05-105488 City of Federal Way E 1ectrical Permit #: . 05 - 105488 - 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: 7-11
Project Address: 31006 PACIFIC S Parcel Number: 785360 0210
Project Description: Alteration to extend 120v circuit in backroom
Owner Applicant Contractor
7-11 MADSEN ELECTRIC MADSEN ELECTRIC
31006 PACIFIC HWY S 3939 S ORCHARD ST 3939 S ORCHARD ST
FEDERAL WAY WA TACOMA WA 98466 TACOMA WA 98466
(253)383-4546
Electrical Fixtures
Description Quantity L Description Quantity Description Quantity
Circuits- Commercial 1
PERMIT EXPIRES April 24,2006.
Permit issued on October 26,2005
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the usewillb ' accord an e aws,rules and regulations of the State of Washington and
the City of Federal Way.
l
Owner or agent: Date: Q
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-105488-00-EL
Owner: 7-11
Address: 31006 PACIFIC HWY S
FEDERAL WAY, WA
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.
O Slab/Concrete Floor(4255) 0 Ditch cover(4030) ❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) 0 Ceiling Cover(4020) 1,4 Final-Electrical(4055)
Approved Approved / Approved
By Date By DateB �1� Date to )
❑ Under-slab groundwork(4295)
Approved
By Date
•
! 44,,,,.
-LDL11
Federal Wa
v PERMIT
COMMUM7IDEVEI4PYBNTSRRYfCES -c 2 6 2005 SF MF CO ME aL DE EN FP
9999E FEDERAL
WAY,
WA 9.PO BOX 9"� C LI C AT I O N
ffiDERAG WAY,WA 94069-97111
•
ssaiass6orFAX ss9r3sz F FEDE
www.cituo Fede lwau.com Gi I ' U / /
BUILDING DEPT.
The olio • is re•aired in orniatlon-an Inco .tete • ••lication will not be acce•ted. Please •rint le•11,1 in or j. ,
■ PROPERTY INFORMATION
SITE ADDRESS -.o. , — - 3/C 0(0 Ae_i/C JWG1 S• SUITE/UNIT#NOASSESSOR'S TAX/PARCEL# - j
— — — LOT SIZE �
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(AI seParateM9eler ►w legald.,atpa«y
. ■ PROJECT INFORMATION >
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION Ja ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESC 0 (Provid detailed description of work included on this permit L2O . onitV G�� G'K
o.� . 12 . : .. ro e
„ilvt,
PROJECT NAME(Name of Business or Owner Last Name) 7-//i "-- _ -
U PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER 74/ TN 'e. (.2ç ) qrc//-SSJI/
MAILING ADDRESS CITY,STATE,ZIP
3to b( �
V tt, s. ter at-/J,t y /.F q.ice) 3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
01 RAS67/6 Eled•77e.lam -- (as-3)3F3 -YSY�
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
353 '! :S . d,PL6 7 D / e`r-a / 9F''L,4 U579 c2of-Q3K3—
CITY OF•FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE -- FAX NUMBER
L q-9 2--/ .6 .41 3 3-B• L . / / Ac3 1 5-1Y 4401/9
CONTRACTORS REGISTRATION NUMBER loopy of cant minima with each application( EXPIRATION DATE
W1 —3 -0S G E- L Y6Pk / /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
�4-Wt c . ( ) -
MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
a Architect a Tenant a Agent a Other(Describe) ( ) -
CONTACT PRIMARY PHONE E-MAIL ADDRESS
o- " (J.5313Z3- �sy (0 •
LENDER ' NAME
MAILING ADDRESS CITY,STATE,ZIP
I♦ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
•EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPIWIKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
WATER SERVICE PROVIDER a LAKEHAVEN a BENUMB a TACOMA: a PRIVATE(WELL)
SEWER sE nrremz PRfNTMED n T.AWE rrAVTIM .-. arrear rm. .-.......'�.- -.
a
ELECTRICAL PERMIT INFORMATION
• . _
.. RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Ci Family Square Feet Service or Feeder EachAdd'n
(First 1300 fts-$104.50;Each add'n 500 ft2-$33.50) ❑ 0 to 100 amp $113.50 $69.50'
❑ Detached outbuilding or garage ❑ 101-200 amp 141.00 89.00
(Inspected with service) $44.00 ❑ 201-400 amp 264.50 104.00
❑ Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50
(Inspected separately) $69.50 ❑ 601-800 amp 398.50- . 168.50
O 801 - 1000 amp 486.50 V 203.50 •
NEW MULTI-FAMILY(three units or more) ❑ 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 COMMERCIAL/INDUSTRIAL
❑ 601 -800 amp 247.00' 132.00 •
❑ Over 800 amp 353.50 264.50 Service or Feeders
0 0 to 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
❑ 0 to 200 amp $87.00
❑ 201-600 amp 141.00 ❑ tI of circuits to be added/altered
❑ over 600 amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea)
ft 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
MOBILE HOMES
❑ Service or feeder only $69.50
❑•Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residentica/Multi Faunily $61.00
❑ d of service or feeders
(First service/feed-$69.50;each adcPn-$45.00) Commercial/Industrial Service or Feeder Ampacity
O 0-100 amps $69.50
❑ I01-200 amps 89.00-
❑ 201-400 amps 104.50
❑ 401-600 amps - 141.00
❑ over 600 amps 152.50
•
MISCELLANEOUS-SERVICE/EQUIPMENT
❑ #of Thermostats ❑ N of Signs
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'nsign$24.50/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 0 Yard Pole meter loops $104.50
Cl Security Alarm System ❑ Additional Plan Review $104.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
CI ❑ Automation Fee on all Permits $5.00
• (Per System(s)-lot 2500 62461.00;
Each add'''.2500 fta-16.00)•Per WAC 29646.910(510#&11
Bulletin#100-January 7,2005 Page 3 of 4 IdHandouts\Pcrmit Application •
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PROJECT FLOOR AREAS
t� AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
_ J
FIRST
SECOND 1
. i
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS clQsrnla rmoronco tura r ; •- =;' ` ;
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
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(Gonadal) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES ' MISC(Describe)
. - • COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/ShowerC..mbH SHOWERS WATER CLOSETS(r.aeq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(cob.Aoki VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
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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
ant 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,includin he undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance of the its ffic and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE / DATE /6
moue) (Mei
RELATIONSHIP TO • •OJECT a Owner a Agent a Contractor a Architect a Other
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application•