03-104235 ,s •1 N.L.
`City of Federal Way Electrical Permit #:03 - 104235 - 00 - EL
Community Development Services
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: VERCOUTERE
Project Address: 1611 SW 322ND 5k Parcel Number: 010450 0290
Project Description: Rewire 40-amp circuit for hot tub.
Owner Applicant Contractor
Robert J Vercoutere PUGET SOUND ELECTRICAL SERVICES PUGET SOUND ELECTRICAL SERVICES
1611 SW 322ND ST 13420 4TH AVE S 13420 4TH AVE S
FEDERAL WAY WA SEATTLE WA 98168 SEATTLE WA 98168
98023-5424 (206)335-2451
Electrical Fixtures
Description Quantity Description Quantity Description 1Quantity
Circuits-Residential I
PERMIT EXPIRES March 13,2004.
Permit issued on September 15,2003
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.
,----) (r:77.--
Owner or agent: Date:
1-?7--C3j gN. tivt ( p,\3.? 1---(A/0 ____ 0
C/
...)
\,(7... p
0 ,o
is ..
O
' CONSTRUCTION PERMIT APPLIC +TION
CITY OF �� RECEIVED APPLICATION NUMBER: 0.5- L 0 X- - - _
Federal Way APPLICATION NUMBER: -
S E P 1 5 2003 APPLICATION NUMBER: - -
**The fvlf6Wp�i IEMMe enation-Please print(in ink)or type**
Please note: Electrical,Fire Prevensull_�IIoo
n and Engineering permits may require a separate application.
■ PROPERTY INFORMATION :.
SITE ADDRESS: /6 // 4,7 7 2 2 ` (2/
/ /1" ASSESSOR'S TAX/PARCEL #: 0 / O c -0 - Q -g D
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING O PLUMBING o MECHANICAL a DEMOLITION
S ELECTRICAL //,,❑ ENGINEERING ❑ FIRE PREVENTIONEN / SYSTEM
D
PROJECT DESCRIPTION(Provide detailed description): ////f R/4/ V/0 /70/- 7`0 e�/`-��` erc .e/-77/
0,4 rig ,1/ ,To/-2 ,yb/Tvg
. PROJECT NAME:
PEOPLE INFORMATION
PROPERTY OWNER: NAME: /0,....c,6::::2r _ i DAYTIME PHONE:
Vti1/ca-v-`t-eN2 WS'3) X38- 5/6.3
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
/6'// .4, 3"'Z' /7 CV IV.
' CONTRACTOR: NAM : / DAYTIME PHONE:
1i 6 /OP .05 ft2-010 — fi sc. - S � Ec_. ( 2.06) 3 35-z�r 5/
MAILING ADDRESS(STREET,ADDRESS; STATE.ZIP): I EVENING PHONE:
/ 2,07// 6/t Ca J-G,Er I ( ) -
CITY OF FEDERAL WAY BUSINESS CENSE NUMBER:/7/ FAX NUMBER:
5-e, / /(//91/,g' ��/7' /Z' - ( )
CONTRACTOR'S REGISTRATION NUMBER: (//T I EXPIRATION DATE:
KoPY of card required) POct T SE / 7 !/ 4/ i / /
APPLICANT: NAME:
4 DAYTIME PHONE:
'4 e / ,,e f %C e/-2r6/ I ( )
MAILING ADDRESS(STREET A �S;CITY,STA,..,ZIP): C' ��� ���� ENING PHONE:
:7 4.20 ill/- .�C--C2
RELATIONSHIP TO PROJECT: j FAX NUMBER:
0 ARCHITECT a TENANT ❑ OTHER( DESCRIBE):5.Lt,t/2>te ( ).
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER O APPLICANT 0 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 o NO
WATER SERVICE PROVIDER: a LAKEHAVEN O HIGHLINE O TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: O LAKEHAVEN O HIGHLINE 0 PRIVATE(SEPTIC)
,• y •
**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 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 INSERTS) 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) ❑ 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(including costs,expenses,and attorneys'fees Incurred in the
Investigation and defense of such claim),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 city,including its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
f _ _ 2
NAME/TITLE: DATE:
o PROPERTY OWNER' ❑ APPLICANT ❑CONTRACTOR
.FOR OFFICE USE ONLY: I
d NEW ' ._0 ADDITION o ALTERATION a OREPAIR „ • -; 0 TENANT IMPROVEMENT "
'CENSUS`CODE.+<*z �' rf =LOT SIZES r w
:ZONING -DESIGNATION_• ;
BUILDING SHELL-ONLY? =L1 YES NO
COMP PLAN DESIGNATION :BASIC PLAN? 4-- o YES ❑'No '- -
SECTION- `rTOWNSHIP' RANGE NEW ADDRESS REQUIRED? ❑YES ❑ NO
PLATTEDLOT?• '':''❑YES
-;❑`NO "�'`.� . -�',;; CHANGE OF USE? a YES'`-fl NO-•
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.cityoffederalway.com
■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 _It of Thermostats(First-$43.00;add'n-$13.00ca)
(First 1300 ft`-$85.50;Each add'n 500 It`-$27.50) _Service and feeder $93.00 a of Low voltage fire or burglar alarms
Square Feet: First 2500 It1-$50.00;Each add'n 2500 ft`-$13 00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _d of service or feeders *Per WAC 296-46-910(5)(b)(i&ii)
_Each outbuilding or garage $57.00 (First service/feeder-$57.00;Add'n service/ _#of Signs(First sign-$43.00;add'n sign
(Inspected separately) feeder-537 each) $20.00 each)
VSwimming pool,hot tub,spa $85.50
l _Yard Pole meter loops $57.00 ! j
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units ar more) Altered Service or Feeders
Service Feeder Amps Service or Add'n _0 to 200 5 93 OU
_Up to 200 amp S 93.00 $ 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 U 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
(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 _0-100 $ 57.00 I I
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
a of circuits I _over 600 125.00-
(1-4 circuits-557.00;Add'n circuits$6 ea) Ii
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)
i
i t i 1
I f
TOTAL COLUMN(0):
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 Amounte(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)_
Bulletin #100-December 23, 2002