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03-104634 • E City of Federal Way Community Development Services Electrical Permit #:03 - 104634 - 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: JACK IN THE BOX Project Address: 2400 SW 336TH St. Parcel Number: 132103 9110 Project Description: Install low voltage security system and low voltage closed circuit TV system. 4 Owner Applicant Contractor JACK IN THE BOX INC S S D SYSTEMS S S D SYSTEMS 8909 SW BARBUR BLVD SUITE 250 1740 N LEMON ST 1740 N LEMON ST PORTLAND OR 94219 ANAHEIM CA 92801 ANAHEIM CA 92801 (714)449-9900 Electrical Fixtures Description rduantitcy Description 'Quantity [ Description Quantity Low Voltage-Other Commercial 2500 ' Low Voltage Burglar Alarm -Comm( 2500 PERMIT EXPIRES April 6,2004. Permit issued on October 9,2003 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 b- 'n a ordance ith the laws,rules and regulations of the State of . ash' gton and the City of Federal W. Owner or agent: Date: o � a� tv — -3 3 tt Ow*r- Afjprot,- !/- /4-0 e 6s1 Ct - q fviu/ t• — D — s 9 cl Cry- i r eesiQ0 RE CLIVED CONSTRUCT t ION PERMIT APPLIICATION CITY OF APPLICATION NUMBER: (� 3_ / U q (, 31 - Federal Way OCT 0 9 2003 APPLICATION NUMBER: CITY OF FEDERAL WAY APPLICATION NUMBER: - - **The following BUILDINDEPT. is requiredinformation-Please print(in ink)or type*� Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. "" PROPERTY INFORMATION ' SITE ADDRESS: Z HOC) S•i . 33 to-k. 'S+, 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 o DEMOLITION ELECTRICAL ❑ ENGINEERING o FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): N C W CL�'V SL0Tz CTY s-t- rvl PROJECT NAME: L\< I lJ T tA— - gqa S 3 to 0 'PEOPLE INFORMATION : .: PROPERTY OWNER: NAME: DAYTIME PHONE: %N -rte:. e , (9Cot )98S -ot{Tr MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): I2`too S� 36(n `� �� Fezx2k )(0%.•1 92,023 CONTRACTOR: NAME: DAYTIME PHONE: Or) S ' (-7i4 )' `o -9500 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): � EVENING PHONE: �-1 \© N. t....EmoN Arvm-i- uv\ G,19zso ► (10{ )gkt`T -1100 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: (i' ) 441 -1 s CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE: (mrd required) s s P s Y K c\ C` D (R•T ; /r / 3a / o3 APPLICANT: NAME: i DAYTIME PHONE: (2.53) 92z - Szia MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE' aloe; Freemq'-I RoAt) war 903 1 I ; (206 )31 ( -7'03 RELATIONSHIP TO PROJECT: i FAX NUMBER ❑ ARCHITECT ❑TENANT ytOTHER( DESCRIBE): )lc-T. /31- 11-) 1---t , (25 3 ) 122 - R2 i o E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER Y.1•(1PPLICANT o CONTRACTOR ■ DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE G PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ • PROTECT 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: ❑ ELECTRIC ❑ 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 aril Otctt of the reliance of the dty,induding its officers and employees,upon fl a accuracy of the Information s died to as a part of this application. NAME/TITLE: 110 DATE: k© °\\°-5 o PROPERTY OWNER w APPLICANT ❑CONTRACTOR -FOR.OFFICE USE ONLY >tI qs,�t:, ',a ._,._; .rte �, 'rc�- :z.....,�. �> � ,x, .,,�_,mss., .��:z=; Rc.i ra.::a's � .:cr .r .:.,:,.:�s �� _ �o ADDITION s v i ALTERATIONv ❑.REPAIRS 0 TENANT=IM PROVEMENTft, r�;;; rCENSUS.`CODE x4-"*AW: r;A ,04.0' LOT SIZE t ZONIN! )ESIGNATION,. i 4'4 '�)BUILDING SHELL ONLY7_ DYES ^,❑ NO„ COMP PLAN DESIGNATION r , 4' -i` '; i BASIC PLAN?.0 YES ❑ NO:,�. ;SECTION •,t ., TOWNSHIP_ 'RANGE 1 , .NEW ADDRESS REQUIRED? ' ;❑YES .a NO PLATTED;•LOT? .❑YES' ;a NO ` ` _ CHANGE OF USE? ❑YES .:4i2E NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.citvofederalway.com • • ELECTRICAL - TABLE B NEW RESIDENTIAL SERVICES MOBILE HOMES EQUIPMENT/TEMP SERVICES _Single Family _Service or feeder only $57.00 #o hermostats(First-$43.00;add'n-SI3.00ca) (First 1300 ft2-$85.50;Each add'n 500 ft2-$27.50) _Service and feeder $93.00 #of ow voltage fire or burglar alarms Square Feet: _ First 500 W-550.00:Each add'n 2500 ft2-$13.00 _Each outbuilding or garage $35.50 MOBILE HOME/RV PARK uare Feet: A5 cpc, (Inspected with service) _it of service or feeders * Per WAe 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 (Includes three units or more) Altered Service or Feeders - Service ['cede; Amps Service or Ad3 d'n 0 to 200 5 9 .00 Up to 200 amp 5 93.00 $ 27.50 Feeder 201 -600 216.50 -201 -400 amp 115.50 57.00 -0 to 100 $ 93.00 $ 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 b of circuits _Over 800 amp 289.50 216.50 _401 -600 252.50 101.00 (1-5 circuits-$72.50;Add'n circuits,$6 eat 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/Commerciai/Industrial _0 to 200 amp $ 71.50 _Over 600 volts surcharge 72.50 _0-100 S 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) i I i 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(0) TOTAL COLUMN(D): Total Column(0) 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&rwo): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24) ; ' Bulletin #100-December 23, 2002