04-104989 City of Federal Way Electrical Permit #: 04 - 104989 - 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: ROLLOLAZO
Project Address: 624 SW 293RD St Parcel Number: 119600 0311
Project Description: New intrusion alarm
Owner Applicant Contractor
Ted L Rollolazo BRINKS HOME SECURITY INC BRINKS HOME SECURITY INC
624 SW 293RD ST 19115 WEST VALLEY HWY SUITE H-106 19115 WEST VALLEY HWY SUITE H-106
FEDERAL WAY WA KENT WA 98032 KENT WA 98032
98023-3538 (425)251-9727
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Low Voltage Burgler Alarm-Residenil 2370
PERMIT EXPIRES June 7,2005.
Permit issued on December 9,2004
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: p..e apptexclie/ Date: I 24 1(O'{
r\\?.`\\
o
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-104989-00-EL
Owner: TED L ROLLOLAZO
Address: 624 SW 293RD ST
FEDERAL WAY, WA 98023-3538
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) ❑ 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) Final-Electrical(4055)
Approved Approved Approved
By Date By Date By '4 Date /74(0S---
0
l QST❑ Under-slab groundwork(4295)
Approved
By Date
�; _ t RECEIVEDVEEN BT ,,�
-91D r , l DELOPMRTMENT,
;' Iay
' I DEC 0 9
4;
PERMIT SF MF CO MEiePL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
3353&FIRST WAY SOL7fT• BOX 9718 APPLICATION
FEDERAL WAY, 93(166 3-9718 D / /
253-661-4//5.FAXX 253661-9149
www.dtuoffederaltvau.com
The ollowi • is r+e• fired in ormation—an inco •tete a••lication will not be acce• d. Please •rint le•ibi in.i or l•
],U! LI J� o� PROPERTY INFORMATION
SITE ADDRESS Y V /(� '' 4.'/�� I SUITE/UNIT#
ASSESSOR'S TAX/PARCEL.# 1 I 9. O v 0- �� jLOT SIZE(s•D
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal da peony
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING o PLUMBING ❑ MECHANICAL
0 DEMOLITION)(ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detaileddescription of work included on this permit onlu)
—PROJECT-NA/LE:(Name of Business-or-:Owner.Last:Name)_----.—i- -- :--
PEOPLE INFORMATION
PROPERTY NAME PRIMARY}RY�PHONE Q
OWNER Te[.REsS o I le l azo _ ( Q53) 3).55 1 0Oi
MAILING ADD aq3'cd Si- CITY, of (Oatq $093
CONTRACTOR 9qMPANY NAME LICANT NAME OFFICE PHONE
'i1,-''�/,(^v!� �, e iI 1.( �Q_Q.#7lra bim, ir s (1 ,r) 2-67 - ?7z7
MAILING ADDR S CITY,ST ,ZIP CELL PHONE
ql ffW b /� > Ut/ � 9h ' ( ) -
OF FEDERAL WAY BUS NE C E N ER EXPI TION DATE FAX NUMBER
0-� Z g'42-°B°L_ I. / ( )
-
Cyk
NTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER.
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER ,= o er QW1pt1r095 4t*orrnatifon � NAME
'�,"�rey_ i ect fia"tue ezceeds#$5,"000
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) •
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
•
GARAGE/CARPORT. •
HOW MANY FLOORS? •ror�r_masrnro :Drat rnoxism rornr cruarmamry rRaorosm
**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(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(ranee) MISC(Describe)
DISHWASHERS _ SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Side) 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 its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. ]
NAME/TITLE :i ll0 DATE
(Signature) (Title)
RELATIONSIUP TO PROJECT 0 Owner 0 Agent 0 Contractor ❑Architect ❑ Other
❑NEW ADDITION o ALTERATION a REPAIR i TENANT IMPROVEMENT
ili
BUILDING SHELL ONLY? ❑.YFS I NO BASIC PLANP a to YES a 1�T0
ZONING DESIGN.NATIO _. CHANGE OF VSE? ? ..... ❑YES a NO
NEW ADDRESS REQUIRED?: ❑YES .a NO .. UP/SEPA/SU? ❑YES a..NO
PLATTED LOT? .... a YES a NO DEMO PERMIT REQUIRED?
Bulletin#100-March 30,2004 Page 2 of 4 k\Handouts-Revised\Permit Application
•
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE • NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101-200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201-400 amp 220.50 87.00
❑ Detached outbuilding or garage ❑ 401-600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601-800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) ❑ 801 - 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201-400 amp 117.50 58.00 ❑ Over 600 volts surcharge $74.00
❑ 401-600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601-800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
-❑_D_to.200 amp-- -.72.50 - - - - - - _overL000.-amp - __.___369.50__------ -- -- - - - _
❑ 201 -600 amp 117.50
❑ over 600 amp 177.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58.00;Add'n circuits$6.00/ea)
$74.00 plus 35%of Permit Fee
❑ Mast or meter repair $43.50 ❑ Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee •
MOBILE HOMES
❑ Service or feeder only $58.00 TEMPORARY SERVICE
❑ Service and feeder $94.50
Commercial Residential
MOBILE HOME/RV PARK ❑ 0-100 $58.00 $51.00
❑ #of service or feeders ❑ 101 -200 74.00 51.00
(First service/feeder-$58.00;each add'n-$37.50) ❑ 201 -400 87.00 n/a
❑ 401 -600 117.50 n/a
• ❑ over 600 127.00 n/a'
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
❑ Low Voltage ']J� ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) /IIJJ (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $58.00
❑ Security Alarm System ❑ Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
0
(Per System(s) lrt 2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) `Per WAC 29646-910(5)(b)(i a ii)
Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Permit Application