05-105760 •
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City of Federal Way Electrical Permit #: 05 - 10
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Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection r• • ) 835-305(1
Project Name: AM/PM MINI MART
Project Address: 31855 PACIFIC S Parcel .er: 082104 9194
Project Description: Install(6)new circuits for new soda machine •
Owner Applicant tor
ATLANTIC RICHFIELD COMPAN ALASKA MARINE REFRIG INC ALASKA M NE REFRI INC
PO BOX 512485 9991 SE COTTON DDR 9991 SEC ONWOOE 7
PORT ORCHARD W 66 PORT HARD WA 98
PO BOX 512485 !LOS ANGELES,CA 1-441 ,
90051-0485
lectrical Fixture
Description j[Quant L ion 1 lty Description jrQuantity1
Circuits- Commercial ,i 6
B
PERMI '\ • ;..• 1\401::::)
, 06.
Permit ' \ ovember 9,2005
I ' .y certify •at the e info ion is correct and that onstruction on the above described property and
the o. la • . the use be in accordance with the laws,rules and regulations of the State of Washington and
the C• •eral Wa�yy/� /rn /l
Owner or a: •t: lit����fi'O ` Date: /1 ' 9 , V
•
a\‘5 Elle
C0itce-i�-S 111"1
THIS CARD IS TO REMAIN ON-SITE
CITY OF .x Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-105760-00-EL
Owner:
Address: 31855 PACIFIC HWY S
FEDERAL WAY, WA 98003-5409
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) ❑ Ceiling Cover(4020) 0 Final-Electrical(4055)
Approved Approved Approved
By Date By Date By Date
❑ Under-slab groundwork(4295)
Approved
By Date
PAc 5243 ,
` RECEIVED
lit Ilk 0 5- /57 & 0
Federal Way NOV 0 9 2005 — — / —
PERMIT SF MF CO MD EL •L DE EN FP
COMMUNRY DEVELOPMENT SERVICES
3332AVENUE FEDERAL WAY,WA 98063 mgrrtiOF FEDE ,LI CATI O N
253.8.35-2607•FAX 2,53835-2609 BUILDING
The ohowin. is •.uired in ormation-an incom.lete a. .lication will not be acce.ted. Please .rin t le.ibl (in ink)or .•.
QQ Pan
IN PROPERTY INFORMATION
� �)
SITE ADDRESS ' 5 5 C L J4 G //tug[� S SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# J - _ LOT SIZE(sf1
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Amor*separate page.*IeRadtlr legal descrpten)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING a., PLUMBING 0 MECHANICAL
0 DEMOLITION 'ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this rmit onl
InfzaI( In �'y1L arazci Jr ,soda rilaChtnef
PROJECT NAME(Name of Business or Owner Last Name) 6191 gr[il.} aril m m pi /la/ti-
ll
ll PEOPLE INFORMATION r
PROPERTY NAME rr�� Q PRIMARY PHONE
OWNER S // et 0 ( '7/4' ) h,'2C) - t/
MAILING ADDRESS COY.STATE.ZIP �/�1
if (en-kr PC)/r)kDi- Palin t , OA
CONTRACTOR COMPANY NAME APPLICANT NAMEOFFICE PHONE
L)/45 p /((Y)ne RCF�'lge,-it/ren Cha1 //1/'>/F (31,0s'iI - 441171
MAILING ADDRESS
`c115E C oHonurn-( L e CITY./ t C�-c hArr/, WI4 2Cb)N5C'1 - 9055
COY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
'i0-0 4_ (z 2- '2- B L i / < 1 /maw (34-6) 47l - ihtlit
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
4IAs Miier )e EEJ E�.= of ( ) -
MAILING ADDRESS CITY.STATE.ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect o Tenant 0 Agent o 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 PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED V I - - VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 -.‹ _ • FIRE S I ' - -.:--- t • 'STEM PROPOSED/REQUIRED? 'i YES NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA [I PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
f
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL LIMITING SF TOTAL PROPOSED SF TOTAL SF
**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 BANDUNG UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Co,ncnem aU WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLI I'S
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSE'T'S(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBI3S
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 is officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE L— V DATE
(Signature)
(Signature) ��
RELATIONSHIP TO PROJECT U Owner o Agent ❑ Contractor ❑ Architect o Other
FOR OFFICE USE ONLY
NEW r;ADDITION . ALTERATION ❑REPAIR r.i TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES H NO BASIC PLAN? o YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? p YES ❑NO UP/SEPA/SU? o YES o NO
PLATTED LOT? YES ❑ NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#1(X)—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
Service or Feeder Each Add'n
U Single Family Square Feet
(First 1300 ft2-$104.50:Each add'n 500 1t2-$33.50) U 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 ❑ 201-400 amp 264.50 104.00
U Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50
(Inspected separately) $69.50 U 601-800 amp 398.50 168.50
❑ 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) U 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
❑ 201 -400 amp 141.00 69.50 U Mast or meter repair $96.00
❑ 401 -600 amp 193.00 96.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ 601 -800 amp 247.00 132.00
U Over 800 amp 353.50 264.50 Service or Feeders
❑ Oto 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY U 201 -600 amp 264.50
U 601- 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
❑ 0to200amp $87.00
❑ 201 -600 amp 141.00 `
'0 f' S of circuits to be added/altered I
la over 600 amp 212.50 (1-5 circuits-$89.00:Add'n circuits,$7.00/ea)
U #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
U 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
U Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $61.00
U #of service or feeders
(First service/feeder-$69.50:each add'n-$45.00) Commercial//Industrial Service or Feeder Ampacity
U 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
U #of Thermostats U it of signs
(First-$52.00:add'n-$16.00/ea) (First sign-$52.00:add'n sign$24.50/ea)
U Low Voltage U 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
❑ Security Alarm System U Additional Plan Review
❑ voice Cabling $104.50/hour
❑ Data Cabling (for modified submittals)
❑ U Automation Fee on all Permits .. $5.00
(Per System(s) le 2500 ft2-$61.00:
Each add'n 2500 ft2-16.00)•Per WAC 296-46-910(5HW&rq
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application