03-100407City of Federal Way
Community Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fac 253.661.4129
Electrical Permit #:03 - 100407 - 00 - EL
Inspection request line: 253.835.3050
Project Name: BELMOR MOBILE HOME PARK SPACE 272
Project Address: 2101 S 324TH St Parcel Number: 162104 9037
Project Description: Replace meter pedestal for mobile home, SPACE 272
Owner
Applicant
Contractor
BELMOR HOLDINGS LTD
SHEPPARD & NELSON ELECTRIC
SHEPPARD & NELSON ELECTRIC
1571 BELLEVUE AVE W SUITE 210
PO BOX 3630
PO BOX 3630
VANCOUVER CN
KENT WA 98032-0210
KENT WA 98032-0210
(206) 878-7333
Electrical Fixtures
y riptit t£ Qti
Service or Feeder - Manu./ M.H. Park I
PERMIT EXPIRES July 29, 2003, IF NO WORK IS STARTED.
Permit issued on January 30, 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. A
Owner or agent: See Application Date: I '� O
v C�s�Dttl
a' r
adTp7EIZF�LF:
.� CONSTRUCTION OP
ER-MIT APPLICATION;PPLICATION NUMBER'
Vitt It'
RECEIVED, U - -
PPLICATION NUMBER:
N 3 d
f � � u PPUCATION NUMBER:
,i JAN 9, 2003 _
r, �'" �* **The following is required information -- Please print (in ink) or type** F
Please note: ElectrleKYiQFPFJQ s and Engineering may require a separate application.
BUILDING
SITE ADDRESS:.,�i I S 3� Y "� ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT (This application): ❑ BUILDING n
P( ELECTRICAL
bESCRIPTION (Provide detailed description).
LING ❑ MECHANICAL ❑ DEMOLITION
EERING❑ FIRE PREVENTION SYSTEM
J .I0"D
ir-
�. L
] : I;
I'ROJECI' NAME•,' x
� x a �_!•
• •LE INFORMATIO
PROPERTY}OWNER: x' - OAYi1MEPHONE:
NAME: t t
y 1MNLINGADDRESSOMETADDRmov G -
kCTOR:
it
NAME'
VVV1
DAYTIME PHONE:
EVENING PHONE:
(
-
MAILING (STREET ADDRESS; alYe Z
STATE, IP) �+
a fi a,
CITY OF FEDERAL, WAY BUSINESS LICENSE NUMBERS:',
g $ „a s, , a
FAX NUMBER:
MAILING ADDRESS (STREET ADDRESS; aTY, STATE, ZIP). ' .
EVENING PHONE:
CONTRACTORS REGISTRATION NUMBER:Y ` " # i�+�
+ Y r T
RELATIONSHIP
EXPIRATION
RATION DATE:
-
%OI CMII
v
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE):
( -
APPLICANT: NAME:
E'
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; aTY, STATE, ZIP). ' .
EVENING PHONE:
RELATIONSHIP
TO PROJECT:
FAX NUMBER.-
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE):
( -
E-MAIL ADDRESS:
r CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER' :'Y ' ❑ APPLICANTCONTRACTOR
. ,.,,..
DETAILED BUILDING INFORMATION
USE:
EXSTN(EUILbfNG
SSEDAPPRAISED VALUATION
PROPOSED USE :.,=
PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED` BUILDING?, ' :
❑YES b" NOSUPPRESSION SYSTEM PROPOSED/REQUIRED: 11 YES ❑ NO
WATER SERVICE PROVIDER:
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER:
❑ LAKEHAVEN 11 HIGHLINE 0 PRIVATE (SEPTIC)
w
t
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS; ESTIMATED SELLING PRICE: $
■ PR07ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL,
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)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
. . PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
13LOCK
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 (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 s led to the city asa art of this application. r,
NAME/TITLE: " DATE: _ _I� 0S
❑ PROPERTY OWNER ❑ PPLICANT ❑ CONTRACTOR
e • e e ,�
r ..
l4 ne =12 A
ODMMUNTTY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTII • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •2S3-661-4000 • FAX: 253-661-4129
www.otmffede-ralway.com
■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
_ Single Family
_ Service or feeder only .........................
$50.00
_ # of Thermostats (First 437.50; add'n-$11.50ea)
(First 1300112-$75.00; Each add'n 500 W
-$24.00)
_ Service and feeder ...............................
$81.00_
# of Low voltage fire or burglar alarms
Square Feet:
First 2500 ftZ-$43.50; Each add'n 250011'-$11.50
_ Each outbuilding or garage ...........................
$31.00
MOBILE HOME/RV PARK
Square Feet:
(Inspected with service)
L # of service or feeders
• Per WAC 296-46-910(5)(b)(i & ii)
_ Each outbuilding or garage ...........................
$50.00
(First service/feeder-$50.00; Add'n service/
_ # of Signs (First sign -$37.50; add'n sign
(Inspected separately)
feeder -$32 each)
$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 circuits, $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-Family/Commercial/Industrial
_ 0 to 200 amp ...............................................
$ 68.50
_ Over 600 volts surcharge ......................
63.50
_ 0-100 ................................................ $ 50.00
_ 201 - 600 amp ..............................................
101.00
_ Mast or meter repair..............................
68.50
_ 101-200 ................................................ 63.50
over 600 amp ................................................
151.50
_ 201-400 ................................................ 75.00
_ Mast or meter repair .......................................
37.50
_ 401-600 ........................ ..................... 101.00
_ # of circuits
_ over 600 ...............................................109.00
(14 circuits -$50.00; Add'n circuits $5 ea)
it a new or aiterea commercial service is Luu amps or greater, or a new or aiterea resiaemial service is greater man 4uu amps, a pian review is requirea. Pee is sm ro o1
permit fee +$63.50. Add'l plan review for other submissions is $75.00/hr.
Total Column (D)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50 + ( X .35) = (13)
DEMOLITION
Estimated Permit Fee: (14)
Bond Amount: (15)
Estimated Permit Fee: (16)
Bond Amount: (17)
Mitigation Fee: (18) _
SBCC Surcharge: (19)
(20)
(21)
(22)
Total (Pagesone&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100 - February 19, 2002