03-104817 - zti
City of Federal Way
Community Development Services Electrical Permit #:03 - 104817 - 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: CHAMBLISS
Project Address: 3778 SW 319TH Si- Parcel Number: 873198 1600
Project Description: Install low-voltage security alarm system.
Owner Applicant Contractor
Richard D Chambliss &Silvia Chambliss BRINKS HOME SECURITY INC BRINKS HOME SECURITY INC
3778 SW 319TH ST 19115 WEST VALLEY HWY SUITE H-106 19115 WEST VALLEY HWY SUITE H-106
FEDERAL WAY WA KENT WA 98032 KENT WA 98032
98023-2154 (425)251-9727
Electrical Fixtures
Description Quantity Description Quantity Description Quantity,
Low Voltage Burgler Alarm-Residen 3310
PERMIT EXPIRES April 20,2004.
Permit issued on October 23,2003
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. (t L
Owner or agent: See Application Date: JO "�- 3 ` o
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COMMUNITY SEE RECEIVED
DEPARTMENT
1-- ONSTRUCTION PERMIT APPLICATION
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APP CATION,N%JMBER..
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
^ ' /�
• PROPERTY INFORMATION Q J
SITE ADDRESS: 3�7� ✓Cil �J J q M (.//yC-7ASSESSOR'S TAX/PARCEL#: 6:3 7 3 ) 9 iJ= /(O 0 0
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING 0 PLUMBING o MECHANICAL r_t DEMOLITION
(ELECTRICAL o ENGINEERING o FIRE PREVENTION,� ri�, SYSTEM
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PROJECT DESCRIPTION(Provide detailed description): h o'SIOn a l at(.// I
PROJECT NAME:
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
Riia. Cha ��� (a53 271/- 3'36-
MAILING ADDRESS(STREET ADDRESS;CI r /7./,/_ 9 y'- z__,3
/ ATE,ZIP): �
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CONTRACTOR: NAME: DAYTIME PHONE:
13r /nr6H-om� 5z�vrr- (ya5)a5J - �7a-7
MAILING1 l j RE'S(STREET ADDRESS;�C�,STATE o g o p /gw � �wsZ EVENING PHONE: -
CITY OF FEDERAL WAY BWUSINESUS/LLICCLENSE NU BER: C FFFAX NUMBER:
- - ( ) -
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: DAYTIME PHONE:
( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:
o ARCHITECT o TENANT o OTHER(DESCRIBE): ( ) -
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 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES 0 NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE ❑TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC)
TABLE B y
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $50.00 _# of Thermostats(First-$37.50; add'n-
(First 1300 ft2-$75.00;Each add'n 500 ft2- _Service and feeder $81.00 $11.50ea)
$24.00) _# of Low voltage fire or burglar alarms
Square Feet: MOBILE HOME/RV PARK First 2500 ft2-$43.50; Each add'n 2500 ft2-
_Each outbuilding or garage $31.00 _#of service or feeders $11.50 3310
(Inspected with service) (First service/feeder-$50.00;Add'n Square Feet: V
_Each outbuilding or garage $50.00 service/ *Per WAC 296-46-910(5)(b)(i&ii)
(Inspected separately) feeder-$32 each) _#of Signs(First sign-$37.50;add'n sign
$17.50 each)
_Swimming pool,hot tub,spa $75.00
Yard Pole meter loops $50.00
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 $ 81.00
_Up to 200 amp $ 81.00 $ 24.00 Feeder _201 -600 189.00
_201-400 amp 101.00 50.00 _0 to 100 $ 81.00 $ 50.00 _601 - 1000 284.50
_401-600 amp 138.00 68.50 _101- 200 101.00 63.50 _over 1000 317.00
_601-800 amp 176.50 94.50 _201-400 189.00 75.00 #of circuits
_Over 800 amp 252.50 189.00 401-600 220.50 88.50 (1-5 circuits-$63.50;Add'n circuit`, :'5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800 284.50 120.50
(When inspected separately from the services.) _801- 1000 348.00 145.50 TEMPORARY SERVICE
Service or Feeder _Over 1000 379.00 202.50 Residential/Multi-
_0 to 200 amp $ 68.50 _Over 600 volts surcharge 63.50 Family/Commercial/Industrial
_201-600 amp 101.00 _Mast or meter repair 68.50 _0- 100 $ 50.00
_over 600 amp 151.50 _101- 200 63.50
_Mast or meter repair 37.50 _201 - 400 75.00
_#of circuits _401 -600 101.00
(1-4 circuits-$50.00;Add'n circuits$5 ea) _over 600 109.00
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+$63.50.Add'I plan review for other submissions is$75.00/hr.
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.::>:>:::>::<:::<>:;:<;TOTAL:C IJMN': 0):
Total Column(0)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50 +( X.35) =(13)
• 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 applicati7
NAME/TITLE: A-}t /-7/7 GI6.--C777g1"-c7C---7 DATE:
❑ PROPERTY OWNER in APPLICANT ii CONTRACTOR
FOR>OFFICE:USEONLY:»>
NEW c..ADDITION a AL'ERATION< ai REPAIR .. ❑.TENANT IMPROVEMENT
CENSUSGODE... .
. LoT slzis;
ZONING DESt llfAtION BUILDIliNG SHELL ONLY? .❑YES U NO
1.
COMP PiLAN DESIGNATION ... .....; BASIC PIAN?`.. :r YES L3.Ntlrii ..
SECTION TOWNSHIP RANGE : NEWAI;DDRESS REQUIRED?' ,:> u,VES ..Q:NO...
PLAI1'EDEOT?' >c1 YES d NOGHANGEOF USE? p YESii ....o NO . .
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX: 253-661-4129
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