04-104802 •
City of Federal Way Electrical Permit #: 04 - 104802 - 00 - EI
Community Development Services
P.O.Box 9718 .I
Federal(25Way,WA 98063-9718(253Inspection request line: (253) 835-3050
Ir
Ph:(253)835-7000 Fax:(253)835-2609 P 9
Project Name: PELAYO p•
Project Address: 31512 42ND1SW Parcel Number: 873198 2820
Project Description: add 4 outlets in garage and six smoke detectors.
Owner Applicant Contractor
Chad J Bargsten &Jennifer A Bargsten CHERRIE A.PELAYO CHERRIE A.PELAYO
31512 42ND AVE SW 31512 42ND AVE SW 31512 42ND AVE SW
FEDERAL WAY WA FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
98023-2120 (253)678-1759
Electrical Fixtures
Description _ Quantity L Description Quantity Description JpQuantityj
Circuits-Residential 4 1 Low Voltage Fire Alarm-Residential 2499
PERMIT EXPIRES June 15,2005.
Permit issued on December 17,2004
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: x T' Date: l I I IOL
I f to OtSeONCL
49•\143(o46 OfiekAAQ 1
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THIS CARD IS TO REMAIN ON-SITE , •
CITE of Community Development Inspection Record
Federal Way IVR INP ',CTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104802-00-EL
Owner: CHAD J BARGSTEN
Address: 31512 42ND AVE SW
FEDERAL WAY, WA 98023-2120
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.
O 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
O Rough Electrical(4225) ❑ Ceiling Cover(4020) 1'.1 Final-Electrical(4055)
Approved Approved Approved
0
By Date By Date B '`ti\ ' Date'* 0 i
❑ Under-slab groundwork(4295)
Approved
By Date
t
CRY OF` O\ —
Federal Way PERMIT — 1— a g 0 2_
SF MF CO M PL DE
EN FP
DEVELOPMENT SERVICES
3732 •PO 9718
FEDERAL WAY,WA 98063-9718 APPLICATIONrp
253-835-2607•FAX 253-835-2609 / /unopatuofederahaatlcorn
•
The following is required information-an incomplete ap.lication will not be accepted. Please print legibly(in ink)or type.
-',..1-' . I. PROPERTY INFORMATION
~ SITE ADDRESS 3Is( Z 4i? ?vi - IV PA-AA (vat )
G8013of, Z3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
i '- ■ PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION AYELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
•
lot-AM 11- •tievii4't.A4 GAO- IM 3 e( tot c(r ,, ,',4 c_p awefi Cf
4 a Ktc,• -t DO n— • Will adel co( cntio e e cfo,-
PROJECT NAME(Name of Business or Owner Last Name)
-., ll PEOPLE INFORMATION
PROPERTY NAME r
`� A- ( -� - �/ PRIMARY PHONE
OWNER K,I A • PQ- 7 v ( 3) (0 - FI-5"15
MAILING ADDRESS
01 7/ 4:1"14-- /1 e• STA)
CITY,STATE,ZIP
L3 W) r'V? WAY ) Lo A- -eTY 0z3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIr CELL PHONE
-
l
td1Y Ur rbL)RRAL WAY bUauvESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
_ B L / /
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT - FAX NUMB ER
❑ Architect ❑ Tenant ❑Agent 0 Other(Describe)
l -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
... ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE o TACOMA 0 PRIVATE(WELL)
.
SEWER SERVICE PROVIDER 0 LAKEHAVEN a H1GHLINE 0 PRIVATE(SEPTIC)
•
•
PROJECT FLOOR AREAS •
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
""NEW HOMES ONLY NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
f FI URES _ -
Indicate number of each type of fixture 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(co mmorc,at( W OO D STO V ES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/shoS.«combo) SHOWERS WATER CLOSETS(romp MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sulks) VACUUM BREAKERS ELECTRIC WATER HEATERS
=_.DISCLAIDR/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 DATE
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
a NEW o ADDITION ❑ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES ❑NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? ❑YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? a YES o NO
Bulletin#100—March 30,2004 — Page 2 o('4 k\Handouts—Rcvised\Permit Application
... ELECTRICAL PERMIT INFORMATION ‘ • .
RESIDENTIAL COMMERCIAL
'
- NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
II (First 1300 ft2-$87.00;Each add'n 500 ftz-$28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 0 201 -400 amp 220.50 87.00
❑ Detached outbuilding or garage ❑ 401 -600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601 -800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) ❑ 801 - 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201 -400 amp 117.50 58.00 ❑ Over 600 volts surcharge $74.00
❑ 401 -600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 amp $ 72.50 LI over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ over 600 amp 177.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
XIt of circuits to be added/altered
(I-4 circuits-$58.00;Add'n circuits$6.00/ca) COMMERCIAL/INDUSTRIAL PLAN REVIEW
$74.00 plus 35%of Permit Fee
❑ Mast or meter repair $43.50 ❑ Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES
❑ Service or feeder only $58.00 TEMPORARY SERVICE
❑ Service and feeder $94.50
Commercial Residential
MOBILE HOME/RV PARK ❑ 0- 100 $58.00 $51.00
❑ #of service or feeders 0 101 -200 74.00 51.00
(First service/feeder-$58.00;each add'n-$37.50) ❑ 201 -400 87.00 n/a
CI -600 117.50 n/a
CI over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats ❑ #of Signs
rrst-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
w Voltage CI Swimming pool/hot tub $87.00
CCCCCC Sq are Feet to be served by system(s) SOO (Includes additional circuit,if required)
Fire Alarm System ❑ Yard Pole meter loops $58.00
❑ Security Alarm System ❑ Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
0
(Per System(s) l•,2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) •Per WAC 29646-910(5)(b)(i&ii)
Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Penuit Application
b