04-104510 r ,
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City of Federal Way * Electrical Permit #: 04 - 104510 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: BELKE
Project Address: 616 SW 312TH 5r Parcel Number: 072104 9144
Project Description: Install a new 200-amp service panel to replace existing fuse panel and add one circuit for furnace.
Owner Applicant Contractor
DANA BELKE CTS CONSTRUCTION LTD CTS CONSTRUCTION LTD
616 SW 312TH ST 25410 42ND PL NE 25410 42ND PL NE
FEDERAL WAY WA 98023 KENT WA 98032 KENT WA 98032
(253)941-5119
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Res.0 1
PERMIT EXPIRES May 3,2005.
Permit issued on November 4,2004
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.
Owner or agent: a„�,s \\ , \Jj Date:
• THIS CARD IS TO REMAIN ON-SITE
CITY OF Y Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104510-00-EL
Owner: DANA BELKE
Address: 616 SW 312TH ST
FEDERAL WAY, WA 98023-4817
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
0 Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) 0 Ceiling Cover(4020) IA
Final-Electrical(4055)
Approved Approved Approved
By Date By Date Bk Date Il\f)9 bL1
❑ Under-slab groundwork(4295)
Approved
By Date
4k,
RECEIVED CONSTRUCTION PERMIT APPLICATION
CITY OF 451111.116%......" APPLICATION NUMBER: ' d - r
Federal Way Novo 4 2004 APPLICATION NUMBER: - �� �� �
CITY OF FEDERALWAY
(APPLICATION NUMBER: - -
**Th BTIIDIN 9 DEequired information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
M PROPERTY INFORMATION • -
SITE ADDRESS: kc \14 6S lam) .• ,3 1 ',Z, Mik ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PRO]ECT INFORMATION -
TYPE OF PROJECT(This application): o BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
ELECTRICAL ❑ ENGINNEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): ,y,io_Y cel Q. &) O E3
0.."..4D .3. O.i-L. 1.x.,[2,1,.-r 0 -1.-1.1u.G.. >�a ,1/43- a)'.. Q-- \ �-
PROJECT NAME:
• PEOPLE INFORMATION '
PROPERTY OWNER:
NAME: � DAYFIME PHONE
-0, 'c,
MAILING ADDRESS .. 1 C ,y
(STREET ADDRESS;CITY,STATE,ZI i � 6 5 a 42(9.4
to \ e S1,4 31 a' S% \=aD w,t
CONTRACTOR: NAME: DAYTIME PHONE:
Q- "-V Q.CZ.vs q \- � ', (2c 3)9 4) - Sel/ q
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): C. EVENING PHONE:
I '. l'i l C' ‘A -0 ‘ S'''' YC WO (/G'C'32 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(Copy of Card required) C 'r S C cz.l- Ac Q 1 A1. 5 / /
APPLICANT: NAME: ! DAYTIME PHONE:
CI-k %J.-. \` W ; k-so,-� (2d3 ) 3gL-14y-) L
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE-
`d-5 u�\ o y n,YJ�\ �� \-c va0. g i v 3 z ( )
RELATIONSHIP O PROJECT: j FAX NUMBER:
0 ARCHITECT ❑TENANT ❑ OTHER ( DESCRIBE): t; ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: a PROPERTY OWNER p APPLICANT .c�/CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: S C 2 EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: S
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES 0 NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE 0 PRIVATE(SEPTIC)
i
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**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 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: ❑ 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
Federal Way,but only where such daim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: Q..Q` pt-- (J DATE: t — 0 L'! —04
❑ PROPERTY OWNER o APPLICANT \CONTRACTOR
_:FOR OFFICE USE ONLY: :€.
O NEW ❑ADDITION ,, = o ALTERATION r.• '0:REPAIR w:O TENANT IMPROVEMENT'4,--
-LOT
:!LOT SIZE:
ZONING:DESIGNATION; _ ,;; :BUILDING SHELL ONLY?' 'iiYES, •L❑ NO •
COMP PLAN DESIGNATION , BASIC PLAN?N-2 o YES ❑'NO -
SECTION _, --=;:TOWNSHIP 'RANGE TIEW ADDRESS REQUIRED?%''' �_ ❑YES ❑ NO
-PLATTED LOT? rya YES 01410 CHANGE OF USE? ❑YES' ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
1 , www,dtyoffederalway.com
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■ E TRICAL
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.O0ca)
(First 1300 ft2-585.50.Each add'n 500 111-$27.50) _Service and feeder $93.00 #of Low voltage fire or burglar alarms
Square Feet: _ First 2500 f11-$50.00:Each add'n 2500 ft`-$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
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or more) Altered Service or Feeders I
Service Feeder Amps Service or Add'n 0 to 200 5 93.00
_Up to 201)amp 5 93.00 $ 27.50 Feeder _201 -600 216.50
201 -400 amn 115.50 57.00 _0 to 100 $ 93.00 S 57.00 __601 -1000 326.50
-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 #of circuits
_Over 800 amp 289.50 216.50 401 -600 252.50 101.00 (1-5 circuits-$72.50:Add'n circuits,$6 eat
ALTERED SINGLE/MULTI FAMILY _601 -800 326.50 138.00
(When inspected separately from the services.) _801-1000 399.00 166.50 TEMPORARY SERVICE
c ice or Feeder _Over 1000 434.50 232.00 Residential/Multi-Family/Commercial/Industrial
0 to 200 amp -s_$ 71.50 _Over 600 volts surcharge 72.50 _0-100 $ 57.00
_201 -600 amp 11-5:50 " _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
nennit 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)
4 I
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I I
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I
ii
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 one 8,Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100-December 23, 2002 f
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