03-104436 City of Federal Way
Community Development Services Electrical Permit #:03 - 104436 - 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: 7-11
Project Address: 31006 PACIFIC S Parcel Number: 785360 0210
Project Description: Relocate(5)circuits for back counter remodel.
Owner Applicant Contractor
7-11 MADSEN ELECTRIC MADSEN ELECTRIC
31006 PACIFIC HWY S 3939 S ORCHARD ST 3939 S ORCHARD ST
FEDERAL WAY WA TACOMA WA 98466 TACOMA WA 98466
(253)383-4546
Electrical Fixtures
DescriptionQuantity Description Quantity Description jQuantity
Circuits- Commercial 5
PERMIT EXPIRES March 24,2004.
Permit issued on September 26,2003
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 ' co/coince wi • e laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: j.''aEt
— 30 cb„u l pf,fo
bJ(
,0
CONSTRUCTION PERMIT APPLICATION
CITY Of 1115.'"46%....." RECEIVED
APPLICATION NUMBER: a - La'6 - (�
Federal Way SEP 2 5 2003 APPLICATION NUMBER: -CITY OF FEDERAL WAY (APPLICATION NUMBER: -
BUILDING DEPT.
**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.
■ PROPERTY INFORMATION
SITE ADDRESS: 311064, aLicit. it%LLA 5• ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION -
TYPE OF PROJECT(This application): o BUILDING o PLUMBING ❑ MECHANICAL ❑ DEMOLITION
. ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESSCRIPTION(Provid detailed de cription):
1R e_1 o r-TE (s5-) ki i&v c c /Oh -Pn&e. ( w-ri ie ke mofle e-
t A t<.. Czu.o re p .
PROJECT NAME: 7.4 - 6K..itYrr , (PewtonC C..
IN PEOPLE INFORMATION
PROPERTY OWNER: NAME: ; DAYTIME PHONE
7--!/ j ( )
MAILING ADDRESS(STRf.Q ADDRESS;CITY,ST TE,ZIP):
3'DiLe AC Fie,j�cL,�►g•�S
CONTRACTOR: ( NAME: I DAYTIME PHONE:
M A-DSEk) Eleer,eid- (.Z3 ) 323
MAILING ADDRESS(STREET ADDRESS;CITY.STATE.ZIP): I EVENING PHONE:
3135 S • nee+4�✓Z,� ! ( )
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER:
Lq_ - � _ L 0 la ,33_-$) & - I
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
(ropy of card required) IM i b S E E_ t y O Pe
l
APPLICANT: NAME: ! DAYTIME PHONE:
i ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: j FAX NUMBER:
0 ARCHITECT ❑TENANT to OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ 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:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE O TACOMA ❑ 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
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: 0 ELECTRIC a GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC a 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 . 'ses out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the Information supplied to e city . . part of application. /
NAME/TITLE: -er �s,•r/f� DATE: __'ce--o 3
❑ PROPERTY OWN ❑APPLICANT *CONTRACTOR
FOR,OFFICE,USE ONLY:
NEW 0 ADDITION .q ALTERATION o REPAIR TENANT IMPROVEMENT "'n ::
'CEIVSUS'COD E � t104. : ' 'k' LOTiSIZE '-P LV , ' V. . .
zor NG DESIGNATION OV N0
COMP PL/1N DESIGNATION - � .. • ABASIC PLAN? YES'. a NO ``, ;
SECTION� .- TOWNSHIP RANGE -NE1Af`ADDRESS REQUIREDV ,, ' ,,�YES.`0 NO ,
PLATTED LOT?Ora YES • s CHANGE,OF.USE? , W, °DYES -❑NO rv, '•
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtyoffederalway.com
■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 _#of Thermostats(First-$43.00;add'n-$13.00ca)
(First 1300 ft2-585.50;Each add'n 500 ft`-527.50) _Service and feeder $93.00 II of Low voltage fire or burglar alarms
Square Feet: _ First 2500 ft2-$50.00:Each add'n 2500 ft`-$13.00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _k of service or feeders .Per WAC 296-46-910(5)(b)(i&ii)
_Each outbuilding or garage $57.00 (First service/feeder-557.00;Add'n service/ _#of Signs(First sign-$43.00;add'n sign
(Inspected separately) feeder-$37 each) $20.00 each)
_Swimming pool,hot tub,spa $85.50
_Yard Pole meter loops $57.00
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
Altered Service or Feeders
(Includes three unit or more)
- Service Feeder Amps Service or Add'n =0 to 200 5 93.:10
Up to 200 amp S 93.00 S 27.50 Feeder 201 -600 216
50
201 -400 amp 115.50 57.00 0 to 100 5 93.00 5 57.00 _601 -1000 326.50
-401 -600 amp 158.50 78.50 =101 -200 115.50 72.50 _over 1000 363.00
601 -800 amp 202.50 108.50 201 -400 216.50 85.50 _1$of circuits
_
Over 800 amp 289.50 216.50 _401 -600 252.50 101.00 (1-5 circuits-$72.50;Add'n circuits,$6 ear
ALTERED SINGLE/MULTI FAMILY _601 -800 326.50 138.00 d ^-e•.,.----e.).,.----e.)(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 5 57.00
_201 -600 amp 115.50 _Mast or meter repair 78.50 _101-200 72.50
_over 600 amp 174.00 _201 -400 85.50
-Mast or meter repair 43.00 _401 -600 115.50
-#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$85.50/hr.
FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) ' TOTAL(D)
i l !
t ' i
,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)
: 1 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)
Bulletin#100-December 23,2002