03-104931 t
City of Federal Way
Community Development Services Electrical Permit #:03 - 104931 - 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: HOME USA
Project Address: 2030 S 314TH Parcel Number: 092104 9053
Project Description: Adding 4 circuits for 17 outlets&installing 1 LIV phone line system
Owner Applicant Contractor
ROSEN PROPERTIES NORTHWESTERN ELECT SERVICES INC NORTHWESTERN ELECT SERVICES INC
ROSEN PROPERTIES 1729 S OAKES ST 1729 S OAKES ST
1715 114TH AVE SE UNIT 212 TQACOMA WA 98405 TQACOMA WA 98405
BELLEVUE WA 98004 (253)677-5921
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits- Commercial 4 Low Voltage-Other Commercial 2500
PERMIT EXPIRES April 27,2004.
Permit issued on October 30,2003
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 Way.
Owner or agent: �7 r/� Date: (
70 al/
CtIS5/
RECEIVED
CONSTRUCTION PEZRRMIT APPLICATION
CITY OF OCT 2 9 2003 APPLICATION NUMBER: U _J- _1D - -
Federal Way APPLICATION NUMBER: - -
OITBdLD NG DEPT. AY (APPLICATION NUMBER: -
**The following is required infoc =Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION -
S 44' sr
SITE ADDRESS: (.9-63(.10 ) l ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
_ ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING o MECHANICAL o DEMOLITION
ELECTRICAL 0 ENGINEERING
�o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): cam. T" C Y C
/ 7 oe,_-/efs Phu,
PROJECT NAME: /7/0 h4 e GL
- IN PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
/7/C,Ma C1.5,-/ ; ( 53 )q?y -( ( 09
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: DAYTIME PHONE:
NAME: i
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): I. EVENING PHONE
( ) i
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME: // te / /� DAYTIME PHONE:
/VD✓`H1u�e371' 1 TCE% / - Z, i X<3 -5-la /
MAIUNG/ADDRESS
/(STREET
.AADDRESS;CITY,STATE./�ZIIIPP): a/��,� �r EVENING PHONE:
93 I
RELATIONSHIP TO PROJECT: v FAX NUMBER:
❑ ARCHITECT o TENANT 0 OTHER(DESCRIBE): � t CUt, r!ti ( ) gLi$ -qJ (iq I
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: 00 (44-144-eird e---/ EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES o NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE O TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN a HIGHLINE O PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING Si.FT. PROPOSED SQ.FT. TOTAL
BASEMENT •r
War
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL Value of Mechanical Work: $
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) ❑ ELECTRIC ❑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,including 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 supplied to the city as a
part of this application.
de79
NAME/TITLE: //�%wv► DATE: /0 3 " -aes,z,3
❑ PROPERTY OWNER 0 APPLICANT o CONTRACTOR
FOR OFFICE USE ONLY rI
u NEW u .p ADDmON 0 ALTERATION�� n REPAIR TENANT IMPROVEMENTS
'CENSUS°GOOF - - ry..€21,7 - `a; :` 'LOT SIZE;
ZONING!:,DESIGNATIONS L x DUILOING SHELI ONLY? o YES
=COMP FLAN DESIGNATION xk` ABASIC PLAN? ❑YES oNO `�
-SECTION„=t . TOWNSHIP- RANGE NEW ADDRESS REQUIRED? ❑YES t7NO
'PLATTE[?LOT? n YES „-;;T:1=1 NO `a"r � .CHANGE OF USE?,-z-_--;7-7-5r,1=-'..0 YES 'a NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.citvofederalway.com
M ti�
• ■ 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-$13.00ea)
(First 1300 ft'-$85.50:Each add'n 500 ft -$27.50) _Service and feeder $93.00 #of Low voltage fire or burglar alarms
square Feet. - ..- ' First 2500 ft'-$50.00:Each add'n 2500 ft'-$13.(10
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet:
(Inspected with scrvicc) _#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-543.00;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 morel Altered Service or Feeders
Service Feeder Amps Service or Add'ri 0 to 200 5 Y3 itti
lip to 200 amp 5 93.00 $ 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 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 cap
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 _over 600 125.00
(1-4 circuits-557.00;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)
1
I
t
TOTAL COLUMN(D): I
Total Column(0) 777
Estimated Permit Fee: (12)
Estimated Permit Fee from fine 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)
s" 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 t