03-100414 M
City of Federal Way
Community Development Services Electrical Permit #:03 - 100414 - 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-fame: BELMOR MOBILE HOME PARK SPACES 143& '
Project Address: 2101 S 324TH $r Par _ umber: 162104 9037
Project Description: Replace meter pedestal for mobile home,SPACES 14 44
Owner Applica ontractor
BELMOR HOLDINGS LTD SHEPPARD&NE ELECTRIC HEPP • NELSON ELECTRIC
1571 BELLEVUE AVE W SUITE 210 PO BOX 3630 BO ' .30
VANCOUVER CN KEN A 9803- I KEN' A 98032-0210
:78-7333
Elect • fixtures
Service or Feeder-Manu./M.H.P.
I
P MIT EXPIRES July 29,200 F NO WORK IS STARTED.
Pe ' sued on January 30,2003
(m):
y certify that th atio is correc d at a construction on the above described property and
upancy and the a in acco ce a rules and regulations of the State of Washington and
y A r o �� C �n Date: ' /30/a3
f y ,a ,, :. - RECEIVI
Y"'°' CONSTRUCTION PERMIT APPLICATION
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N): E17E1ZAL JAN 2 Z0 4 APPLICATION NUMBER: — 4 f 121. °`
A z, a. a ',`APPLICATION NUMBER: —
§s ry CITY OF FED
` ,('� ,`� ,,,�,tFEDERAL •):APPLICATION NUMBER:_ .... — — _ _ _ _ —
k BUILDING DEPT ' ' ✓ _ —
a,4 w Yx **The following is required Information--Please print(in Ink)or type** -
4fW"= �tg i 4 .Please note:.Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
I ;4 j' a '
''SITE ADDRESS: 4C.' ♦' S 3 9i,ASSESSOR'S TAX/PARCEL#: -
.•�LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION' .
�At.A4 14'',1 � :_. . 'Ad 'k.•t'i,. .. - • •. . �.
4 ; TYPE OF PROJECT(This application): 0 BUILDING ; (� PLUMBING 13 MECHANICAL 0 DEMOLITION
"`x Lt.4 $ pc ELECTRICAL k4 CI ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJEt DESCRIPTION(Provide detailed description): L G..Q„ rn..-e-- 44-(j— Pe.g 6 122-4-
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(1:--, , PROJECT NAME' 4 4 - ,
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"„•4 ■ PEOPLE INFORMATION
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. PROPERTY OWNER: �p + . DAYTIME • f
• NAME: �k 4 i E PHONE:
{,,x • '.` ,,.. vk w. i ZIP N � (pas) -
R, ( UNG ADDRESS(STREET CITY, A'I'E�ZIP)3 r ,x 1 4
o S 3aY LiW � 9rD03
# CONTRACTOR: NAME: DAYTIME PHONE:
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✓� Sh.c 4� -I: scv� , -e�7`. O SSS -73 33
� i A' „. " MAILING ADDRESS(STREET ADDRESS;QTY,STATE,ZIP) ria ' f, e 6 EVENING PHONE:
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1 i);;,54.1,7
s�1k ' a 4 t .i . ' QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER: �. n t ' +,y r NUMBER:
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); ,,,74LxL v s ' .,, 1 ; t " t i -i1,o'L. *8 Q.E - a a �b �S -7 2 1.
, . r i`�yjt, "3,'' CONTRACTOR'S REGISTRATION NUMBER: " "1 w r+u•a— ! �.S c L EXPIRATITION DATE: /) j`
fid,n y, (wt*,4.;',.•;:c 14, (SPYrcard T ti. 4.1/..3cJ. .. ( 40 G ( /3( / 03 i
APPLICANT: NAME:
DAYTIME PHONE:
C t:ti ( )
1:3,..a MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): z.:' •r:x, ),., ,. - EVENING PHONE: .
( )
RELATIONSHIP TO PROJECT: FAX NUMBER: •
❑ ARCHITECT 0 TENANT ❑ OTHER(DESCRIBE): ( ) -
f•.:.,. 4'., - - - - -" +':x"Y;r 4; E-MAIL ADDRESS:
l CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNERt) APPVt A r.1 CONTRACTOR
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■ DETAILEDBUILDINGINFORMATION
1;:. S.,4','•mi#1,0%, FA`�" 4 in",-,*, f , !•, 4 .1? • "`.- Pox,h1�1�.�'•T.'wsit 'R' ' yak.:,. - '
EXISTING USE: -EXISTING BUILDING ESSED/APPRAISED VALUATION $
PROPOSED USE PROPOSEb VALUA'ION FOR IMPROVEMENTS: $
F
SPRINKLEREDBUILDING?, = ❑ YES ❑ NO^„.7; FIR $OPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES 0 NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE CI TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROSECT 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)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S) '
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 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 myt 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(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 city,induding its officers and employees,upon the accuracy
of the information s • = led to the city as a r art of this application.
NAME/TITLE: DATE: a ( " ag'-
❑ PROPERTY OWNER 0 "PPLICANT 0 CONTRACTOR
°RrF,)ICEiUSE:ONLY'.
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TTED�o O ; 61:116'.2 411 M .5;4 r.:d i i s 'YWS ;A d a
COMMUNITY DEVELOPMENT SERVICES..33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtvo(tedcralway.00m
A
■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $50.00 _#of Thermostats(First-$37.50;add'n-$11.50ea)
(First 1300 ft2-$75.00;Each add'n 500 ft2-$24.00) _Service and feeder $81.00 _#of Low voltage fire or burglar alarms
Square Feet: First 2500 ft2-$43.50;Each add'n 2500 ft2-$11.50
_Each outbuilding or garage $31.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) ail 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
(1-4 circuits-$50.00;Add'n circuits$5 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+$63.50.Add'I plan review for other submissions is$75.00/hr.
�A�.�
FIX
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`+''' 7'l)ItE;DESCRTPT>rOIV .,' �
,' :F`�X'�UREFEE:
PROM %8 OW �, ..�NUNiB�f�Fr'I��IJi�ITS';(C) }..,.� ,. ,_ ,, �....'TOTAL(CS) �q :',.;-'',:''q;
TOTAL COLUMN(D)t
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)
• ENGINEERING
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-February 19, 2002