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03-104540 City of Federal Way Community Development Services Electrical Permit #:03 - 104540 - 00 - EL 33530 1st Way S Federal Way,WA 98003-6210 Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: CHAMBLISS Project Address: 3778 SW 319TH 51' Parcel Number: 873198 1600 Project Description: Replace 125 amp panel. **10/8/03-Revised to 200-amp panel per Contractor** Owner Applicant Contractor Richard D Chambliss &Silvia Chambliss LANDER ELECTRIC SERVICE LLC LANDER ELECTRIC SERVICE LLC 3778 SW 319TH ST 13359 NE 16TH ST 13359 NE 16TH ST FEDERAL WAY WA BELLEVUE WA 98005 BELLEVUE WA 98005 98023-2154 (800)794-4321 Electrical Fixtures Description ,Quantity Description ;; ' Quantity Description ^'Quantity Alt.Serv./Feeder:0 to 200 amps-Res. 1 PERMIT EXPIRES March 31,2004. Permit issued on October 3,2003 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: See Application pphcation Date: /O —3-03//0-8 -03 <1—a3 --+D7' �J-�tl Uj Cc--pv, f of City Development Services eveWay CommunityElectrical Permit #:03 - 104540 - 00 - EL 33530 1st Way S Federal Way,WA 98003-6210 Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: CHAMBLISS Project Address: 3778 SW 319TH Parcel Number: 873198 1600 Project Description: Replace 125 amp panel Owner Applicant Contractor Richard D Chambliss &Silvia Chambliss LANDER ELECTRIC SERVICE LLC LANDER ELECTRIC SERVICE LLC 3778 SW 319TH ST 13359 NE 16TH ST 13359 NE 16TH ST FEDERAL WAY WA BELLEVUE WA 98005 BELLEVUE WA 98005 98023-2154 (800)794-4321 Electrical Fixtures Description Quantity Description Quantity Description ,Quantity Alt.Serv./Feeder:0 to 200 amps-Res. 1 PERMIT EXPIRES March 31,2004. Permit issued on October 3,2003 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. - See Application See Application Owner or agent: Date: • • A T... CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVEI APPLI 4�T ONtI 1MSERI'g t . 0 3 APPLa tidaNUJMBER<'»- ig °ggim ------ .------ OCT **The following is required information-Please print(in ink)or type** Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. '7 ' ,l • PROPERTY INFORMATION SITE ADDRESS: .7 ` 8 .. 1).).w• 3-1�/ S ASSESSOR'S TAX/PARCEL#: - LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): • PROJECT INFORMATION TYPE OF PROJECT(This application): ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION ELECTRICAL o ENGINEERING o FIRE PREVENTION .2i.'VENTIONSY�STEM PROJECT DESCRIPTION(Provide detailed description): k04015 A/r-pI O. . u--'- PROJECT NAME: 00041•) 15 • PEOPLE INFORMATION PROPERTY OWNER: NAME: e DAYTIME PHONE: NAME„---: VI Cfr n' t r SS (�53)1�4 - 3V,02- MAILING A ESS(STREET ADDRESS;CITY,STATE,ZIP): 3116 -LA) Lg-"`54- "gP.riC',r'-ca l J& /. Q3oz3 CONTRACTOR: N E:� DAYTIME PHONE: 7de,� �P�� G i/cLLLC__ (1-09 512- 1 ? MAILING ADDRESS(STREET ADD CITY,��`�P):• ��`� _ �� EVENING PHONE: `1 1111 -I- l ( . CITY OF RAL WAY BUSI S LICENSE NUMBER: F NUMBER: 2 D - o 2) 1o_ Lo b7 - D 0 ( .0 -2-1Wo .CONTRACTOR'S REGISTRATION NUMBER: � � _ L.{� EXPIRATION DATE: (copy of card required) L I 1 P C S q9 1 FJ I / D5 i OS APPLICANT: NAME: DAYTIME PHONE: - MAILING RE S(STREET AD RESS;CITY,STATE,ZI ): EVENING PHONE: ( ) - • RELATIONSHIP TO PROJECT: ,j, FAX NUMBER: CI ARCHITECT ❑TENANT OTHER(DESCRIBE):�,0 Ya ( ) - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT )4 CONTRACTOR ■ DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: , PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING IYIC-❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES 0 NO WATER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** - NUMBER OF BEDROOMS: _ ESTIMATED SELLING PRICE: $ ■ PROJECT FLOOR AREAS FLOOR . EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH \ \Pr OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: ■ FIXTURES Indicate number of each type of fixture MECHANICAL • AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC o GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) ■ 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: Lk 1, ( DATE: o PROPERTY OWNER o APPLICANT CONTRACTOR ........................................................ FOR OFFICE[:USE:ONLX::::> :CE161SUS:CODE '::::::?::::::>.:: ;;:::.:.:::: <:>::;: >:::;; '.:LOT:SIZE..<:::::::::::: .:::::::»:.»>.s: <: :>:>:;;c`:. :; :;;::::::>�::: `. `: :;::::.. ::= ..........................................................:...................................................................................................:.................................................................. . ZONINGDESIGNATION: 3:::: ;::::::>:::'> >;::::::;::: ::::: :::: LL NE ❑YES.....:.©'NO ....:'r: ... ...................... .................................BUILDING:.SE� i?. Y7.... .. .. . <:COMP:Pli1N. .. sCt>NO;<;;<::<:<:.;;::;;:: ::>::>::;::::>.::i«::::<>:<;< -:::: :${kSx�................................................:...::.....::.,:.....:...:. ..: ................................... COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.cityoffederalway.com 09/24/2003 13:23 FAX 2536614129 CITY FEDERALWAY 0 001 • . ,. !• ELECTRICAL • TABLE B. • !EW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES , -Single Family • _Service or feeder only 557.00 _II of Thermostats(First-543.00;add'n-S 13.O0ca) (First 1300 h,'-SRS.SU:Each add'n SUU(11-527.50) _Service and feeder 593.00 _#of Low voltage(Ire or burglar alarms ,quare Feet: First 2500 Ill-550.00:Each add'n 2500 ft'-S 13.00. _Each outbuilding or garage . 535.50 MOBILE HOME/RV PARK Square Fcct; (Inspected with service) _8 of service or feeders •Per WAC 296-46-910(5)(b)(1&ii) _Each outbuilding or garage 557.00 (Firs(service/feeder-557.00;Add'n service/ #of Signs(First sign-S43.00;add'n sign (Inspected separately) feeder-S37 each) 520.00 each) _Swimming pool,hot tub,spa........____._585.50 _Yard Pole meter loops 55.7.00 NEW MULTI-FAMILY COMMERCIAL/INDUSTRIA' COMMERCIAL/INDUSTRIAL (includes three units or more) Altered Service or Feeders Service Feeder Amps Ssrvtce or Add'n _0 to 200 5 9 3.UU _Up to 200)amp 5 93.00 S 27.50 Feeder _201 -600 ...__.216.50 _201 -400 amp 115.50 57.00 _0 to 100 93.00 5 57.00 _601-1000 326.50 401 -600 amp 158.50 78.50 _101 -200 115.50 72,50 _over 1000 36100 601 -800 amp 202.50 108.50 _201-400 216.50.. 85.507-5 (1-8 ofcircuits _Over800 amp. 289.50 216.50 _401-600 252.50 101.00 5 circuits-572.50;Add'n circuits,56 ea) ALTERED SINGLE/MULTI FAMILY _601 800 326.50_ 138.00 (When inspected separately from the services.) _801-1000..__._...............399.00 166,50 TEMPORARY SERVICE S rvice or Feeder . .) Over 1000 434.50....._._232.00 Residential/Mufti-Family/Commerciai/lndustrial 0 to 200 amp5 71.50 _Over 600 volts surcharge_..____............72.50 _0-100 ' S 57.00 _201-600 amp .50 _Mast or meter repair 78.50 _101-200 72.50 over 600 amp 174.00' _20!-400 85.50 _Mast or meter repair • 43.00 I _401-600 115.50 p of circuits _over 600 • 125.00 (1-4 circuits-557.00;Add'n circuits 56 ea) 11a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps_a plan review is required.Fee is 35%of Hermit fee+572.50.Add'l plan review for other submissions is 585.50/hr. • FIXTURE DESCRIPTION(A) . FIXTURE.FEE FROM TABLE B(B), . ' -.NUMBER OF UNITS(C) 4 TOTAL(D) i � I n•- . .:"/TOTALCOLUMN(D):• Toil Caiucna(0) Estimated Permit Fee: (12) ' Estimated Permit Fee from ane 12 Estimated Plan Review Fee: $72.50+( X.35)=(13) • --:: -: -:$'DEMOLITION - . _- _.--..-•••:,-.,-...-_ _ . ._- Estimated Permit Fee: (14) • Bond Amount:(15) . • . _ ENGINEERING Estimated Permit Fee:(16) Bond Amount: (17) • ._ •-'r - MOTHER FEES •-- _ _ .- --_. Mitigation Fee:(18) (20) (L2) SBCC Surcharge:(19) (21) (23) Total (Pages one&Tyro): Une(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)x(18)+(19)-x(20)+(21)+(22)+(23)_ (24) Bulletin #100-December 23,2002 4