03-102707 •
City of Federal Way
Community Development Services Electrical Permit #:03 - 102707 - 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: DICKSON
Project Address: 1107 SW 334TH Pt Parcel Numb, 926496 I '
Project Description: Add 4 circuits outlets and lights.
Owner Applicant Contract.
Thomas L Dickson &Christine E Dickson VALLEY ELEC ONSTRUCT INC VA CTRICAL ,NSTRUC N INC
1107 SW 334TH PL VALLEY TRICA CONSTRUCT INC EY ELECTRICAL Ck TR ON INC
FEDERAL WAY WA 31816 1 H AVE SE 1816 109TH AV E
98023-5317 AUBU (253)833-9234
111.0)
0
Elect' Fixtures
R1 19 c oI r..0 't . :Qucalriflt
Circuits-Residential 4
' . 1 •umber 28,2003.
Ik
-d on Ju y 1,2003
I h• .y certify that th: .ove info . 4, -ct a at the construction on the above described property and
the o• '.ncy and ' se ` t .ance ,s the laws,rules and regulations of the State of Washington and
the City .
'ay. �� •
' S •
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Owner or agent: Date: /c5 J
J
�. RECEIVED' CONSTRUCTION PERMIT APPLICATION
CITY OF �...," APPLICATION NUMBER: 0 - I_Q�'202 - CZ
Federal Way JUL 0 1 2003 APPLICATION NUMBER: -kPPLICATION NUMBER: - -
CITY OF FEDERAL WAY
**The foilowi Ji ,E rlaE Tormation—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
- • PROPERTY INFORMATION _
SITE ADDRESS: \ ` (1I SlL ..3(.4") ` ASSESSOR'S TAX/PARCEL#: /1..(.2 y q62. - O j 6
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING 0 MECHANICAL o DEMOLITION
>LECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
{ PROJECT DESCRIPTION(Provide detailed description): k C\-(----) L\1n , \-K-S c szsg_
PROJECT NAME: \X,0 Q
- • PEOPLE INFORMATION.;
PROPERTY OWNER: NAME: : DAYTIME PHONE'
(LS \► 1.. • � 6 J 1 ( )
MAILING (STREETADDRESS;C13" )
`` \6 W4RI
CONTRACTOR: f NAME: ;VDAYTIME PHIAIV 5.AuL"--`i ,c_-,-(-3-:9-\(--A, - e.) .,tii-r !2.s5)6 9-274
MAILING ADDRESS(STREET ADDRESS CITY,STATE.Z EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:-
- - 3) 33 ->
CONTRACTORS REGISTRATION NUMBER: r /� EXPIRATION DAT36
:j�
(copy of card required) V.AU-- 2—C_ �T-\3 i \v / d6 / ��
APPLICANT: NAME: DAYTIME PHONE:
• ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): { EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 ARCHITECT ❑ TENANT o OTHER(DESCRIBE): ( )
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER U APPLICANT ,��CONTRACTOR
` ■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES o NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN o 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
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 o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) _ SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S) 1
■ 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 h. • armless the City of Federal Way as to any daim(induding costs,expenses,and attorneys'fees Incurred in the
investigation an• defe -- • ••u da' ),which may be m. • • by any person,induding the undersigned,and filed against the City of
Federal Way,but only wh i :su ' :im arises put •,e • • ce of the city,induding its officers and em• oyees ,upon the accuracy
of the Informatio -upplie o the •ty as a .•• of • :p. • •on.
NAME/TITLE: , , I _ I
_ DATE: 1 IP 1
o PROPERTY OWN R o APPLICANT r. CONTRACTOR
FOR OFFICE USE,ONLY:
❑:NEW zr r p ADDITION ❑ALTERATION - REPAIR ❑TENANT IMPROVEMENTxi
CENSUS CODE .z ` - - 4' LOT SIZE . 2 ,
,ZONING DESIGNATION. .._ ,+w. _.._i .." BUILDING SHELL''ONLY?^❑YES -❑ NO ,.z,
'-COMP PLAN DESIGNATION _, , , .BASIC PLAN? .,4❑YES ':i ,❑'NO,
SECTION;..,,., ::
TOWNSHIP ' ' RANGE ���_ ANEW ADDRESS REQUIRED? . '1"� 76 YES •, o NO
PLATTED LOT? ❑•YES;> F dN0 -'t ' CHANGE OF USE?.-. o YES'.t.--o NO -
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.citvoffederalway.com
. ■ ELECT•ICAL ' •
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 _#of Thermostats(First-$43.00;add'n-$I3.00ea)
(First 1300 1t1-$85.50:Each add'n 500 ft'-$27.50) _Service and feeder $93.00 _#of Low voltage fire or burglar alarms
Square Feet: first 2500 ft'-$50.00:Each add'n 2500 ft`-513.00
_Each outbuilding or garage 535.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _#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/ _#of Signs(First sign-$43.00;add'n sign
(Inspected separately) feeder-537 each) $20.00 each)
_Swimming pool,hot tub,spa $85.50
I _Yard Pole meter loops $57.00
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or morel Altered Service or Feeders
III! Service Feeder Amps Service or Add'n _0 to 200 5 93 uo
_tip to 200 amp 1 93.00 S 2750 Feeder 201 -600 216.50
-201 -400 amp 115.50 57.00 -0 to 100 g 93.00 $ 57.00 -601 -1000 226.50
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 _it of circuits
Over 800 amp 289.50
ALTERED SINGLE/MULTI FAMILY
216.50 _401 -600 252.50 101.00 i I-5 circuits-$72.50;Add'n circuits,$6 ear
_601 -800 326.50 138.00
(When inspected separately from the services.) _801 -1000 399.00 166.50 TEMPORARY SERVICE
ervice 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
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
{/S
of circuits _over 600 125.00
! (1-4 circuits-$57.00:Add'n circuits$6 ea)
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
nemtit fee+$72.50.Add'I plan review for other submissions is$85.50/hr.
FIXTURE DESCRIPTION(A) FIXTURE,FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D)
1
•
1
TOTAL COLUMN(D): !
Total Column(D)
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)
SBCC Surcharge: (19) (21) (23)
Total (Pages ones,Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin#100-December 23, 2002