03-104399 City of Federal Way
Community Development Services Electrical Permit #:03 - 104399 - 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: BIG LOTS
Project Address: 1211 S 320TH 9t Parcel Number: 150050 0030
Project Description: Install(9)thermostats for HVAC system in conjunction with tenant improvements.
Owner Applicant Contractor
1560 INVESTORS LLC EVERGREEN REFRIGERATION INC EVERGREEN REFRIGERATION INC
200 S BROAD ST#6 727 S KENYON 727 S KENYON
SEATTLE WA 98108 SEATTLE WA 98108
(206)763-1744
Electrical Fixtures
Thermostat ' 9
PERMIT EXPIRES March 22,2004.
Permit issued on September 24,2003
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: 0.01044/‘.--11.114-1-••Y' Date: RA14l6
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RECEIVED CONSTRUC I ION PERMIT APPLICATION
CITY OF �� APPLICATION NUMBER: o 3 - I Q (.31t - EL-
Federal
El✓Federal Way SEP 2 4 2003 APPLICATION NUMBER: - -
FEDERAL WAY
'APPLICATION NUMBER: - -
"The orTY t On_F Cinformation—Please print(in ink)or type*"
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
- ' ,--- U':PROPERTY INFORMATION .
SITE ADDRESS: t `"t U ...)az)��� \- ASSESSOR'S TAX/PARCEL #: I 5 0 0 S 0- 0 Q 3o
LEGAL DESCRIPTION Q SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): 5riBUILDING o PLUMBING 0 MECHANICAL 0 DEMOLITION
0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): /I) CrE II tii C`. kb: L-
4 PROJECT NAME: 61 LI LO TS
. - ■ PEOPLE INFORMATION ,.
PROPERTY OWNER: NAME: / DAY?IME PHONE
i `J
i
MAILING ADDRESS`STREET ADDRESS;CITY,STATE,ZIP):.
3() Pk';Li ;p (, P,06A 10I(4 VlikkAtr ,Ok `"r)ti-a
CONTRACTOR: NAME: DAYTIME PHONE:
Evc,c c.,h, fizz-Pc : e-c4+;6),, ( C )76 - -1 7tii(
MAILING ADDRESS( EET ADDRESS;CITY,STATE.Z�: I EVENING PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
0 CI0 — tcL '/63 00 (.6L l ( 1) 3 - d3
CONTRACTOR'S REGISTRATION NUMBER: ! EXPIRATION DATE:
(SPY or card required)
vCR (R -f 4 / j
APPLICANT: ( NAME: DAYTIME PHONE:
( ) -
fMAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
(
RELATIONSHIP TO PROJECT: j FAX NUMBER:
❑ ARCHITECT o TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER ❑ APPLICANT o CONTRACTOR
: -■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES ❑ NO
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROSECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL Value of Mechanical Work: $
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 o 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 daim(induding costs,expenses,and attorneys'fees incurred In the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the dty,induding Its officers and employees,upon the accuracy
of the information suppliedlito the dty as a part of this application. //
NAME/TITLE: C/ ptDATE:ti ` Lr _ ��� i"G .
�
o PROPERTY OWNER o APPLICANT e' CONTRACTOR
FOR.OFFICE.USE ONLYl
NEWS; 13`ADDIIONq ALTERATION, oaREPAIR NANT.IMPROVEMENT
....
�; w��`�«��s ....:, 'AIA# � LOT:SIZE �� "'�Sa�� ��" ��"'''1':;� �. ,.'
=CENSUSCODE�°. x ,-,��� • � , �, #
ZONING�DESIGNATION .ri ... ✓TY ...-., ,
COMP PLAN DESIGNATIONP: > ABASIC PLAN? o§AYES'' , o:NOi
SECTION' TOWNSHIP- RANGE NEW ADDRESS REQUIRED? ,,. -pyo YES o:NO , ."
"'PLATTED LOT? ;3 YES tea NO ,CHANGE OF YES '-❑ NO
•
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,dtvoffederalway.com
• ELECTRICAL
•
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES ISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 b of Thermostats(First-$43.00;add'n-SI3.00ca)
(First 1300 ft'-585.50:Each add'n 500 ft`-$27.50) _Service and feeder $93.00 _11 of Low voltage fire or burglar alarms
iquare Feet. _ First 2500 Il'-$50.00;Each add'n 2500 ft`-$13.00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _ti of service or feeders * Per WAC 296-46-910(5)(b)(i R ii)
_Each outbuilding or garage $57.00 (First service/feeder-557.00;Add'n service/ _4 of Signs(First sign-543.00;add'n sign
(Inspected separately) feeder-$37 each) $20.00 each)
Swimming pool,hot tub,spa $85.50
1 _Yard Pole meter loops 557.00
I i
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or more) -
Altered Service or Feeders
Service Feeder Amps Service or Add's 0 to 200 5 93.00
_Up to 200 amp $ 93.00 $ 27.50 Feeder 201 -600 216.50
201 -400 amn 115.50 57.00 0 to 100 5 93.00 5 57.00 601 -1000 126.50
-401 -600 amp 158.50 78.50 =101 -200 115.50 72.50 _over 1000 363.00
601 -800 amp 202.50 108.50 201 -400 216.50 85.50 _#of circuits
_Over 800 amp 289.50 216.50 _401 -600 252.50 101.00 (1-5 circuits-$72.50:Add'n circuits,$6 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
Service or Feeder ___Over 1000 434.50 232.00 Residential/Multi-Family/Commercial/Industrial
_0 to 200 amp $ 71.50 Over 600 volts surcharge 72.50 _U-100 $ 57.00
_201 -600 amp 115.50 _Mast or meter repair 78.50 _101 -200 72.50 !I
_over 600 amp 174.00 _201 -400 85.50
Mast or meter repair 43.00 _401 -600 115.50
--(1-4
4 of circuits _over 600 125.00
(1-4 circuits-$57.00;Add'n circuits$6 ea)
If a 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
Permit fee+$72.50.Add'I plan review for other submissions is 585.50/hr.
FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D)
j t
TOTAL COLUMN(D): .
Total Column(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 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)
• OTHER FEES .
Mitigation Fee: (18) (20) (22) '
SBCC Surcharge: (19) (21) (23)
Total (Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
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Bulletin #100-December 23, 2002