03-103323 City of Federal Way
Community Development Services Electrical Permit #:03 - 103323 - 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: T-MOBILE
Project Address: 30605 1ST S QI S Parcel Number: 339210 0020
Project Description: Provide 200-amp service and 60-amp feeder for cellular micro-cells on existing PSE power pole.
Owner Applicant Contractor
CHURCH OF GOD HOLINESS VALLEY ELECTRIC CO OF MT VERN VALLEY ELECTRIC CO OF MT VERN
30605 1ST PL S 3001 OLD HWY 99 S 3001 OLD HWY 99 S
FEDERAL WAY WA MOUNT VERNON WA 98273 MOUNT VERNON WA 98273
98003-4039 (425)483-6869
Electrical Fixtures
_ ___....4 I#, - A be : * • A;,,,Asa
Service/Feeder:101-200 amps-Comm 2
PERMIT EXPIRES February 10,2004.
Permit issued on August 14,2003
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 acc s dance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
3 Owner or agent: // Dater(V—°
tD— /o �`it.r / 4/01/3Get/4°
/919
RECEIVED.
'�� CONSTRUCTION PERMIT APPLICATION
CITY OF �.. AUG 1 4 2003 APPLICATION NUMBER: 6? - i0 ,
Federal WayAPPLICATION NUMBER: - 33 - UV L
CITY OF FEDERAL WAY
BUILDING DEPT. `APPLICATION 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: 30405- /s± a S ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROTECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING 0 MECHANICAL 0 DEMOLITION
ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM /'f
PROJECT DESCRIPTION(Provide detailed description): 4 a/ c� S-741 4-rx—
Cear P' 4 e_ ETA, •
PROJECT NAME: T- Iwo bi (e. - tS±ii-ti'_ - co'i_
I PEOPLE INFORMATION
PROPERTY OWNER: NAME: L ,. r ; DAYTIME PHONE:
�� 4-(0 (l ; ( )
MAILING ADDRESS(STREET AD ESS;CITY,STATE,ZIP):
CONTRACTOR: I NAME: \ DAYTIME PHONE:
Ij VAI I EY 61e,c Lc- KitE- ' �, ' (360 ) YZV - 66o 2..
MA�ILING ADDRESS(STREET ADDRESS;CITY.STATE.ZIPP . EVENING PHONE:
4.tt20 I
(9 l ' 9174 J 2 i ( ) -
xOF FEDER�} AY BUSINESS LICENSE NUMBER: FAX NUMBER:
� I (AA - - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE: f
(copy of card required) V k 1 L E- £ C-' 1 `'1 / & 4 ; / /
APPLICANT: N E: % DAYTIME PHONE:
,9 U E (ec e- ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 ARCHITECT 0 TENANT 0 OTHER( DESCRIBE): 5 '{ I ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER O APPLICANT (CONTRACTOR
- - ■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES 0 NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ 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:
■ 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 ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC a 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(including 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 information supplied to the city as a part of this tion.
NAME/TITLE: appli �� DATE: �� f
o PROPERTY OWNER a APPLICANT a CONTRACTOR
.FOR.OFFICE.USE;ONLY k
,t7 NEW .- . ,, 1 ADDITION CI ALTERATION ❑REPAIR , 11TENANT-IMPROVEMENT� _.
'CENSUS`.CODE:; . ; ' ax >LOT SIZE: ',- rWMa-. f 3'._
ZONINGpESIGNATION � BUILDiNG SHELL ONLY? U YES .a NO
COMP PLAN I ESIGNATION r a ',, BASIC PLAN? ;>❑YES b,NO �"
SECTION , '; TOWNSHIP =" {RANGE v NEW ADDRESS REQUIRED? :a YES.4 a NO ,
'-'PLATTEUlOT? ;a YES' ,E NO '. CHANGE OF USE?, a YES- n NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,dtvoffederelway.com
•
• ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 _it of Thermostats(First-$43.00;add'n-$13.00ca)
(First 1300(12-585.50:Each add'n 500 ft2-$27.50) _Service and feeder $93.00 _a of Low voltage fire or burglar alarms
Square Feet: _ First 2500 f11-550.00:Each add'n 2500 ft2-$13 00
_Each outbuilding or garage 535.50 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/ _a of Signs(First sign-$43.00;add'n sign
(Inspected separately) feeder-$37 each) - $20.00 each)
Swimming pool,hot tub,spa $85.50
I _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 5 93.00
_Up to 2011 amp 5 93.00 $ 27.50 Feeder _201 -600 216.50
201 -400 amp 115.50 57.00 I 0 to 100 -1 93.00 5 57.00 _601 - 1000 126.50
-401-600 amp 158.50 78.50 j 101 -200 115.50 7-2.50 _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 (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
a of circuits I _over 600 125.00
-
(1-4 circuits-$57.00;Add'n circuits$6 ea)
i J
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+$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) J TOTAL(D)
!
t r
j I
r
TOTAL COLUMN(D): I .
Total Column CD)
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 8Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100-December 23, 2002