03-103315 City of Federal Way
Community Development Services Electrical Permit #:03 - 103315 - 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: SIMPLEX GRINNELL
Project Address: 32001 32NDIS SL Suite301 Parcel Number: 162104 9001
A
Project Description: Install low-voltage fire alarm wiring.
Owner Applicant Contractor
FOSS REDEVELOPMENT H&M ELECTRIC INC H&M ELECTRIC INC
PO BOX 94449 8227 44TH AVE W 8227 44TH AVE W
SEATTLE WA 98124 MUKILTEO WA 98275 MUKILTEO WA 98275
(425)423-9250
Electrical Fixtures
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Low Voltage Fire Alarm-Commercia' 7000
PERMIT EXPIRES February 10,2004
Permit issued on August 14,2003
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 Waaee Application
Owner or agent: Date: �l(di
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CONSTRUCTION PERMIT APPLICATION
CITY of APPLICATION NUMBER:a LQ
Federal Way
c�Eiv�� B�_ �1Ppt.ICATION NUMBER: _ _ 5:-
-
AUG 1 f JA< APPUCATIt3N NUMBER.• _ _ - _ _ _ _ _ _ '
**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
SITE ADDRESS: 32001 32"1 S.Suite 301 ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING ❑ PLUMBING ❑ MECHANICAL 0 DEMOLITION
X ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): Install low voltage
Cabling for new fire alarm (by others).
PROJECT NAME: Simplex Grinnell
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
Foss RRDevelopment ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
P.O.Box 94449 Seattle,Washington 98124
CONTRACTOR: NAME: DAYTIME PHONE:
H&M Electric Inc, ( 425) 423 -9250
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
8227 44"'Avenue West Suite G Muk[Iteo Washington 98275 ( ) —
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:19-93-103797-00-BL FAX NUMBER:
( 425 ) 290 - 5714
CONTRACTORS REGISTRATION NUMBER:HMELEI*077KR EXPIRATION DATE:
(copy of card required) I
APPLICANT: NAME: DAYTIME PHONE:
H&M Electric.Inc ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
same ( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT o TENANT ❑OTHER(DESCRIBE):Electrical Contractor ( )
` E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER 0 APPLICANT X CONTRACTOR
• PROJECT INFORMATION
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
• PLUMBING
Base Fee Number of Rxtures
$26.00 +{ X$9.00/fixture}= (8)Estimated Permit Fee
Estimated Permit Fee
X .65= (9)Estimated Plan Review Fee
Miscellaneous Fixture Charge:(10)
T I(Page One): Line s (1)+(2 +(3)+(4 +(5)+(6)+(7)+(8)+(9 +(10)= (11)
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family Service or feeder only $57.00 #of Thermostats(First-$43.00;add'n-$13.00ea)
(First 1300 ft2-$85.50;Each add'n 500 ft2-$27.50) _Service and feeder $93.00 of Low voltage fire or burglar alarms
Square Feet: First 2500 ft2-$50. 0;Each add'n 2500 ft2-$13.00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet: �+000
(Inspected with service) _#of service or feeders *Per WAC 296-46-910(5)(bXi&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-$37 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 $ 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 $ 93.00 $ 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 _#of circuits
_Over 800 amp 289.50 216.50 _401-600 252.50 101.00 (1-5 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/CommerciaUlndustrial
_0 to 200 amp $ 71.50 _Over 600 volts surcharge 72.50 _0-100 $ 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-$57.00;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.Addl plan review for other submissions is$85.50/hr.
FIXTURE DESCRIPTION(A)' FIXTURE FEE FROM TABLE B(B) I IUM)III;EROF omits(C). TOTAL( )
TOTAL COLUMN(D):
Total Column(D)
Estimated Permit Fee: (12) -.3c..6 >c.`F
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $72.50+( X.35)=(13)
• DEMOLITION
Estimated Permit Fee: (14)
Bond Amount:(15)
• ENGINEERING
•
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES 0 NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN o HIGHLINE o TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN 0 HIGHL.INE ❑PRIVATE(SEPTIC)
**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
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 ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) •
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ 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 claim(including costs,expenses,and attorneys'fees incurred in the
investigation and . of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way, . only wh such daim arises out o . e reliance of the city,including its officers and employees,upon the accuracy
of the info •n suppli-• to the city it o is application.
NAME/TITL " L�� V •7 DATE: P. I i 0 S
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❑ PROPERTY OWNER ❑APPLICANT CONTRACTOR