03-104252 City ofFederalWay
CommunityDevelopment Services Electrical Permit #:03 - 104252 - 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: 32935 1ST S. A'Ve5 Parcel Number: 182104 9037
Project Description: Relocate(6)circuits for counter remodel.
Owner Applicant Contractor
KORNBLAU&SON INC LOUIS MADSEN ELECTRIC MADSEN ELECTRIC
50 S GARFIELD AVE 3939 S ORCHARD ST 3939 S ORCHARD ST
ALHAMBRA CA TACOMA WA 98466 TACOMA WA 98466
91801-3829 (253)383-4546
Electrical Fixtures
Description Quantity Description Quanti F Description Quantity
Circuits- Commercial 6
PERMIT EXPIRES March 14,2004.
Permit issued on September 16,2003
I hereby certify that the above ,rmation is correct and that the construction on the above described property and
the occupancy and the use w. b- in ac , dance w4. the laws,rules and regulations of the State of Washington and
the City of Federal Way. /
Owner or agent: �� . Date:
t0-30- 03 — — Osk- (Pe— V
,....A, RE.GENEDCONSTRUCI ION PERMIT APPLICATION
CITY OF 1111. .✓
APPLICATION NUMBER: O 5 - 1 O q AE? 6L1
Federal Way
P 1 y 2003 APPLICATION NUMBER:
0APPLICATION NUMBER: - -
CI-
CITY OF FEDERAL WAY
*`The followin¢ ►WedDEQTmation-Please print(in ink)or type**
!
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
:■ PROPERTY INFORMATION : .
a
SITE ADDRESS: �:=2 C/ .31 ��,fit)L 5 ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- I. PROJECT INFORMATION _ -
TYPE OF PROJECT(This application): o BUILDING o PLUMBING 0 MECHANICAL 0 DEMOLITION
)`ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESC
IPTION(Provide detai)ed description):
et--r�:erkT& ( i )\ O
PROJECT NAME: i-I / 5LL_it %Ge 'Rl.c4CAL- L--
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: ; DAYTIME PHONE-
"7—i 1 jG1e_ � ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
.
CONTRACTOR: NAME: ' DAYTIME PHONE:
M Ase k) El (a1L us3 ) 3 FS -LL-g4,
MAILINGADDRESS(STREET ADDRESS,
CITY,STATE,ZIP): I. EVENING PHONE:
WAY BUSINESS UCENSE NUMBER: FAX 1 I ( ) G �,�c
CITY OF FEDERAL
FAX NUMBER: Y >> / j
- - (?53) EL/4 t:0e/C( !
CONTRACTOR'S REGISTRATION NUMBER: EXP/�
TION
(ropy of card required) P.
t E I 13
-1' F L+'-,— i DATE:
c) / �1l ,
APPLICANT: NAME: r !L 1•/ [ DAYTIME PHONE:
SA-VA ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
1 ( ) -
RELATIONSHIP TO PROJECT: j FAX NUMBER:
0 ARCHITECT ❑ TENANT 0 OTHER( DESCRIBE): i ( -
I �
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
-■ DETAILED BUILDING INFORMATION _
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: _ ESTIMATED SELLING PRICE: $
■ PROTECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL I
BASEMENT
_FIS
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) o 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 s • dal arises out of the reliance of the city,induding its officers and employees,upon the accuracy
iof the Information supplied e ci s of this application.
NAME/TITLE: /j Lt /\ DATE: /6 --(2,...---:—
o PROPERTY OW• R ❑APPLICANT ONTRACTOR
.,.FOR.OFFICE.USE ONLY: rI
1:1314EW1-Ve�p ADDITION Gp ALTERATIONV,a_,tn.REPAIR NTK6TENANT.IMPROVEMENT ";'
'CENSUS CODE .. . d FA' r.LOT SIZE: ...ter, .,.., .` ,r +, .
:ZONING,DESIGNATIONf :.r_ , ?",- , iBUILDING SHELUONLY? El.YES: =a NO ,.T
=COMP PLAN DESIGNATION. „> ABASIC PLAN?' EI YES ❑'NO _"
SECTION » TOWNSHIP_t"'. ,'RANGE F . NEW ADDRESS REQUIRED? -d YES ,.o NO •
'TPL'ATTED LOT? "'o YES „F o NO C`''t i -_.. •CHANGE OF USE? _ k 'v ❑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,dtyofederalway.com
. I ELECTRILIAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 it of Thermostats(First-$43.00;add'n-$I3.00ca)
(First 1300 ft'-585.50;Each add'n 500 ft $27.50) _Service and feeder $93.00 _#of Low voltage fire or burglar alarms
iquarc Feet: _ first 2500 111-550.00.Each add'n 2500 ft`-$13.00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _N 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/ _d of Signs(First sign-$43.00;add'n sign
(Inspected separately) feeder-537 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 Feeder Amps Service or Add'n 0 to 200 5 93.00
Up to 200 amp $ 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 =
601 -800 amp 202.50 108.50 201-400 216.50 85.50 Ii over 1000 363.00
of circ
Over 800 amp 289.50 216.50 401-600 252.50 101.00 (I-5 circuit I;Add'n circuit $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/Commerciai/Industrial
=
0 to 200 amp $ 71.50 _Over 600 volts surcharge 72.50 0- 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 1 15.50
-rr of circuits I -over 600 125.00
(1-4 circuits-557.00;Add'n circuits$6 ea)
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) 1 FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D)
i•
•
•
I
l
i
TOTAL COLUMN(D):
Total Column(0)
Estimated Permit Fee: (12)
4 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