04-101517 •
City of Federal Way
Community Development Services Electrical Permit #:04 - 101517 - 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: WALGREENS DRUG STORE
Project Address: 28817 MILITARY S Parcel Number: 042104 9030
Project Description: Install low voltage T-stats
Owner Applicant Contractor
WALGREEN CO*MARGARITA E KELLEN I EVERGREEN REFRIGERATION EVERGREEN REFRIGERATION
WALGREEN CO EVERGREEN REFRIGERATION EVERGREEN REFRIGERATION
PO BOX 901 727 S KENYON ST 727 S KENYON ST
DEERFIELD IL 60015 SEATTLE WA 98108 (206)763-1744
Electrical Fixtures
Description Quantity Description Quantity Description ,Quantity
Thermostat 8
PERMIT EXPIRES October 20,2004.
Permit issued on April 23,2004
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.
Owner or agent: 1C � I --. Date: � " 23 —o C-A
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tj' .' ^j COMMUNITY DEVELOPMENT SERVICES
APR L� ." (�:U`r 33530 FIRST WAY SOUTH•PO BOX 9718
FEDERAL 253 661-91 WA FAX 253-63-9718
GRY OF
Federal UV yrs( Y�;- �_D r„gyp, MIT APPLICATION �- 4129
www ahtoNederalwaucom
BUILLANC:z DEPT. 0 // //►/' �t�) (/1'�J '/
For Office Use Only: 0 k - J {_ � 1-f - \� ��L TD: 7 / �3 / d 9
FW File Number:
The ollowin• is re•uired i ormation-an incom•fete a••lication will not be acce•ted. Please •rint le•ibl in ink or •e.
�] ■ PROPERTY INFORMATION
SITE ADDRESS: t5g cc /14,//4.i vi Apt. 5, SUITE/APT#
ASSESSOR'S TAX/PARCEL#: l SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT(This application): ? BUILDING ?PLUMBING ?MECHANICAL ?DEMOLITION
LECTRIC ?ENGINEERING? FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only): 1 Aei-I1 cA I D k VJ-
PROJECT NAME(Name of Business/Owner Last Name): Y v IK�C�se...e._...&_ S
• PEOPLE INFORMATION
PROPERTY NAME: ��// PRIMARY PHONE:
OWNER: /'�--jl lel a- ( )
MAILIN ADDRESS i TRE DizESSAD ;(: CITY,STATE,ZIP
x88/5 Adfir. l V. 5d. FtdeiLAI ►a.Tn9 IA'. x$o3
CONTRACTOR: NAME`c ��` fit/ COMPANY OFFICE
PHONE:
MAILING ADDRESS(STREET ADDRESS;) CIWI:
CITY,STATE,ZIP p ( PHONE:
is'?
vl�4
....6:: C
CITY EDERAL AY BUST D Y� )� JCa � YR TI . 1 X W 0
ENSE NUMBER: EXPIRATION DATE: FAX NUMBER:
2.03_-.C)O-1 Q L q cc-o O \,L \z / 31 /cLI ( ) -
CONTRACTORS REGISTRATION NUMBER. j}� en
EXPIRATION DATE:
, �
(copy of card required with each application) am-1m 1�,�c �. / /b
LENDER: NAME: DAYTIME PHONE: '
(If Proposed Value>$5,000) ( ) -
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME:
� COMPANY(C� ' OFFICE PHONE:
MA IN (S--`e-TREET ADDRESS(: CITY,STA IP � ���12-66 I -7(.3 - 1144
R70IONSHIP T PROJECT: y� +• _u-A. �$�A FAX NUMB ER:
?Architect ? Tenant ? Other(Describe): (2Ob) 1/03-2,389
CONTACT PERSON FOR THIS PROJECT: ?Property Own ?Contractor ?Applicant
E-MAIL ADDRESS:
• DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $— VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ?YES ? NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ?YES ?NO
WATER SERVICE PROVIDER: ? LAKEHAVEN ?HIGHLINE ?TACOMA ? PRIVATE(WELL)
SEWER SERVICE PROVIDER: ?LAKEHAVEN ?HIGHLINE ? 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 EXISDNG 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(commercial( 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(roilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sink VACUUM BREAKERS ELECTRIC WATER HEATERS
I. 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 a part of this application.
-Z3 -ay
NAME/TITLE: I ' �L�--- DATE:
(Signature) ttle)
RELATIONSHIP TO PROJECT: ? Property Owner ? Applicant . Contractor ? Architect ?
FOR OFFICE USE ONLY:
?NEW ?ADDITION ?ALTERATION ?REPAIR ?TENANT IMPROVEMENT
BUILDING SHELL ONLY? • ?YES ?NO BASIC PLAN? ?YES ?NO
ZONING DESIGNATION: CHANGE OF USE? ?YES ?NO
NEW ADDRESS REQUIRED? ?YES ?NO -UP/SEPA/SU? ?YES ?NO
PLATTED LOT? ?YES ?NO DEMO PERMIT REQUIRED? ?YES ?NO
Bulletin#100—January 13,2004 Page 2 of 4 k:\Handouts—Revised\Permit Application
•
'' • 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) ❑ 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
❑ 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
❑ 0 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
$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 ❑ 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
2 #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): Pt 2500 ft2-$51.00;
Each add'n 2500 ft2-13.50)'Per WAC 296-46-910(5)(6)(1&ti)
Bulletin#100-January 13,2004 Page 3 of 4 k:\l-landouts-Revised\Permit Application