05-105106 a
• City of Federal Way Electrical Permit #: 05 - 105106 - 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: EMBREY
Project Address: 4014 SW 313TH Parcel Number: 873199 0060
Project Description: Alter(3)circuits for outlets,lighting&switches in kitchen.
Owner Applicant Contractor
RALPH&SANDRA EMBREY STARLA ELLWOOD STARLA ELLWOOD
4014 SW 313TH CT 11111 20TH PL NE 11111 20TH PL NE
FEDERAL WAY WA 98023-2145 LAKE STEVENS WA 98258 LAKE STEVENS WA 98258
(425)377-1982
Electrical Fixtures
Description 'Quantity Description ,Quantity Description (Quantity;
Circuits-Residential 3
PERMIT EXPIRES April 2,2006.
Permit issued on October 4,2005
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 City of Federal Way.
Owner or agent: ,/� #3i/��,�; Date: /0 —4/—e
, ATHIS CARD IS TO REMAIN ON-SITE - ..
CITY OF Community Development Inspection Record -
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-105106-00-EL
Owner: RALPH & SANDRA EMBREY
Address: 4014 SW 313TH ST
FEDERAL WAY, WA 98023-2145
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.
❑ 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
••
ila Rough Electrical(4225) 0 Ceiling Cover(4020) Di Final-Electrical(4055)
Approved Approved Approved
1:)f)
By �1\�� Date it By Date By 60,07 Date3 N
• r
,❑ Under-slab groundwork(4295)
Approved
By Date
RECEIVED
FederalOCT 042005 05 - j . Lc -c
COMMUMTYDEVELOPMENT SERRV o PERMIT SF MF CO M' 'L DE EN FP
33325Arm AVENUE
soUTT!•ro S• F�DERA
�� 2 � " PLICATION
semaae rca Xr.,4 3,.. BUILDING DEiirimi
The ollowi • is •aired in ormation-an Inco •fete . ••lication will not be acce•ted Please •rint le• •l n or p .
n 7
NI PROPERTY INFORMATION
SITE ADDRESS 4/40/9J LC/ J /3-& - SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 7 3 / (7 - D d z2 0 LOT SIZE(of)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach«r em p .f r len"iwd dawatoNonl
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
/l x_,o$ess a.,
-3 n4A, sly 14-ria j�l17r.L,/ 4 L15k/ (zfh
cr ,07 .L.,44,- a Ay 6 a2- ,r,' ls.Kc. .
PROJECT NAME(Name of Business or Owner t Name)
' al PEOPLE INFORMATION
PROPERTY NAME�� C _ i / PRIMARY PHONE/�-�__,Nh ks-3 6Sy I A-S'
MAILING DRESS CITY,STATg,ZIP
y6/r/ SA) 3/3 'i" fS Lv7 41./l9. 9eoZ3
CONTRACTOR COMPANY NAME APPLICANT NAME
OFFICE PHONE
>lU/S-L,POP"' Cie - core . c4r-G` Ellu)duc;/ (C(ZS-)577 / if Z.
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
l/lP - - ( PG ,li-C L .Siv. w11- z Al
CITY OF WAY BUS ESE LICENSE NUMBER i^- EXPIRATION DATE - FAX NUMBER
/Q os / (y�5 �7.2 -oa _r
CONTRACTOR' EO RATION NUMBER(espy of rogairod with seek application( EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME
CY, OFFICE PHONE -
MAILING ADD CITY,STATE,ZIP - CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
❑Architect ❑Tenant ❑Agent ❑Other(Describe) ( ) -
CONTACTE _ /
t//UGYJI.�,r(� I[ PRIMARY PHONE E-MAIL ADDRESS
( (7s )377 - / 1E2_ 91C„{a31&invi.431,
LENDER
MAILING ADDRESS CITY,STATE,ZIP
■ 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 a NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAIGEHAVEN a HIGRLINE a PRIVATE(SEPTIC)
•
- PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL I
SQ.FT. SQ.FT. SQ.FT. I
BASEMENT 111
FIRST •
SECOND
THIRD
FOURTH .
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT
. /
NUMBER OF FLOORS
13a7nre PROPOSED TOTAL ,�<< ,, <l',..0. ', ;. "'1, -
xn
**NEW HOMES ONLY''• NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ ,
FIXTURES
Indicate number of each type of fixture to be installed&relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $ /' NN
i •
AIR HANDLING UNITS / EVAPORATIVE COOLERS OAS LOGS REFRIO.SYSTEMS
BBQS FANS HOODS(Gosotetaq WOODSTOVES
BOILERS FIREPLACE INSERTS GFS ' MISC(Describe)
-
• COMPRESSO" FURNACES GAS R HEATERS
DUCTS GAS PIPE OUTLETS ---
PLUMBING
• :8(a b/slwwrCool* SHOWERS WATER CLOSETS Roaq MISC(Describe)
I ISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom MOO 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
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,including the undersigned,and filed against the City of Federal Way,but only where such claim
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
gpPcatton. C /O
NAME/TITLE DATE ����
(Signa (Mel
ATIONSHIP TO PROJECT ❑ Owner a Agent ❑ Contractor 0 Architect 0 Other
IJr >`±001,0(4)4 ',1t,°4:Ctl,trti(cj,:t - 0✓WAW ,q:,) ,.V;f'i' 1”:1CYW,-;:.0,)21.jirt'
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Bulletin$t00—January 7,2005Page 2 of 4 k\Handouts\Pennit Application 1
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet CI to 100 amp 1300 ft2 $104.50;Each add'n 500 ft2-$33.50) $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
❑ 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 SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
❑ Oto 200 amp $87.00
❑ 201-600 amp 141.00 ❑ S of circuits to be added/altered
= •• •i i amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea)
❑ # .f circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1 .' uits-$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
!II: MOBILE HOMES
❑ Service or feeder only $69.50
❑ Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK ResidentiaWultiFan dly $61.00
❑ S of service or feeders
i (First service/feeder-$69.50;each add'n-$45.00) Comrnercial'/Industrial Service or Feeder Ampacity
❑ 0-100 amps _ $69.50
❑ 101-200 amps 89.00
❑ 201-400 amps 104.50
❑ 401-600 amps - 141.00
❑ over 600 amps 152.50
•
MISCELLANEOUS SERVICE/EQUIPMENT
O 1 of Thermostats CI I of Signs
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00;addh sign$24.50/ea)
O Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Mann System 0 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 System(s) iA 2500 ftp$61.00;
Each add'n 2500 112-16.00) 'Per WAC 296-/6910(5J(*&fi)
Bulletin#100-January 7,2005 Page 3 of 4 NHandoutsTermit Application