05-103321 City of Federal Way Electrical Permit #: 05 - 103321 - 00 - EL
Comfnunity Development Services
P.O.Bbx9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: NW UROLOGY SPECIALISTS CLINIC
Project Address: 34612 6TH,firV i Parcel Number: 926480 0010
Project Description: Installing a new 200 amp,3-phase panel and wiring;installing L/V fire alarm wiring
Owner Applicant Contractor
TIM RECTOR DANARD ELECTRIC INC DANARD ELECTRIC INC
PO BOX 890 18819 38TH AVE E 18819 38TH AVE E
BLACK DIAMOND WA 98010-0890 TACOMA WA 98446-1142 TACOMA WA 98446-1142
(253)875-8650
Electrical Fixtures
Description ,Quantity Description '; Quantity Description Quantity
Low Voltage Fire Alarm-Commercia 4700 Service/Feeder.201400 amps-Conti 1
PERMIT EXPIRES January 7,2006.
Permit issued on July 11,2005
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 wit . laws,' s and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: LL,,ALtI - Date:
1\(.1)
\A'cj‘
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 •
PERMIT #: 05-103321-00-EL
Owner: TIM RECTOR
Address: 34612 6TH AVE S
FEDERAL WAY, WA 98003
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) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
,[ Rough Electrical (4225) Ceiling Cover(4020) PI Final-Electrical(4055)
Approved Approved Approved
1
By '�` Dates C.-_,k ‘ Date �� By •,4, Date I t;•( ,(
• •
❑ Under-slab groundwork(4295)
Approved
By Date
r
IRECEIVED -
crrYoF ':i�,wc: .++
= Federal Vlla�/ JUL 1 1 2005 � � - � � -� � 2._
PERMIT SF MF CO MEdi,L DE EN FP
COMMUNITY DEVELOAdF1VT SER VICES
33325 8
FEDERAL
WAY,
WA 98063-9q1"
.63-9 OF F E D E Rq�,
FEDERAL WAY,WA 98063-9 BUILDING D $ LI CATI 0 N TD / /
253-835-2607•FAX 253-835.2609
www.cityoffederalway.alm
The ollowl • is re• ired in ormation-an incom•fete • ••lication will not be acce•ted. Please •rint le• •1_ (in or t j• .
MD //--(! Ave1 PROPERTY INFORMATION/ I
SITE ADDRESS �'MD ih ,4 S, Q�,l Way WOO 3 SUITE/UNIT#
ASSESSOR'S TAX/`ARM' # - _ _ _ _ LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) _
ijA
glaach separate page for lengthy Iep4 description)
I' PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION sr ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed on description of work included this permit only)
1s fl Ele&M'& / Ar - 1-1:: - .,vim &ttb fey
PROJECT NAME(Name of Business or Owner Last Name) red eca ( 6.)A y !'rh.b&tied Div
1 NI PEOPLE INFORMATION J
PROPERTY NAMEPRIMARY PHONE
OWNER S Ca01L & C4('oP1S ( ) -
MAILINGAATE,ZIP
DDRESS6 Ox q9O CITY, kick DI{;l,I'✓lrj✓1 04 WA
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
b ^o( &kecir)'C! Ken OW k (a53 ) 175 - 86s a
MAILING ADDRESS CITY STATE,ZIP • CELL PHONE
1 Sg 1 q .3 S'''y` Avg 6 7 c®rlifti ttill 906(a67) G77 - 9,2o7
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - - B L / / ( )
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
APPLICANT COMPANY � APPLICANT NAME OFFICE PHONE
ec/r')C X v2 IJP1e- (253) 175 - 8"&<50
MAILING ADDRESS,STATE,ZIP CELL PHONE
egg 1 IRELATIONSHIP 3( 4 b. 'look-tTO PROJECT a f A/A q vG (? 3)NUMBER FAX 67/ - `���
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? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
F(6-&-r. . -
.gd
ELECTRICAL PERMIT INFORMATION
oo- acn..‘q 3 f t
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
CI 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
U Detached outbuilding or garage _1 t'
101-200 amp 141.00 89.00
(Inspected with service) $44.00 ( 201-400 amp ( 64.50_) 104.00
❑ Detached outbuilding or garage U 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 ❑ 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 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 ❑ #of circuits to be added/altered
❑ over 600 amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea)
❑ #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 Residential/Multi-Family $61.00
❑ #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
❑ 101-200 amps 89.00
❑ 201-400 amps 104.50
❑ 401-600 amps 141.00
❑ over 600 amps 152.50
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)
U 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 ❑ Automation Fee on all Permits .. $5.00
(Per System(s) 1st 2500 ft2-$61.00;
Each add'n 2500 ft2-16.00) .Per WAC 296-46-910(5)(b)(i&ii)
�. S0
Bulletin#100-January 7,2005 Page 3 of 4 I \Handouts\Permit Application
•
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 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL sr
**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(commercial) 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 closet) 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 s o cer d employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE I/A)
DATE "/—
ignat're) (Title)
RELATIONSHIP TO PROJECT a Own ❑ Agent -ntractor ❑ Architect ❑ Other
41...
FOR OFFICE USE ONLY6, mss.
o NEW a ADDITION a ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a'YES o NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? o YES o NO
PLATTED LOT? a YES a>NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application