04-105013 City of Federal Way Electrical Permit #: 04 - 105013 - 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: LOVE P.11'
Project Address: 31621 21ST'SW Parcel Number: 122103 9081
Project Description: Install low-voltage security alarm.
Owner Applicant Contractor
PAMELA LOVE CHUBB SECURITY NW.,INC dba SECURE S CHUBB SECURITY NW.,INC dba SECURE S
31621 21ST AVE SW 150 12TH AVE 150 12TH AVE
FEDERAL WAY WA SEATTLE WA 98122 SEATTLE WA 98122
98023-2247 (206)521-5678
Electrical Fixtures
P Description Quantity Description Quantity Description Quantity
Low Voltage Burgler Alarm-Residen 2250
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 June 15,2005.
Permit issued on December 17,2004
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/ /./
Date: Z`l " ""��
rJ�i \
THIS CARD IS TO REMAIN ON-SITE
CITY OF A Community .development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-105013-00-EL
Owner: PAMELA LOVE
Address: 31621 21ST AVE SW
FEDERAL WAY, WA 98023-2247
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) ❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
0 Rough Electrical(4225) ❑ Ceiling Cover(4020) Final-Electrical(4055)
Approved Approved Approved
By Date By Date By WA,' Date I
❑ Under-slab groundwork(4295)
Approved
By Date
12-10-'04 16:31 FROM-Chubb Security 2065215340 T-794 P02/05 U-396
CITY or'i1
Federal Way RECEIVED - ( O U ( 3
PERMIT
rommumrrosv ,oPmEnrSERVIcc SF MF CO me PL DE Eli FP
1.IJpF.DERAL AY,WA NUE SOUTH
1697 EC 1 7 2004APPLICATION TD
333.835•:bu9•AAA 353.635•2609
__I,"lir'i°nrd"id"'ou4`wicITYYOF FEDERAL WAY
The ollowin• is re•uiAVi,PaNrmatFon-•an incom•fete a�•iication will not be acce•ted. Please •rhit to•ibl in in or •e.
IN PROPERTY INFORMATION
SITE ADDRESS.3\C2\ ,. 1 i" --cre . (...-4,.) SUITE/UNIT Ii
ASSESSOR'S TAX/PARCEL if , ( d- 011� i. O 3 - q d F?". / LOT SIZE( )9
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) _,# . ��.. —
wth
IA . se;xrmopag.JorI 'Duly I&i • :enpiw1
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION L ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onWU)
Yh
PROJECT NAME(Name of Business or Owner Last Name)
IIIA PEOPLE INFORMATION
PROPERTY
OWNERya m. .lac ` (PRIMARY j3)PIInNfi ' c] �'1 to
MAILING ADDRESS Crry,4T'" "'n
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
TAkkAO\ T .,--....• 002)452 I . �
MAIL °ADDRESS CITY,a•TATp,21P
ect �4r EI.I.F1dONh
1 �`•' poi—(..., er .. Q 11 2Z l ) -_I IP'�
C TY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE UMBER
aQ-OO-1 01 a c ) c -B a )2 /3 ( / a(..( (dap )s it -6a
CONTRACTOR'S REGISTRATION NUMBER(copy otford required with each application)
EXPIRATION DATE
^CuS2_ CI CI s - / /
«�_
APPLICANT COMPANMEY NAAPPLICANT NAME OFFICE PHONY,:
MAILING ADDRESS - r CITY,STATIi,Zn, CELL PHONE
RELATIONSHIP TO PROJECT 1
FAX NumarR
ry
o Architect n Tenant 0 Agent ❑ Other(Describe) ( ) _
CONTACT NAME PRIMARY PHf1N1. F.-MAIL ADDRESS
) -
LENDER Per RCW 19.27.095: Lender informattien ix NAME
required if project value ekceeder S5,o00.
MAILING AD()RESg CITY,STATE,ZIP
ITR DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PRQpOSEb WORK $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES. 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE D TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER o I,AKEHAVEN n HIGHLINIE a PRIVATE(SEPTIC)
12-10-'04 16:32 FROM-Chubb Security 2065215340 T-794 P03/05 U-396
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
S•.FT. S•_PT, SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK:(COVERED?)
GARAGE ❑ CARPORT❑ -
PxISTINO Yhoeoseo TOTAL TOTAL SXISTINO SY TOTAL reoro•sD SP Tom,.Sr
NUMBER OP FLOORS
r
**NEW HOMES ONLY** NUMBER OF'BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated aspart of this D..•.. ._i.i
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(coeunt,6„t) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES OAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Showy,.Cu,),n) SHOWERS WATER CLOSETS(Toiloq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
-- LAYS((irlhroom 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 each 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 �1�.. I r DATE 12//6/o yJ
re) YI'Ale) fff
RELATIONSHIP TO PROJECT 0 Owner 0 Agent. 0 Contractor 0 Architect C Other.
FOR.OBFICE:USF'O}±i14Y' r ' ,. .. .I
o NEW a ADDITION o ALTERATION o REPAIR n TENANT IMPROVEMENT
BUILDING SHELL ONLY? ci YES I:,NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? (,YES n NO
NEW ADDRESS REQUIRED? n YES o NO UP/SEPA/SU? c;YES o NO
PLATTED LOT? n YES ❑NO DEMO PERMIT REQUIRED? a YES r,NO
Bullet in ii 1(10—August 19,2004 Page 2 of 4 Ic\I-litndouts\Permit Application
, 12-10-'04 16:32 FROM-Chubb Security 2065215340 T-794 PO4/05 U-396
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTjAk SERVICE NEW C9MMERCIAL/I1WUSTRIAL SERVICE
❑ Single Family Square Peet Service or Feeder Each Add'n
(First 1300 ft'--$87.00;Each add'n 5001'0-S28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
O Detached outbuilding or garage Q 101 -200 amp 117.50 74.00
(inspected with service) $36.50 ❑ 201 -400 amp 220.50 87.00
❑ Detached outbuilding or garage U 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/INDIJ TRIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FF-AMIL' ❑ 0 to 200 amp $ 94.50
0 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 amp $ 72.50 0 over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ over 600 amp I77.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
U #of circuits to be added/altered
(1-4 circuits-$58,00;Add'n circuits$6.00/rat) COMMERCIAL/INDUSTRIAL PLAN REVIEW
$74,00 plus 35%of Permit Fee
❑ Mast or meter repair $43.50 0 Service- 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
SINGLE ULT
/MI FAMILY PLAN REVIEW
D, Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBJLE HOMES
❑ Service or feeder only $58.00 TEMPORARY SERVICE
U Service and feeder $94.50
Commercial Residential
MOBILE BIOME/RV PARK Q 0-100 $58.00 $51.00
❑ #of service or feeders 0 101 -200 74.00 51.00
(First service/feeder-$58,00;each add'n-$37,50)
0 201 -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;adcrn sign$20.50/ca)
jil Low Voltage ❑ Swimming pooi/hot tub $87.00
Square Feet to be served by systems) a' 4) (Includes additional circuit,if required)
0 Fire Alarm System ❑ Yard Pole meter loops $58.00
Security Alarm System ❑ Additional Plan Review $87.00/hour
Voice Cabling (for modified submittals)
CI Data Cabling
(Per Sy$tem(s) 1612500 ft2•$51.00;
Each add'n 2500 ft°-13.50) "Per WAC'296-164.91015)04641.it/
Bulletin#100-August 19,2004 Page 3 of 4 k1(landuutsV'ermit Application