05-100909 City of Federal WayElectrical Permit #: 05 - 100909 - 00 - EL
• Community Development Services
P.O.Box 9718
Fh:(ral 25 ) ay,WA 98063-(253 Inspection request line: (253) 835-30513
Ph: 835-7000(253) Fax (253)835-2609 P 9
1
Project Name: WEB MD
Project Address: 33400 9TH 5 t R ve S 66+e 0704 Parcel Number: 926501 0060
Project Description: Install voice&data cabling for tenant improvements.
Owner Applicant Contractor
GOLDEN STONE LLC BLACK BOX NETWORK SERVICES BLACK BOX NETWORK SERVICES
33400 9TH AVE S BLACK BOX NETWORK SERVICES BLACK BOX NETWORK SERVICES
FEDERAL WAY WA 98003 200 ANDOVER PARK E SUITE 1 200 ANDOVER PARK E SUITE 1
TUKWILA WA 98188 (206)575-1363
Electrical Fixtures
Description rduantity Description Quantity Description ,Quantity
Low Voltage-Other Commercial 4500
PERMIT EXPIRES August 24,2005.
Permit issued on February 25,2005
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in acc e with laws,rules and regulations of the State of Washington and
the City of Federal Z
Owner or agent: Date: C5 2—40,
Z S O
1
THIS CARD IS TO REMAIN ON-SITE - .
CITY of Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100909-00-EL
Owner:
Address: 33400 9TH AVE S Suite 204
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.
0 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) Tx, Final-Electrical(4055)
Approved Approved Approved
By Date By Date By Date /
❑ Under-slab groundwork(4295)
Approved
By Date
i
I
,�. 41k,, RECEIVED C2_ - 1 0 o I' n 9
Federal Way PERMIT
OOMMUNIIYDEVEWPMEN7 SERVICES FEB 2 XI_ SF MF CO ME tOPL DE EN FP
33325 D AVENUE SOUTH•63 BOX 9718 TD
FEDERAL WAY,WA 98063-9718
253-835-2607•faX253-s35-26P3)TY OF FEpERgL WAY
/--
.1
y�ww.dttp((ederaiwaq.aottt BUILDING DEPT.
The ollowi • is • ired in ormation-an inco •tete a••lication will not be acc 1.ted. Please •rint le•ibl (in in or . .
IM PROPERTY INFORMATION
N ,,,,�
SITE ADDRESS J, 00 QV I \V .S, Sc0 0• SUITE/UNIT ik
ASSESSOR'S TAX/PARCEL 9 - _...
LOT SIZE fri)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attath separate page for lengthy legal description)
I. PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION •iiil ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
Q'OlCiii t b F
PROJECT NAME(Name of Business or Owner Last Name) k1 (1`• V'`•)
U PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER 005F-696 - ( A )
j -c -'z5C)
MA � PSS
CITY STATE,ZIP
32C) . tbco-iii WG r3,G. . SIG 160 fegiateru W (,J) , %oo y
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
el -601 C5 - \IC,S• <)eff ikAiN&O tA1 ( 20, ) 535' - /3403
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
2o M P> . , .-rt,#1 ijiLA- \tic), t(iS (2Ob )963 - s�O O
Crri OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
0 - °3 -1 0 L se-° o-B L /2/ 3i / CS (2 � ) 57S'- /3(e2_
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
13 U k C Kg ►J q 6 (4 J L- / /
APPLICANT COMPANY NAME CN7nL APCANT NAME OFFICE PHONE -
MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
t:- 4lS J e` S -d\)6 ( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect _❑Tenant ❑Agent ❑ Other(Describe) ( ) -
CONTACT NAMEc)t✓, \ `` (PRIMARY ADDRESS
�(J�) �Vb5� - � 14Rnvw V `1141, '
LENDER , ,P2i. * a • NAME e-6 . Ccs
✓'f'v'1 ,.
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑LAKEHAVEN ❑HIGHLINE ❑PRIVATE(SEPTIC)
- PROJECT FLOOR AREAS
FT.
AREA DESCRIPTION EXISTING PROPSQ.OSFT.ED TOTAL
SQ.FT.
BASEMENT
FIRST ;
SECOND
THIRD
FOURTH .
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS E7°�'"O PROPOSED TOTAL TOTALEXISTIIGSF - TOTALPROPOSED sr TOTAL
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of facture 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(commercia4 W OODSTOV ES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS log ttimtsnow,rcomno{ SHOWERS WATER CLOSETS(roa'q MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(BuhnoomSi ks! VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correctto 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 an •erson, eluding the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the cePf i c{tj ncl,ding officers and employees,upon the accuracy of the information supplied to the city as a part of
this appiicatiarf .
NAME/TITLri DATE L) `�S
( nature) (Title)
RELATIONSH PROJECT 0 Owner ❑ Agent 1A Contractor 0 Architect 0 Other
,'- •� '
3s o DT ONN"''' '''''4%-41?--
��'�ALTERATION l]REPAIR �p `ENANT IIYtP120VEMENT „$ ' '
i0.l o o '''+'""77:}444°
4 $ . BASIC'E op o YES y 1 A,, �'
r .s► -IGNATION , �r , CHANGE OF USE? � i a YES T,O
`DD,RESS 2•EQUIREDY 40,-XES NO y UP/SEPA/SU? � &❑YES O
wED: �
as "� ...? �'.� tiDEMO�PERMII`+ eI)IRED� YES O
w
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application
ELECTRICAL PEkIMrr INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(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
❑ 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
❑ 0 to 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 Residential/Multi-Family $61.00
❑ _ #of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Ampacity
❑
o-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 Voltage4L�y") ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) 6-V (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $104.50 ,/
❑ Security Alarm System ❑ Additional Plan Review $104.50/hour
VI Voice Cabling (for modified submittals)
GI Data Cabling
0 El Automation Fee on all Permits .. $5.00
(Per System(s) 1•t 2500 ft2-$61.00;
Each add'n 2500 ft2-16.00) •Per WAC 296-46-910(5)M6/(&ii)
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application