03-104793 City ofFederalWay
CommunityunityDevelopment Services Electrical Permit #:03 - 104793 - 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: LEVY
Project Address: 34503 9TH S.Av€5 Ske 39° Parcel Number: 750451 0050
Project Description: Install thermostat for VAV box in tenant space.
Owner Applicant Contractor
MEDICAL REAL ESTATE SVCS UNITED SYSTEMS INC(Electrical Contractor; UNITED SYSTEMS INC(Electrical Contractor;
1501 4TH AVE 7404 EVERGREEN WAY SUITE A 7404 EVERGREEN WAY SUITE A
SEATTLE WA EVERETT WA 98203 EVERETT WA 98203
98101-3225 (425)710-0099
Electrical Fixtures
Description Quantity Description Quantity Description 'Quantity
Thermostat 1
PERMIT EXPIRES April 19,2004.
Permit issued on October 22,2003
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.
Owner or agent: Gt....A...A os AcAdel/ Date: (O r - 43
"Q—A-J."9J 11—It. - oma
� cs�
RECEIVED CONSTRUC:I ION PERMIT PLICATION
CITY OF ./ APPLICATION NUMBER: OS - J Q VII 3-
Federal Way OCT 2 2 2003 APPLICATION NUMBER: - -
CITY OF FEDERAL WAY (APPLICATION NUMBER: - -
**The following isLrreq Ciirea information—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
IN MATI
"ITE ADDRESS: 3 1.503 L•e•ki A".€ so' ASSESSOR'S TAX/PARCEL #:
EGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING o PLUMBING o MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ENGINEERING o FIRE PREVENTION SYSTEM
PRO) CT DESCRIPTION(Provide detailed description): --Y .'at I ere rt A/ fvogravvtitlitak?
PROJECT NAME:
PEOPLE INFORMATION
PROPERTY OWNER: NAM i DAYTIME PHONE:
�x( c�i( �e�( a SeIrvl cep ( )
MAILI1G ADDRESS(STREETAD S;CITY,ST ZIP w
(J�(a�11 a I-
CONTRACTOR: I NAME: n�(6:2- ) ��� DAYTIME PHONE. -
MAI NG DDRESS( ET ADDRESS; ,STATE.ZI ): l .� er . EVENING PH :
0 r�ev� a� 6ONE
3 ( )
I CITY OF FEDERAL WAY BUSINESSDENSE NUMBER: FAX NUMBER:
)
CONTRACTOR'S REGISTRATION NUMBER: j EXPIRATION DATE:
(ropy of card required)
APPLICANT: NAME: DAYTIME PHONE
)
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: j FAX NUMBER:
❑ ARCHITECT ❑ TENANT o OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
- ■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN a HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PRO]ECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
_ t
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: o ELECTRIC o 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 arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the informatio supplied to the as a part of this application. / n/ ('�
NAME/TITLE: pare
DATE: 1 6 °i `��
a PROPERTY OWNER o APPLICANT a CONTRACTOR
_FOR.OFFICE.USE ONLY:;.:.
❑;ADDITION ▪❑▪ ALTERATION tee❑ REPAIRI =_ l TENANT-IM PROVEMENT ,.
CENSUS.:CODE 4- �4r ,4 , ':-.."2-S4 ..2V * 4LOT:SIZE
'ZONING DESIGNATION ¥_ rBUILDING SHELL ONLY? nYES,7_ x❑ NO
=COMP PLAN'DESIGNATION ?,,. »' BASICPLAN? =❑YES"' _❑`NO,_.
•
:SECTION ; $TOWNSHIP.` RANGE � .NEW ADDRESS REQUIRED? •g a YES
PLATTED LOT? =❑YES oNO '" '', ..� '`CHANGE OF USE? ,, ._:o YES "b NO
• COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
yvww.c tyoffederalway.com
s s 1
■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES (MSC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 L k of-Thermostats(First-$43.00;add'n-$13.00ca)
(First 1300 ft'-585.50;Each add'n 500 ft -$27.50) _Service and feeder $93.00 #of Low voltage fire or burglar alarms
Square Feet: _ First 2500 Il'-$50.00:Each add'n 2500 ft`-$13 00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _ft 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/ _ft of Signs(First sign-543.00;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 ur more) - Altered Service or Feeders
If Service Feeder Amps Service or Add'n 11 to 200 5 93 o
_up to 200 amp $ 93.00 5 27.50 Feeder _201 -600 216.50
201 -400 amp 115.50 57.00 0 to 100 $ 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 ft
of circuits
_Over 800 amp 289.50 216.50 401 -600 252.50 101.00 (I-5 circuits-$72.50;Add'n circuits,$6 ea;
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 -600 115.50
_#of circuits _over 600 125.00
(1-4 circuits-557.00;Add'n circuits$6 ea)
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''plan review for other submissions is$85.50/hr.
FIXTURE DESCRIPTION(A) l FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D)
i I I
TOTAL COLUMN(D): l
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)
I. SBCC Surcharge: (19) (21) (23)
Total (Pages one&Two): Eine(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
I
Bulletin #100-December 23, 2002