03-100366 ' q ' 4, ,
I .
City of Federal Way
4, Community Development Services Electrical Permit #:03 - 100366 - 00 - EL
33530 1st Way S .r
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: DASH POINT CHIROPRACTIC .
Project Address: 1612 SW DASH POINT RE) Parcel Number: 122103 9074
Project Description: Addbranch circuits and(1) 100-ampbranch circuit;wiringfor voice/data.
(12)20-amp ik ev-,4,51)I
k
Owner Applicant Contractor
AUDREY/SYDNEY IRMAS CHARITABLE F( PACIFIC NORTHWEST ELECTRIC PACIFIC NORTHWEST ELECTRIC
20206 72ND AVE S 5122 S 284TH PL 5122 S 284TH PL
KENT WA 98032-2322 AUBURN WA 98001 AUBURN WA 98001
(253)854-8545
Electrical Fixtures
.,,,, . 1 VS riptioh. :,7f,%' la:'-',:04tiA _ €3escriptidi l$:l Cab=Ty � ;script on "-i1:066htity
Circuits- Commercial 16 Low Voltage-Other Commercial 2500
PERMIT EXPIRES July 26,2003,IF NO WORK IS STARTED.
Permit issued on January 27,2003
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 Feder"1 W . 1
Owner or agent: ^ ilfraa Date: /- 9-1�3
P/C)
71.
1 — 30 —E-9j •..,"-"` cwe-tr v C"--e- /)a4
z - L(_ D 3 Ct-j`L�N Cove. A1°PP-e ve-0 i7
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•
•
City of Federal Way
Community Development Services Electrical Permit #:03 - 100366 - 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: DASH POINT CHIROPRACTIC
Project Address: 1612 SW DASH POINT Parcel Number: 122103 9074
Project Description: Add(12)20-amp branch circuits and(1) 100-amp branch circuit.
Owner Applicant Contractor
AUDREY/SYDNEY IRMAS CHARITABLE F( PACIFIC NORTHWEST ELECTRIC PACIFIC NORTHWEST ELECTRIC
20206 72ND AVE S 5122 S 284TH PL 5122 S 284TH PL
KENT WA 98032-2322 AUBURN WA 98001 AUBURN WA 98001
(253)854-8545
Electrical Fixtures
Circuits- Commercial 16
PERMIT EXPIRES July 26,2003,IF NO WORK IS STARTED.
Permit issued on January 27,2003
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. /
` � 7 - D 3._
Owner or agent: Date:
/'°
� '� 2 1 — o 3 W /1- (/� fr �i2 a lr
RECEIVED CONSTRUCTION PERMIT APPLICATION
CITY OF �/ APPLICATION NUMBER: 61 - 1 0036fj_ =e-0_LsL
Federal Way JAN 2 7 2003 APPLICATION NUMBER: - -
CITY
OE FEDERAL WAY !APPLICATION NUMBER: - -
**The fcML,t 0PrPitfr d 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: RQ 12 St.v V)k4 P{- Roac`, ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING o PLUMBING o MECHANICAL o DEMOLITION
%ELECTRICAL o ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): It'DD.. 12-- z..0 4-s) R r,4Nck TL C a () 1 C )A-+.(D
(3rANCAA- ULT
PROJECT NAME: - 4r A1-54 ,e2/0,/ £ p &/1- /4C-
-
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE'
STfv>✓ `l . i ( ) -
MAILING ADDRESS(STREET ADDRESS;OrTY,STATE,ZIP):
! ` I
CONTRACTOR: NAME: C i DAYTIME PHONE:
?A.0 c C+ k.)0 r 4& a S+ l�le.c�UL. z N c D.,s3 )ifs-4 - -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): I EVENING PHONE:
5122 S. 2- 4 -tom. PL ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
A v (�„+. ? 'VO/ - - i ( ) -
(
CONTRACTOR'S REGISTRATIbN NUMBER: Q17-- 7 �j�� EXPIRATION DATE:
(copy of card required) ®�/ G G�� O 7` / /� 7 / / / Q
APPLICANT: NAME: DAYTIME PHONE:
t 14-a-LA-o J-11----• (�S3> en! -FS S—
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
5 i Zz c * 2- i . PL. h,l,,,d 4.,51. 5P0/ ! ( ) -
RELATIONSHIP TO PROJECT: I FAX NUMBER:
M I o ARCHITECT o TENANT 0 OTHER(DESCRIBE): i ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER o APPLICANT CONTRACTOR
■ DETAILED BUILDING INFORMATION •
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE o 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
Indi•-•to number of each type o fixture
MECHANICAL
AIR HANDLING UNIT(S) APORATIVE COOLER(S) G,' LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOO S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANG ) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT S• RCE: 0 ELECTRIC o 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)
re 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(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 Information supplie. to the city as • •art of this application.
NAME/TITLE• Kr/ _/_
❑ A
Or DATE: / Z7 0 5--
PROPERTY OWNER oCANT N.GONTRACTOR
FOR OFFICE USE ONLY:; 1
xb NEW o ADDITION ❑ALTERATION ci REPAIR b TENANT IMPROVEMENT
CENSUS'CODE40 :7.,.a.- ,. �a�' '��'',:rLOTSIZE.Fq'af40fr: ,r�,� x�;,.��.; '�� °.��.
} LDING
'ZONING DESIGNATION..�,�..� i,�i� ,���-fir � =BUILDING SHELL'ONLY?ir.a'YES' ?,❑ NO _'-° .
COMP PLAN DESIGNATION , ; k� 'BASIC PLAN?" Y=o YES , ❑NO;
SECTION';_.�, .,,; 1 'WNSHIP__ °RANGE �s N'EW ADDRESS REQUIRED? �3.. �¢ ❑'YES. 't3 NO
!‘PLATTED LOT?x i❑YES o-NO .CHANGE OF USE? :4“. . F.❑YES.1'1'-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.dtvofTederalway.com
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 02-$85.50;Each add'n 500 112-$27.50) _Service and feeder $93.00 #of Low voltage fire or burglar alarms
Square Feet: First 2500 ft2-$50.00;Each add'n 2500 ft2-$13.00
_Each outbuilding or garage $35.50 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-$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
If i
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or more) Altered Service or Feeders
Service Feeder y/j mps Service or Add'n _0 to 200 93.00
_Up to 200 amp 5 93.00 $ 27.50 lam Feeder 201 -600 216.50 i
_201 -400 amp 115.50 57.00 t'to 100 5 93.00 $ 57.00 601 -1000 326.50 I!
_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 /.4#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/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 i
_Mast or meter repair 43.00 401 -600 115.50
-d 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.Add'I plan review for other submissions is$85.50/hr.
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FIXTURE DESCRIPTION(A) FIXTURE,FEE`FROM TABLE B(B) ' NUMBER OF UNITS(C) TOTAL(D)
i {
TOTAL COLUMN(D): i
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)
• ENGI.NEERING
Estimated Permit Fee: (16)
Bond Amount: (17)
■ 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