of the
city,including its officers and snap upon the accuracy of the information supplied to the city as a part of this application.
NAME/TITLE (` / L� /7"DATE � /D — 4
�s���aanni�
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent Contractor 0 Architect 0 Other
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ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single FamilyFeet Service or Feeder Each Add'n 00
(First 1300 104.50 Each add'n 500 ftP-$33.50) % 1. 0 to 100 amp $113.50 $69.59 X 8 �j5'15�y°�•
❑ Detached outbuilding or garage -' 101-200 amp 141.00 89.00 )c. I - p l ,c16
(Inspected with service) $44.00 iipil 201-400 amp 264.50 104.00
❑ Detached outbuilding or garage �- 401-600 amp 308.00 123.50 X. 1 = 30 8•d O
(Inspected separately) $69.50 ❑ 601-800 amp 398.50 168.50 qcmoi -
` J•0
0 801 -1000 0
amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) 0 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 COLO ERCIAL/INDUSTRIAL
❑ 601-800 amp 247.00 132.00
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ Oto 200 amp $113.50
ALTERED MGM/MULTI FAMILY 0 201 -600 amp 264.50
Bernice or Feeder 0 601 -1000 amp 398.50
❑ over 1000 amp 443.50
❑ Oto 200 amp $87.00
❑ 201-600 amp 141.00 ❑ it of circuits to be added/altered
❑ over 600 amp 212.50 (1-5 circuits-$89.00:Add'n circuits.$7.00/ea)
❑ it 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
MOBHa HOMES
❑ Service or feeder only $69.50
❑ Service and feeder $113.50
TEMPORARY SERVICE
][OBII.E HOME/RV PARE -Fatuity $61.00
❑ ci of service or feeders
(First service/feeder-$89.50:each add'n-$45.00) Service or Seeder Ampacity
U 0-100 amps $69.50
❑ 101-200 amps 89.00
❑ 201-400 amps 104.50
❑ 401-600 amps 141.00
U over 600 amps 152.50
MISCELLANEOUS SERVICE/EQUIPMENT
❑ it of Thermostats 0 It of Signs
(First-$52.00:add'n-$16.00/ea) (First sign-$52.00:add'n sign$24.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tab $87.00
Square Feet to be served by system(s) (Includes additional circuit.If required)
❑ Fire Alarm System ❑ Yard Pole meter loops $104.50
O Security Alarm System ❑ Additional Plan Review $104.50/hour
O Voice Cabling (for modified submittals)
❑ Data Cabling Automation Fee on all Permits $5.00
(Per System(s)1't 2500 fie-$61.00:
Each add'n 2500 ft2-16.00)•Per WAC 296 16-9105Nbia&i0
Bulletin*100-January 7,2005 Page 3 of 4 /e.41---f13-62a
andouts\Permit ' .. i.n .