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City of Federal Way Electrical Permit #: 05 - 105197 - 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: MEDINA
Project Address: 33732 32ND SW Parcel Number: 954280 1390
Project Description: Add(2)circuits for remodel of garage to habitable space.
Owner Applicant Contractor
LILIA MEDINA LILIA MEDINA LILIA MEDINA
33732 32ND AVE SW 33732 32ND AVE SW 33732 32ND AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
(253)653-0363
Electrical Fixtures
Description Quantity Description IQuantity Description 1Quantity
Circuits-Residential 2
PERMIT EXPIRES April 5,2006.
Permit issued on October 7,2005
I hereby certify that the abo - information is correct and that 1,- construction on the above described property and
the occupancy and the us- ' 1 --e in accordance with • ;X rules and regulations of the State of Washington and
the City of Federal Way /
Owner or agent: i l/lOt / Date: is — 1— CSS
✓I
,,
V �I
THIS CARD IS TO REMAIN ON-SITE •.A.
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-105197-00-EL
Owner: LILIA MEDINA
Address: 33732 32ND AVE SW
FEDERAL WAY, WA 98023-7723
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
. •❑ Rough Electrical'(4225)
.
❑ ' Final-Electrical(4055)
Approved � Approved Approved
•B Date (D' / By Date By Date
❑ Under-slab groundwork(4295)
Approved
By Date
i
Federal Way RECEIVED . CS - • !
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FEDERA2 WAY,FAX
53.8 3 260
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?53135V IT FAX?;;;lO 2609
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The ollowi • is , 9 eW 9n o9rm Mori—an Inco .tete , ,,Uication will not be acce•ted. Please •rint ie• -1 in in or
■ PROPERTY JNFOR',IATIO:;
SITE ADDRESS 33732 '32 Na \i • T�11J G} J,C� SUITE/UNIT#
------41-9,5-71,1
ASSESSOR'S TAX/PARCEL# , O V / / V LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
G►aaaharyorolePro lw Mpthy kid dpvtaien)
• PROJECT INFOI:MATION
TYPE OF PERMIT 0 BUILDING ❑ UMBING 0 MECHANICAL
0 DEMOLITIO ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work ded on this permit only)
c e 05 CA NS kin Lae.
2- eC i 5,
PROJECT NAME(Name of Business or Owner Last Name) 11/4..if f Cet.vaz..._,
• PEOPLE INFORMATION
POWNER ROPERTY NAME k,--1,c,
r��^J,l `Y PRIMARY PHONE
(2s3) 453-6 ,(33
MAILING ADDRESS CITY,STATE,ZIP
337,32 32(i,f.k. A\I 6 W ce.6416.1 W 'l ck T02,3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
IL O DRESS CITY,STATE,ZIP CELL PHONE
( ) r
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER _ EXPIRATION DATE - FAX NUMBER
CONTRACTORS (copy of c�required REGISTRATION NUMBERL
/ / )
red with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
nAE of �«(le,(-�y ou Nei — . ( ) -
MAILING ADDRESS CITY,STATE,ZIPCELL PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
a Architect a Tenant a Agent a Other(Describe) ( ) -
CONTACT NAME PRIT PHONE E-MAIL ADDRESS
SA E • ficX ' " -C Ot,e* J ) -
LSXDER •{,- ;< fY .•,i;:, !;4,r.,,- c44,;,,,,;,xi.,;, z NAME
MAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? o YES a NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE 0 TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT. _
BASEMENT
FI -
SECOND
THIRD
FOURTH •
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?) ••
GARAGE 0 CARPORT 0
•
NUMBER OF FLOORS • "I Paoroam I tterN
fig+ '
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture 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(c.mm ed.q WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
' • COMPRESSORS - FURNACES RAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(Gem/showercombo) SHOWERS WATER CLOSETS(met) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVs patlueem 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 Wa as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claims,which may be m•- any person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance of ,including its cers and emplo es,upon the accuracy of the information supplied to the city as a part of
this application.
NAME! TITLE •(� v� ''tom G `��(/( ' / D
/ dolimf
DATE /0 LJ
(Signature) (Title)
RELATIONSHIP TO PROJECT "(4 weer o Agent o Contractor o Architect o Other
P-'I ;9r)t)€'r`(c);,FVt•'S (y,Vr•(Oct ,a .Vii •+rl;,){h,ptl+€ 1Irl%;tea',t:n!I }aft'
, 4th k i,;*0fe :;":171V/A., (�!
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application
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ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
di 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
❑ 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
❑ 801- 1000 amp 486.50 203.50
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 0 Mast or meter repair $96.00
❑ 401 -600 amp 193:00 96.00 ALTERED COMMERCIAL/INDUSTRIAL
0 601 -800 amp 247.00 132.00
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ 0 to 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50
❑ 601 - 1000 amp 398.50
f Service or Feeder ❑ over 1000 amp 443.50
0 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)
Cl 9.... $of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$69.50;Add'n circuits$7.00/ay $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 Residentlal/Muit4-Fandiy $61.00
❑ 4 of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Ampacity
❑ 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
1 •
MISCELLANEOUS SERVICE/EQUIPMENT
❑ $of Thermostats ❑ #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 tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $104.50
❑ Security Alarm System ❑ Additional Plan Review $104.50/hour
' ❑ Voice Cabling (for modified submittals)
❑ Data Cabling
0 Automation Fee on all Permits .. $5.00
CI
(Per Syatem(s) la 2500 ft2-$61.00;
Each add'n 2500 ft2-16.00)•Per WAC 296-46-910(5)ry/(&ii)
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application