03-105077 •
City of Federal Way
Community Development Services Electrical Permit #:03 - 105077 - 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: GERLT Pe")V
Project Address: 31900 53RD1SW Parcel Number: 189860 0140
Project Description: Adding 2 circuits for new residential addition.
Owner Applicant Contractor
Richard L Gerlt &Larissa G Gerlt Richard L Gerlt Richard L Gerlt
31900 53RD AVE SW 31900 53RD AVE SW 31900 53RD AVE SW
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-2027 98023-2027 (253)927-1375
Electrical Fixtures
Description Quantity Description ', Quantity Description Quantity
Circuits-Residential 2
PERMIT EXPIRES May 10,2004.
Permit issued on November 12,2003
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 Wa .
Owner or agent: Date:
Z\a-t\otA
X.„
do\ ‘\'‘.
- . A116,
RECEIVED - CONSTRUCTION PERMIT APPLICATION
CITY OF �../ APPLICATION NUMBER: 0,3- 105 D i L - (2)
Federal Way NAV 2 2003 APPLICATION NUMBER: —
CITY OF FEDERAL WAY (APPLICATION NUMBER: — —
BUILDING DEPT.
**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: 30O 3rd A/e s 2 ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- III PROJECT INFORMATION - -
TYPE OF PROJECT(This application): o BUILDING o PLUMBING 0 MECHANICAL o DEMOLITION
A ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): i� al PIP' i%l /0 Ar
/y i r 4 / r • . / / ` e
AAA / A' / G i t .i — / . A <//i. ' .
7' e; 1,5' i l-/-C II e e7 ,.
t PROJECT NAME:
PEOPLE INFORMATION :
PROPERTY OWNER: NAME. Lao
_ J DAYTIME PHONE
' it14eld , _s PI 6 er MAILING ADDRESS(STREET ADD I
SS;CI-Y.,,STATE,ZIP):
30t70 53rd A-1,/e-S iv Fedenti Wp 7 vi, )1 4). ',g-fi P3
CONTRACTOR: NAME: r DAYTIME PHON/EE. _
MAILISADDRES STREET ADD c S; c v, ZIP):er ((VENIN3P)ON) _cg5�
`I ( ) -
1 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: I FAX NUMBER:
- - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: j EXPIRATION DATE:
(ropy of card required) / /
V APPLICANT: NAME: ! DAYTIME PHONE:
-
i� g ( )
MAILI 00 ES EET ADDR S CITY,STA ZIP): ��� i EVENING PHONE:
f. ( /
RELATIONSHIP TO PROJECT: j FAX NUMBER:
❑ ARCHITECT o TENANT ❑ OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: ,'.f;1 Jell //) EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ I �'O, ,0 80
`. PROPOSED USE: sPi a PROPOSED VALUATION FOR IMPROVEMENTS: $ efq I D r 0
SPRINKLERED BUILDING? o YES jiKNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0010
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ATACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN 0 HIGHLINE .PRIVATE(SEPTIC) '
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
PROTECT 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 Value of Mechanical Work: $
AIR HANDLING UN1T(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: a ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) a 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,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the dty,induding Its officers and employees,upon the accuracy
of the informations ii to the dty as part o this application.
NAME/TITLE: ,? t DATE: / / ! 6 — 0
❑ PROPERTY OWNER ❑APPLICANT ❑CONTRACTOR
-FOR.OFFICE,USE ONLY• J
7'NEW��g ADDITION ?[I ALTERATIONa REPAIR twat TENANT IMPROV...EMENT
'CENSUS CODES
ZONING'}DESIGNATION.
� 7 .r . (BUILDING SHELL'ONL ? o YES _❑°(Np '
COMP PLANDESIGNATION t.}'- ;BASIC PLAN?'�C7 YES' d`.NO s r
;`SECTION OWNSHIP._ RANGE INEW ADDRESS REQUIRED? , t "a YES N ❑`NO ,
PLATTED LOT -4';'74].YES. a IVO CHANGE:OF USE? `- n YES1:'a"NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P0 BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000 i FAX:253-661-4129
www.citvoffederalway.com
• ■ ELECTaICALr►
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 ft2-$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 fl'-$50.00:Each add'n 2500 ft`-513 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-557.00;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
I i
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or mord -
Altered Service or Feeders
111 Service Feeder Amps Service or Add'n 0 to 200 5 93 00
_tJp to 200 amp $ 93.00 $ 27.50 Feeder _201 -600 216.56
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 is 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 5 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
,,,_���111 Mast or meter repair 43.00 _401 -600 115.50
! eg#of circuits _over 600 125.00
t t-4 circuits-$57.00;Add'n circuits$6 ea) I`
I
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) TOTAL(D)
G
I I
t
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)
-. 1 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