05-100422 city of Federal Way Electrical Permit #: 05 — 100422 — 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) 835-305C
Project Name: FARMERS INSURANCE
Project Address: 33310 1ST% Way S I2jteft 3 Parcel Number: 926500 0255
Project Description: Relocate lights;install switches and receptacles;make connections to furniture whips.
Owner Applicant Contractor
Diane Share Foreman NORTH STAR ELECTRIC NORTH STAR ELECTRIC
33310 1ST WAYS 1905 S JACKSON ST 1905 S JACKSON ST
FEDERAL WAY WA SEATTLE WA 98144 SEATTLE WA 98144
98003-4544 (206)329-1596
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Sery./Feeder up to 200 amps-Co. 1
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 10)and must comply with FWCC,Chapter 22,
Article XIV"Critical Areas" and fill out a Hazardous Materials Inventory Statement,if applicable.
PERMIT EXPIRES July 30,2005.
Permit issued on January 31,2005
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way. / /—
Owner or agent: ,' Date:
/— D
Q�
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THIS CARD IS TO REMAIN ON-SITE
A ,
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100422-00-EL
Owner: DIANE SHARE FOREMAN
Address: 33310 1ST WY S BLD B
FEDERAL WAY, WA
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) W Final-Electrical(4055)
Approved Approved Approved
By Date - By Date By Al ,J Date 4u
❑ Under-slab groundwork(4295)
Approved
By Date
f
�:� RECEIVED O - s2 a 4 �
Federal Way PERMIT
CO1bMf.HY1TYDEVElAPMIDV7'SERVICES JAN 3 1 2005 SF MF CO M' L DE EN FP
33325 8TH FEDERA!WAY,WA 98•AO BOX 3-9718 9718 PLICATION
FEDERAL WAY,WA 98063-9718
2S3-835-2607•FAX 253-835-2601 rY OF FED E
www.dtyoffederatwau.conF BUILDING DEPT,
The of , , is ..-aired -rmation-an in-, ,lets • ;,•hcation will not be - .. - - Please , V •I, - or 7_ • .
NI PROPERTY INFORMATION
SITE ADDRESS 3 3 3 /U is T [,_,G1.>(/ s a/Q'/
8 SUITE/UNIT;s
ASSESSOR'S TAX/PARCEL# _ _ _ _ LOT SIZE(sfl
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
Gitt Ja ralavcwlcriffiathwI.Od description)
■ PROJECr INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PI 1MBING 0 MECHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) /
g F_ / cc fe. L t y A f.1 /iA/s T-2?// swL, 1 7cc Ae. r, /ee e...?ter c.,/c,/c,
/la I( r a/4/1/P '74'1;-:i•J s 7"-c. F,i riq/; 746 l'Z' (tJ h i,f
PROJECT NAME(Name of Business or Owner Last Name) t4 rM C Z 5 .1..o N. ca,
MI PEOPLE INFORMAriON
PROPERTY NAME PRIMARY PHONE
OWNER ( ) -
MAILING ADDRESS CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
AL 4 57Je i2 E/ecj4 (02°6 )3,2P -/5
MAILING ADDREESS KK COY,STATE,ZIP J_I 9 CELL PHONE
/9�)5 DS BUSINESS LICENSE NUMBER Sea 1`fk EXPIRATION 0l N (AX NUM)ER
o-_v Q-1 (2 s k- B L / / (og06) A.2? - pyo?
CONTRACTOR'S REGISTRATION NUMBER(copy at card requited with each appHealba) EXPIRATION DATE
d o /�' rAsE / 2408 / /
APPLICANT COM?ANY NAME APPLICANT NAME OFFICE PHONE
/Yo/2 Til 5lc /2. CE/eth'i'c_. ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL DDRESS
/if,c.ARcL E Llein/ 5 L2i1 ) 1?? -(5 ,e�aeLQ.@.Xf Qret..Ie
LENDER Far RCW 15.27.095: Leader lNbrnostion is NAME
»brad ffprq/set value exceeds 86,000 (91
MAILING ADDRESS CITY,STATE,ZIP
II DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑LAKEHAVEN 0 HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECFFLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS =ATM
mrosE
oD Tara. IOTA tunas s► TOTAL PROPOSED Toro.•/,
"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 HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(c mm,.ci4 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 rro,le) 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 authorised 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 o f the reliance of the city,including its officers and employees,upon the accuracy of the in formation supplied to the city as a part of
this application. n
NAME/TITLE DATE / ` o�d�J• Q."
gnatu (Title)
RELATIONSHIP TO CT ❑ Owner ❑Agent 0 Contractor 0 Architect ❑ Other
FOR OFFICE USE OILY
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES ❑NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
NEW ADDRESS REQUIRED? o YES o NO IIP/SEPA/SII? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES ❑NO
Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts\Permit Application
r
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 ft2-$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 U 201-400 amp 264.50 104.00
U Detached outbuilding or garage U 401-600 amp 308.00 123.50
(Inspected separately) $69.50 U 601-800 amp 398.50 168.50
U 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 530.50 283.00
Service Feeder
U Up to 200 amp $113.50 $33.50 ❑ Over 600 volts surcharge $89.00
U 201 -400 amp 141.00 69.50 U Mast or meter repair $96.00
U 401 -600 amp 193.00 96.00 ALTERED COMMERCIAL/INDUSTRIAL
U 601 -800 amp 247.00 132.00
U Over 800 amp 353.50 264.50 Service or Feeders
...0 to 200 amp $113.50 -1404ZIF
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
U 201 -600 amp 141.00 ❑ #of circuits to be added/altered
U 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
U Service- 1,000 amps or greater
U Mast or meter repair $52.00 U 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 ResfdentiaVMultt-Family $61.00
❑ #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
U 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
❑ #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 U Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
O Fire Alarm System U Yard Pole meter loops $104.50
O Security Alarm System ❑ Additional Plan Review $104.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
U Automation Fee on all Permits .. $5.00
CI
(Per System(s) 1.t 2500 ft2-$61.00;
Each add'n 2500 ft2-16.00)"Per WAC 29646-910(5)(b))I&ti)
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application