05-103896 City of Federal Way Electrical Permit #: 05 - 103896 - 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: LAKEHAVEN WELL#17
Project Address: 975 SW 320 Si" Parcel Number: 182104 9039
Project Description: Install conduit for low voltage access system.
Owner Applicant Contractor
LAKEHAVEN UTILITY DISTRIC STATEWIDE SECURITY STATEWIDE SECURITY
PO Box 4249 PO BOX 2019 PO BOX 2019
REDMOND WA 98073 REDMOND WA 98073
PO Box 4249 !Federal Way,WA 98063-4249 (425)558-4640
Electrical Fixtures
Description Quantity Description lQuantity Description Quantity
Low Voltage Burglar Alarm -Comm 2500
PERMIT EXPIRES February 1,2006.
Permit issued on August 5,2005
I hereby certify that the above information'is correct and that the co}struction 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: a Date: - > -01
/o
THIS CARD IS TO REMAIN ON-SITE
CITY OF 1100 Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 .
PERMIT#: 05-103896-00-EL .
Owner:
Address: 975 SW 320 ST 1
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.
❑ 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) 0 Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved Approved /
`By Date By Date By Date ` `
❑ Under-slab groundwork(4295)
Approved
By Date
1 RECEIVED
Federal Way , i!"� 05- __to_- _.”__ Le
SERVII S,,,,A
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SF MF CO ME 440'I, DE EN FP
COMMUNITY DEVELOPMENT
939YSdni ERALWY,WA SOUTH•POBOX 9718 APPLICAT ` .ERaLwa
FEDERAL WAY,WA 98069-.260 / /
• sss-aass6o7•FAX 259-Q35.4609 ��i��G DEPT.
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The ollowi • is re• ired in ormation—an Inco •late a••lication will not be acre•ted. Please •rint le•ibi in or j. .
■ PROPERTY INFORMATION
s. 7
SITE ADDRESS Sc�.; 3��L6/-/
T / c •(-�> SUITE/UNIT i
ASSESSOR'S TAX/PARCEL# i /`�L / Y- ct 4_ LOT SIZE(fl
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Aaaah agwmtepage for k i"legal deemOdoa1
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailyd c1elcriptioprf work included on this a onl
-l t ., Q rte. -c
-
C /tel s< // / 7
PROJECT NAME(Name of Business or Owner Last Name)
MI PEOPLE INFORMATION
PROPERTYE I PRIMARY PHONE
OWNER riti\I1 Imo( /l/ 1)1C-le(C--4 �S���IY( -(S/C,
'MAILING ADDRESS ST E,ZIP
/- .
r
CONTRACTOR CO AME APPLICANT NAME i O(FFFIC�E PHONE
<- k Lt_)1.dC ‘.('C 4-k-`'.1-)7 Z I'kr --Pt,-(-
NO AD ,ST ,ZW r CELL PHONE
/ • ', r c,c L 1 C1 Kt' / /a 4�- (,)17-r a7S(2c l 7 3u-2-7.2.
CcIT OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER �,,
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
APPLICANT COMP/d'IYAAr/, `4 " APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL.PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
0 Architect 0 Tenant fo Agent 0 Other(Describe) ( ) _
CONTACT NAT, L /r /y../ PRIMARY PHONE
(/ r. / . —7.
E-MAIL ADDRESS
LENDER :> ,<? " ; • 2 Ac•;:; r ,r;;; s :r,,„,„ r,r. _, NAME
a of !/^,/t •i, ,,f,, ,,r,,.c 1..an a
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ci YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? O YES O NO
WATER SERVICE PROVIDER O LAKEHAVEN O HIGHLINE O TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAIO;HAVEN 0 HIGHLINE a PRIVATE(SEPTIC)
- PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND -
1
THIRD
FOURTH -
ADDITIONAL FLOORS(DESCRIBE) -
DECK(COVERED?)
GARAGE 0 CARPORT 0
E7uMrwo PROPOSED TOTAL
NUMBER OF FLOORS ' "-u � ,r„�a R•t,,....,,�i[r,a �: Er
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES I
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(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES ' MISC(Describe)
COMPRESSORS FURNACES OAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS Irouei 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 cert(fy 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 of the reliance of the city,incicsdi its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. .%
7
/
NAME/TITLE , %�� /---7�/ _
DATE / �!;``
/ ... �.
(Signature) ( (Title)
RELATIONSHIP TO PROJECT ❑ Owner a Agent Contractor a Architect a Other
,V:4T uta€)t•rs(e) i i,'i6......4,,V0(c1.• ' ,=.11'D)VvVr;` G✓)+F.t7;t.i' I,f,Wz1el,..... t`
ife3 Ii,le.(e iDi,r ':.r! ."; `'n , i€ 3 9'ilft 1El�P� � �� 40.,
I - - pte a�>`i;(6): ) l`� ,� @y.'I ft31
;Di I,�00)Ay. j"; Di®�i4e i e�t.-:j .-(G) x,w t i t+.y Dricifii� 'r;' ;to?
w
<?� pro; Ci�)�`C�;l��'grr aar�eA%��r': �"5.4 � k{�'
7
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(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 ❑ 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
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 Restdentlal/MuILi-Family $61.00
❑ #of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercia/ladustrIal 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)
Low Voltage / U Swimming pool/hot tub $87.00
Square Feet to be served by system(s)42S (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)
❑ Da/ bling
( I4u�s vf rt) ❑ Automation Fee on all Permits $5.00
(Per Systan(s)-1a 2500 ft2-$61.00;
Each add'n 2500 ft2-16.00)•Per WAC 296-46-910(5)(bi(i&
1
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application