04-101661 •
City ueveWay
Communnityity Development Services Electrical Permit #:04 - 101661 - 01 - 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: REYNOLDS-WALSH
Project Address: 30210 23RD Sl. Parcel Number: 012103 9005
Project Description: Relocate 320-amp service to existing detached shop and install new panel.REVISED 6/9/04 to alter
service for septic system connection
Owner Applicant Contractor
Druery E Clark EVERGREEN STATE ELECTRIC INC EVERGREEN STATE ELECTRIC INC
30210 23RD AVE SW PO BOX 1448 PO BOX 1448
FEDERAL WAY WA ORTING WA 98360 ORTING WA 98360
98023-2351 (253)770-0656
Electrical Fixtures
Description IQuantity i Description Quantity Description Quantity
Alt_Serv./Feeder 0 to 200 amps-Res. 1
PERMIT EXPIRES December 6,2004.
Permit issued on June 9,2004
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. e,
Owner or agent:-VI Date: J V rt./e. l� (�00 ti
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City of Federal Way
Community Development Services Electrical Permit #:04 - 101661 - 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: REYNOLDS-WALSH
Project Address: 30210 23RD SW Parcel Number: 012103 9005
Project Description: Relocate 320-amp service to existing detached shop and install new panel.
Owner Applicant Contractor
KATHY REYNOLDS EVERGREEN STATE ELECTRIC INC EVERGREEN STATE ELECTRIC INC
30210 23RD AVE SW PO BOX 1448 PO BOX 1448
FEDERAL WAY WA 98023 ORTING WA 98360 ORTING WA 98360
(253)770-0656
Electrical Fixtures
Description Quantityl, Description ;Quantity Description (Quantity
Alt.Serv./Feeder:201 to 600 amps-RI 1
I_ J
PERMIT EXPIRES October 31,2004.
Permit issued on May 4,2004
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: 5 V'k v2) Date: 5/41/ay
0_q_ - -L --6 L
Federal Way PERMIT RECE•
IVF CO MEOL DE EN FP
COMMUNITY DEVELOPMEPR'SERVICES
33530 FIRST WAY SOUTH•PO BOX 9718 7�7 (0
53 ;;;15F 253-661-4129
APPLI CATI O.Y�y/�I'A�
tw,w.atuofederalwau.eom
The ollowin r is re•uired in ormation-an inco •tete a••Iicatiotct IQgtWIE: ', .. `Tease •rint le•ibl (in ink)or
PROPERTY INFORMA'PIC::
• SITE ADDRESS 3 O 10 t: SCD A V e. 5 LK) . SUITE/UNIT# '--
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
/Attach sepwule Page for lengthy legal desaipion)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION K ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed 1 escription of work included on this permit onlu)
d1 A ' - 10\rt ' - eg . - S eic'i c . iSJIt.T�:.,.4 IQTOr
'EX'S "LTi tUC� _ ir [v.: - - •h "Y 1i.t3 ON- & e.. 1173 ;
_T5dP C J yc2rw._ e.T ) AC {).
PROJECT NAME(Name of Business or Owner Last Name) key i 3 o l(J1 s
PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER Ka'A,,1 ReVAU)1a5 ( ) -
MAILING ADDRESS ( CITY,STATE,ZIP
304,10 011 v— Lt. Sw ,, Peattekk t ic,y Wc,. et$O' ,
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
EU er re.e'J Sro.Te �.1,ce . (R53 ) -no -0G5-(0
MAILING ADl�SSos ip
CITY;STATE, IP �0. 2 PHONE
� �
al T �e Ac o . PV/) p ��'7 ) 3 y S$
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER / EXPIRATION DATE FAX NUMBER
L1---9Ct Ca-310a A 0 LB L Dec- / 31 / 004( ( ) -
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
Ev 51). 1) s _a_ococzTfN- '1 /o ( / off
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
• SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN a HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
I SEWER SERVICE PROVIDER ❑ LAKEHAVEN a 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 EXISTING AND PROPOSED
**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.
MECILAIVICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS)commerc aI) 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(toilet) 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
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. (� \ D `
NAME/TITLE jJW/"Jib-. fl&?�.Aksb �eS Cle►U\1c\ dDt)1cal-5°{'
�/ (Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent 0 Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
o NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o 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 ff 100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
s
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Single Family Square Feet 5 O� 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 74.04-&'
(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) CI 801 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
0 201 -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
❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 amp $ 72.50 ❑ over 1000 amp 369.50
X201 -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)
❑ (1 #of circuits to be added/altered
-4 circuits-$58.00;Add'n circuits$6.00/ea) COMMERCIAL/INDUSTRIAL PLAN REVIEW
$74.00 plus 35%of Permit Fee
❑ 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 U 0-100 $58.00 $51.00
❑ #of service or feeders ❑ 101 -200 74.00 51.00
(First service/feeder-$58.00;each add'n-$37.50) ❑ 201 -400 87.00 n/a
❑ 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
O #of Thermostats ❑ #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
O Security Alarm System ❑ Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
O Data Cabling
(Per System(s) 1•,2500 ft2-$51.00,
Each add'n 2500 ft2-13 50) •Per WAC 29646-910(5)(b)(i 6,ii)
Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Permit Application ,