05-106032 ^" , 1►
Cliyol?FederalWay Electrical Permit #: 05-106032-00-EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: SOUTH SOUND ORAL MEDICINE
Project Address: 34709 9TH AVE S Suite B300 Parcel Number: 926480 0015
Project Description: Adding or Altering(8)circuits to support conversion of medical space into dental space.
Owner Applicant Contractor
CCD ENTERPRISES BRIGHTEN ELECTRIC,INC. BRIGHTEN ELECTRIC,INC.
1601 5TH AVE SUITE 1703 PO BOX 2958 BRIGHEI977CL(02/13/07)
SEATTLE WA 98101 EVERETT WA 98213 PO BOX 2958
EVERETT WA 98213
Additional Permit Information
Electrical Fixtures
Circuits- Commercial 8
CONDITIONS:
PERMIT EXPIRES Monday, May 22, 2006
Permit Issued on Wednesday, November 23, 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 Ci of Federal Way.
Owner or agent: IMMO Date: /i Z 3
ou1/1/
)11 r v
THIS CARD IS TO REMAIN ON-SITE '.
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 _
PERMIT#: 05-106032-00-EL
Owner: CCD ENTERPRISES
Address: 34709 9TH AVE S Suite B300
FEDERAL WAY, WA 98003
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) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
•
41:1Rough Electrical(4225) �a Ceiling Cover(4020) Final-Electrical(4055)
Approved Approved Approved
By,,<e-c_„, Date//—Z fj-d •�By� 1 Date\1 2,1_flc , By��,� Date `2 1��
❑ Under-slab groundwork(4295)
Approved
By Date
P '
cm a..� a 5 - C D / 12 3 —
Federal Way PERMI'EcELVED
� n1 SF MF CO ME�•L DE EN FP
33325CES
3835-2807*Fs 9718 APPLICATJN 2005 —
FEDERAL WAY,WA 9ls063.971Q
AX 253-835-2809
www.cllVoffederalwaU com
The to (fled r radon-an it com tett . Please t Or
SITE ADDRESS 3 LI 7 0 9 - 1 r /11,/e S e SUITE/UNIT# 6-300
ASSESSOR'S TAX/PARCEL# — — — ..___ LOT SIZE(Si)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Moth nsPocote page for invite'legal descriptio,
• PRO LEI T INFORMATION
TYPE OF PERMIT 0 BUILDING 0 G 0 MECHANICAL
0 DEMOLITION RICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
Cep✓ikitI-l'.> 3/94( Fro$4 frieA;r I CII W1 C 1-0
v1 nrA ( ((llUlu C_
PROJECT NAME(Name of Business or Owner Last Name) <- U.0 1 gOtald 0 ita Medi ,)ei
• PEOPLE I\FORMA IION
PROPERTY NAME__ PRIMARY
PH
NE
OWNER & b En erp4:sCs - _ (620# X3601-4),%f.
MAILING
I(0d 15 A-�ADDSS .ern-- A.-)/1- 98 /O l
CONTRACTOR COMPANYP4.1M APPLICANT NAME OFFICE PHONE
Or. ryklte•t eke Yr1c 7 U1/1e • stiacir'd' rHi•wo � ('MP q .>- 02 305
MAILING ADDRESS COY,STATE,ZIP V CELL PHONE
P6 & -zi so - fi rei'1' Ui}, LifVS (Vr) 1zt -V(ca
CITY OF FEDERAL WAY BUSINESS LICENSE NUMB / EXPIRATION DATE FAX NUMBEI
I / / ( WLSl '113 -6238
C CPOR'S REG TION NUMBER(copy of card rgalnd with eael application) EXPIRATION DATE
g B I E N k t I i 1 c L- d Z / 1.3 / •z007 --
APPLICANT C c ci••ANNYY NAME(/�,J, ( APPLICANT NAME OFFICE PHONE
l�• ADDRESS J\ CITY,STATE.ZIP CELL PHONE
( ) -
REIATIONSHIP TO PROJECT FAX NUMBER
O Architect 0 Tenant ❑Agent ❑ Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL RESS
St ixar4- M;hoy i t (qZ ) 1/LZ- 1-q Si) b:eyAErr�em@V • N. wer-
LENDER Per ItCW 19.27.095: Zander(Nbrination Is NAME
regntnd(Vprwhct value axoeea.$5.000 14 14
MAILING ADDRESS CITY.STATE,ZIP PHONE
( ) -
• DF,I Al I ED BF11 DING IN FORMA[ION
EXISTING USE A t! u 141 PROPOSED USE C) C MINI ►4 I L
6 0
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORE $ 3 G U 0
SPRINELERED BUILDING? o YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER 0 LAEEHAVEN a IUGHLINE ❑TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAEEHAVEN a HIGIQ.INE a PRIVATE(SEPTIC)
r `f
p.n. 1 Fl OOR ARFAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
89.FT. 89.FT. SQ.FT.
BASEM
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT❑
NUMBER OF FLOORS
=rum TOTAL meTmosr TOTAL oraeos► TOTAL e
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIX I('121'.
Indicate number of each type of Jlxture . be installed or relocated as part. this project. Do not include existingfbraures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBCS FANS HOODS(comma. WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSO•= FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
•• % (or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toilet) MI 1 « be)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom sow VACUUM BREAKERS ELECTRIC WATER HEATERS
1)I,('1.11\IFR,'Sl(,NA11 RE 13LO('K
I core*under penalty(If perjury that the irl}brmatlon furnished by me is true and correct to the best of my knowledge,andjUrther.that I
am authorised by the owner of the above premises to perform the work fir 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 . DATE ///4,3/6.
(Signature) Mk)RELATIONSHIP TO PROJECT ■ s• er ❑Agent li ntractor o Architect o Other
FOR OFFICE USE ONLY
o NEW o ADDITION a ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o TES o NO IIP/SEPA/SU? o YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Permnit Application
r r
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
U Detached outbuilding or garage U 101-200 amp 141.00 89.00
(Inspected with service) $44.00 U 201-400 amp 264.50 104.00
U Detached outbuilding or garage ❑ 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
U Up to 200 amp $113.50 $33.50 U Over 600 volts surcharge $89.00
O 201 -400 amp 141.00 69.50 ❑ Mast or meter repair $96.00
O 401 -600 amp 193.00 96.00
13 601 -800 amp 247.00 132.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ 0 to 200 amp $113.50
ALTERED SIN0LE/MULTI FAMILY O 201-600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
O 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/ea)
❑ #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
O Service- 1,000 amps or greater
❑ Mast or meter repair $52.00 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
U Service or feeder only $69.50
❑ Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/MuUI-Family $61.00
❑ #of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercial/industrial Service or Feeder Arnpaelty
❑ 0-100 amps $69.50
❑ 101-200 amps 89.00
U 201-400 amps 104.50
U 401-600 amps 141.00
U over 600 amps 152.50
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signa
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea)
❑ Low Voltage O Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,If required)
❑ Fire Alarm System U Yard Pole meter loops $104.50
o Security Alarm System ❑ Additional Plan Review $104.50/hour
❑ Voice Cablingfor modified submittals)
13 Data Cabling
Automation Fee on all Permits .. C$5.00
(Per System(s)le 2500 ft2-$61.00;
Each add'n 2500 ft2-16.00)•Per WAC 296-46-910(50)ft&IU
Bulletin#100-January 7,2005 Page 3 of 4 k\liandouts\Pennit Application