04-104831 City of Federal Way Electrical Permit #: 04 - 104831 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: FLETCHER
Project Address: 28810 21ST 3 AV S Parcel Number: 422280 0350
Project Description: Install upgrade to low-voltage security system.
Owner Applicant Contractor
Ray Fletcher &Clara Fletcher CHUBB SECURITY NW.,INC dba SECURE S CHUBB SECURITY NW.,INC dba SECURE S
28810 21ST AVE S 150 12TH AVE 150 12TH AVE
FEDERAL WAY WA SEATTLE WA 98122 SEATTLE WA 98122
98003-3840 (206)521-5678
Electrical Fixtures
Description ;Quantity Description Quantity _ Description 11Quantity
Low Voltage Burgler Alarm-ResideM 1800
PERMIT EXPIRES May 29,2005.
Permit issued on November 30,2004
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 Feder A�a3�. / Q
Owner or agent: _ Al- 61. Date: // ` /o D 4f
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104831-00-EL
Owner: RAY FLETCHER
Address: 28810 21ST AVE S
FEDERAL WAY, WA 98003-3840
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
❑ Rough Electrical(4225) 0 Ceiling Cover(4020) Final-Electrical(4055)
Approved Approved Approved
By Date By Date 'WA Date %L
❑ Under-slab groundwork(4295)
Approved
By Date
CITY OF 4: . RECEIVED —
Federal Way NOV3 PERMIT
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,'o.11. .VITYDE4ELOPME,Nr5ERll(ES OV 0 2004 SF MF CO MEG) PL DE EN FP
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U(J )PO .Y9 Jh ,PLI CATI O N
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�;tvrsat,n •F.a ?,;�-sss2��fiY OF FEDEFi
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1'1,1,,.rntuolted.wJwr,r1.,nm BUILDING DEPT.
The ollowin• is re•uired in ormation-an incom•lete a••lication will not be acce•ted. Please •rint le.ibl (in ink)or •e.
• PROPERTY INFORMATION
SITE ADDRESS 2 S c 1 O, t IV-e-`.- SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # _ - LOT SIZE(sf)
u3 <p`r �
LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1) -� t��R-t- ,
,:Iltoc.l,separate page for lengthy legal Arian)
in PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION VELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit oniti)
'1-rn`Th-{-r(1\ l(vet rcc(t-L h- e( ),ri Sj i -e dr\
PROJECT NAME(Name of Business or Owner Last Name)
• PEOPLE INFORMATION
PROPERTY N PRIMARY PI IONE
OWNER %U V1--e,--\CC J!— c 3 ?ci I - I fiC-(
MAILING ADDRZSS CITY,STATE,ZIP
aptt0 91 a���_ s 0 A 1 eti-Al ( L qv
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
- VC'\`.1-) C'el'' '14 . 1�L' (au) 5Z-1 C��8
ADDRESS CITY,STATE,ZIP CELL PHONE
1 (� V, f. r>
CITY OF FEDERAL WAY 13USINES,S LICENSE NUMBER r1 , , // EXPIRATION DATE FAX NUMBER
ER
l 3 tz B LE l2 /3( ' O&-( ( )' 2I 12L( l;
CONTRACTOR'S REGISTRATION NUMBEE(copy of card required with each application) EXPIRATION DATE
cv1U �Db $&� q 0c.A. 1 / /
APPLICANT COMPANY NAME APPLICANT NAMI'; OFFICE PHONE
it r c< CQU;-vim ( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑ Tenant C Agent 0 Other (Describe) (
CONTACT NM i PRIMARY PHONE —
AVNL[ �1 ((,�� +�v y ✓ (4Lk)�-j - "Co
F:-�L�ILki/1/155
LENDER Per RCW 19.27.095: Lender information is NAME 1
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE.ZIP
in DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? C YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? C YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN L7 HIGHLINE 0 TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN HIGHLINE n PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD 1
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
1**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number ofeach type offixture to be installed or relocated aspart of project. rem
_ns.. Jp ff this Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG. SYSTEMS
BBQS FANS HOODS(comm-r,..4) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC (Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS )o,rub;Shmvrrcombo) SHOWERS WATER CLOSETS ITo7Ior) MISC (Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
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 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. ---� ,n
NAME/TITLE JC''� .� ��tl`y v4�'�� '�h I `It DATE /f' C -G.y
(Signature) (Title) J
RELATIONSHIP TO PROJECT n Owner n Agent u"Fontractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
NEW c ADDITION , ALTERATION LI REPAIR F., TENANT IMPROVEMENT
BUILDING SHELL ONLY? YES NO BASIC PLAN? YES NO
ZONING DESIGNATION CHANGE OF USE? YES a NO
NEW ADDRESS REQUIRED? c YES - NO UP/SEPA/SU? YES ,NO
PLATTED LOT? 7 YES NO DEMO PERMIT REQUIRED? YES NO
13ullctin#IOO-Ansi t 19 ?Illl-I Pu„' nt'I I.,II...- I_ ..,,,___._
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ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet
Service or Feeder Each Add'n
(First 1300 ft2-$87.00; Each add'n 500 ft2-$28.00) ❑ 0 to 100 snip $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 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
❑ Over 600 volts surcharge $74.00
0 201 - 400 amp 117.50 58.00
❑ 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 ❑ over 1000 amp 369.50
❑ 201 - 600 amp 117.50
U over 600 amp 177.00 ❑ # of circuits to be added/altered
(1-5 circuits-$74.00;Acld'n circuits,$6.00/ea)
❑ # of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58.00;Add'n circuits$6.00/ea)
$74.00 plus 35%of Permit Fee
❑ Mast or meter repair $43.50 ❑ Service- 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑. Service Over 400 amps
$74.00 plus 350/ 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 ❑ 101 - 200 74.00 51.00
(First service/feeder-$58.00;each add'n-$37.50) ❑ 201 -400 87.00 n/;i
❑ 401 -600 117.50 „/a
❑ over 600 127.00 0/0
MISCELLANEOUS SERVICE/EQUIPMENT
U _# of Thermostats U # of Signs
(First -$43.50; add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
itt Low Voltage U Swimming pool/hot tub $87.00
Square Feet to be served by system(s) 1.�(-' (Includes additional circuit,if required)
❑ Fire Alarm System U Yard Pole meter loops $58.00
gSecurity Alarm System U Additional Plan Review
Voice Cabling $87.00/hour
(for modified submittals)
❑ Data Cabling
0
(Per System(s) 1 2500 ft2-$51.00,
Each add'n 2500 ft.-13.50) 'Per WAC ,o-4i,',;(4.-7/1/M,,',iil
Bulletin 0100-An„iict 19 '7(HU PAM 1 Ilf.1 1-,[1 .1.......,n......... A I: .•