03-102932 City of Federal Way 3
Community Development Services Electrical Permit#:03 - 102932 - 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: BUTZERIN
Project Address: 28831 14TH i GTS Parcel Number: 516210 0550
Project Description: Electrical work for the installation of a portable hot tub for existing residence.
Owner Applicant Contractor
Robert G Butzerin &Jodi S Butzerin HARASEN ELECTRIC INC HARASEN ELECTRIC INC
28831 14TH CT S 4408 222ND ST SW 4408 222ND ST SW
FEDERAL WAY WA MOUNTLAKE TERRACE WA 98043 MOUNTLAKE TERRACE WA 98043
98003-3774 (206)335-8722
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Hot Tub 1
PERMIT EXPIRES January 12,2004.
Permit issued on July 16,2003
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 ay.
Owner or agent: Date: 7// LD
/2- -5 es 3 CdyY-eO/rOy` S
- l -6 3 lea/ 49,--Gv-c..1 /
,lam
...
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......._A. RECEIVED CONSTRUCTION PERMIT APPLICATION
CITY OF P"
-1r
I APPLICATION NUMBER: C2.3 - /o e- �3 2- Uv :&
Federal Way JUL 1 6 2003 APPLICATION NUMBER: - -
CITY OF FEDERAL WAY APPLICATION NUMBER: - -
1 "'The followBdlispAgjL®f piformation—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
SITE ADDRESS: 2p U 31 19 *r I.,
CST ASSESSOR'S TAX/PARCEL #: l v- �Z>
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
1 - I PROJECT INFORMATION _ _ -
TYPE OF PROJECT(This application): o BUILDING o PLUMBING 0 MECHANICAL o DEMOLITION
I
t ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 4j;re._ f qUv 0 p r ht(0 (� St
f
PROJECT NAME: Z-CeS I L [tlz'C r/ /)
I PEOPLE INFORMATION
PROPERTY OWNER: NAME: .- DAYTIME PHONE
`J0 0/ /pU7'72 f J (025-3) 1'416,— 1(o 5
( MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
.51. t. 4 57/7(
CONTRACTOR: ! NAME: DAYTIME PHONE:
%/' 5GA Ef (AOlam) 33 5--- ?I7..2,Z
1 ac rc ��- �r c_ �
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): I EVENING PHONE:
liZig° 020)-el 541' Mc,uarf(kk__ teff-4c_C l✓,4 sA) 3 (Z26-) 775 -/6, Frc
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: { FAX NUMBER:
FIGd 7//c.(v 3 - - i ( )
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
(copy of card required) 14. A R A S G ( g 1 1 L E i G / 5- / c7 cT
APPLICANT: NAME: , DAYTIME PHONE:
3 /IPt1C{5Ct4 (telD4. ) 3-3h - 2r7.?a
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): EVENING PHONE:
ClqU OZA)-- SGJ Pic,,c,i f(c, 4e//c,cc_ L✓A `l yo 2-/j (
{ RELATIONSHIP TO PROJECT: j FAX NUMBER:
0 ARCHITECT ❑ TENANT o OTHER ( DESCRIBE): ( ) -
I �
E-MAIL ADDRESS:
i CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER ❑ 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 ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
r
**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: 0 ELECTRIC o 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 claim(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 claim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the Informatio supplied to the city as a part of this application.
NAME/TITLE: ize.4.0.14. .... r ('GS idEJ
Grt-f DATE: 7/1 c../c.7 3
o PROPERTY WNER ❑ APPLICANT o CONTRACTOR
FOR OFFICE USE.ONLY: "•
- ❑;,NEWA11. OiADDITION �;.--I;Q ALTERATION--R.t ,p.REPAIR a;,o:TENANT IMPROVEMENT'"-,.,
'CENSUS`:CODE. .= _. 'LOT SIZE y '-?•
;ZONING .BUILDING SHE'LL,ONLY?1,.u YES -O NO
COMP PLAN DESIGNATION BASIC PLAN? ❑YES ❑ NO
SECTION- TOWNSHIP. _y , 'RANGE =?° . NEW ADDRESS REQUIRED? x. ❑YES q NO
-.PLATTED";LOT? i'❑YES rI NO ` CHANGE OF USE7, ❑YES x=11 NO -
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,citvofffederalway.com
•
■ ELECTRICAL
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-$13.00ca)
(First 1300 ft'-$85.50;Each add'n 500 112-$27.50) _Service and feeder $93.00 #of Low voltage fire or burglar alarms
Square Ecce _ first 2500(1r-$50.00:Each add'n 2500 111-$13.(1(;
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _#of service or feeders *Per WAC 296-46-9I0(5)(b)(i&ii)
_Each outbuilding or garage $57.00 (First service/feeder-557.00;Add'n service/ _#of Signs(First sign-$43.00;add'n sign
(Inspected separately) feeder-$37 each) 11 $20.00 each)
/ Swimming pool,hot tub,spa $85.50
I t _Yard Pole meter loops $57.00
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 i 93.00
f _up to 200 amp Sr 93.00 S 27.50 Feeder _201 -600 216.50
-201 -400 amp 115.50 57.00 -0 to 100 5 93.00 1 57.00 -601 -1000 226.50
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 k of circuits
Over 800 amp 289.50 216.50 401 -600 252.50 101.00 (1-5 circuits-$72.50:Add'n circuits,$6 ear
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
_Mast or meter repair 43.00 _401 -600 115.50
#of circuits 1 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 TABLE B(B) _ NUMBER OF UNITS(C) TOTAL(D)
TOTAL COLUMN(D): 1 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)
■ ENGINEERING •
Estimated Permit Fee: (16)
F 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