03-102897 A f e
City o1 Federal Way
Community Development Services Electrical Permit #:03 - 102897 - 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: 359TH&HWY 99 STREET SIGNAL
Project Address: 1-c, tvf de, Parcel Number: CITY WIDE
Project Description: Traffic signal installation and service of corner of 359TH&HWY 99
Owner Applicant Contractor
CITY OF FEDERAL WAY-PW*GARY KENI MT ELECTRIC INC MT ELECTRIC INC
33530 1ST WAY S
FEDERAL WAY WA 98003
(425)888-2232
Electrical Fixtures
VW z IlyVs%a 1 1t •: lel
Service/Feeder: 0-100 amps-Comm. 1
PERMIT EXPIRES January 11,2004.
Permit issued on July 15,2003
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. . 4
Owner or agent: J --��� Date: "),- /
1
7�2 D3 Com- ec w g( ems(
S- 2 g-O-3 5.er- '('-W442--405
ar01
�� CONSTRUCTION PERMIT APPLICATION
CITY OF �./ APPLICATION NUMBER: i93- w2s1 7_ -
eto
Fe d e ra l Way APPLICATION NUMBER: - -
1APPLICATION 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: 3cq 4 if y,,,) 99 ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PRO3ECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING ❑ MECHANICAL ❑ DEMOLITION
o ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): T/'4�� $ y.. �H-si c( "'La(
PROJECT NAME:
• I PEOPLE INFORMATION
PROPERTY OWNER: NAME: ; DAYTIME PHONE
•S Crf
MAILING ADDRESS REpADDRESS;CITY,STATE,: wAr
-3 3 Sao / R-cc -c, F c c,,,a y 4 i
CONTRACTOR: NAME: DAYTIME PHONE• :
(ems 4e t•--e (4/2.)- )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): I. EVENING PHONE:
Pc, Bok 6g4 t 9 6 s (106 ) 7th-`7633
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: i FAX NUMBER:
(4011 x- 67417
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
(copy of card required)
APPLICANT: f NAME: DAYTIME/ PHONE: ry
II MAILING ADDRESS(STREETADDRESS;CITY STATE ): j (`!Z 7 ) fi� Y j
EVENING PHONE:
�//"/�o acc (�G sove L -t,� ��o�j" (a06 ) '7r6-11633
RELATIONSHIP TO PROJECT: j FAX NUMBER:
❑ ARCHITECT ❑ TENANT 0-OTHER ( DESCRIBE) kp
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER 0 APPLICANT ❑ CONTRACTOR
- -■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ 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 UNITS) 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: o ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC o 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 daim(induding costs,expenses,and attorneys'fees Incurred in the
investigation and defense of such claim),which may be made by any person,induding the undersigned,and filed against the City of
Federa'Way,but only where such daim arises out of the r ance of the city,induding its officers and employees,upon the accuracy
of the Infopsatibn supplie the d as a part of this ap i tion.
NAME/TITLE: DATE: 7
o PROPERTY OWNER ❑APPLICANT ❑CONTRACTOR
FOR OFFICE USE ONLY:
;D.NEW .Vfl ADDITION =_I]ALTERATION IW, o:REPAIR n TENANTxIMPROVEMENT
"CENSUS`CODE _•.. , 'l - :LOT SIZE:_,, . -4s_. Ma I
:ZONING DESIGNATION: ,4 M� r , _ , ,.�._, BUILDING SHELL ONLY?u YES :=❑ NO
-COMP PLAN DESIGNATION '- BASIC PLAN? ''❑YES ' "❑'NO, -
SECTION - .. ,TOWNSHIP !RANGE :' .NEM/ADDRESS REQUIRED? , o YES 13 NO
-PLATTED LOT?;?'~❑YES o NO -V," CHANGE OF USE? o YES `=fl NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtvoffederalway.com
■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family Service or feeder only $57.00 II of Thermostats(First-$43.00;add'n-$I3.00ca)
(First 1300 ft2-585 50;Each add'n 500 112-$27.50) _Service and feeder $93.00 ft of Low voltage fire or burglar alarms
Square Feet. _ First 2500(12-$50.00:Each add'n 2500 ft2-S 13.(X;
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _ft 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/ _d 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
tl
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 5 93.00
-Up to 200 amp $ 93.00 $ 27.50 C........ Feeder 201 -600 ?16.50
-201 -a0fi amp I1S.SU S7.00 $ 93.00 $ 57.00 -601 -1000 126.50
401 -600 amp 158.50 78.500 115.50 72.50 over 1000 363.00
601 -800 amp 202.50 108.50 _201 -400 216.50 85.50 ft of circuits
Over 800 amp 289.50 216.50 401 -600.._._................ 252.50 101.00 i 1-5 circuits-$72.50:Add'n circuits,$6 eai
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 _-U-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
_a 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+572.50.Add'I plan review for other submissions is$85.50/hr.
FIXTURE DESCRIPTION(A) FIXTURE;FEE FROM TABLES(B) NUMBER OF UNITS(C) TOTAL(D)
i (
�
f•
l I
TOTAL COLUMN(D): .
Total Column(0)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $72.50+( X.35)= (13)
. ■ DEMOLITION , .
Estimated Permit Fee: (14)
I
'Bond Amount:(15)
■ EN.GINEERING • °. .. -
Estimated Permit Fee: (16)
Bond Amount: (17)
al OTHER FEES . ..
Mitigation Fee: (18) (20) (22)
SBCC Surcharge: (19) (21) (23)
TotaI (Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100-December 23, 2002