05-100641 City of !ederl way Electrical Permit #: 05 - 100641 - 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) 835-305C
Project Name: PACIFIC DENTAL CLINIC
Project Address: 33505 PACIFIC S SuiteA Parcel Number: 926503 0010
Project Description: Remove and reset 2X4 recessed ceiling lights.
Owner Applicant Contractor
Du S Jung SAM'S ELECTRIC SAM'S ELECTRIC
33501 PACIFIC HWY S 15110 85TH AVE NE 15110 85TH AVE NE
FEDERAL WAY WA KENMORE WA 98028 KENMORE WA 98028
98003-6809 •
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits- Commercial 3
PERMIT EXPIRES August 10,2005.
Permit issued on February 11,2005
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, les and regulations of the State of Washington and
the City of Federal Wa
Owner or agent: �/��i - Date: 1 i j QT
FINALED
Ot.)‹
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City of Federal Way Electrical Permit #: 05 - 100641 - 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) 835-305C
Project Name: PACIFIC DENTAL CLINIC s
Project Address: 33505 PACIFIC S SuiteA Parcel Number: 926503 0010
Project Description: Remove and reset 2X4 recessed ceiling lights.For SUITES AT 33507,3305B,33505A,33501,Pacific Hw)
S.
Owner Applicant Contractor
Du S Jung SAM'S ELECTRICAL CONTRACTING LLC SAM'S ELECTRICAL CONTRACTING LLC
33501 PACIFIC HWY S 15110 85TH AVE NE 15110 85TH AVE NE
FEDERAL WAY WA KENMORE WA 98028 KENMORE WA 98028
98003-6809 (206)931-1402
Electrical Fixtures
Description IQuantityj Description Quantity Description Quantity
Circuits- Commercial I 3
PERMIT EXPIRES August 10,2005.
Permit issuedon February 1t,2005
I hereby certify that the above information is correct and I the construction on the above described property and
the occupancy and the use will be in accordance .® e I. , s,rules and regulations of the State of Washington and
the City of Federal W
Owner or age I ,i,�_ +` 41 Date: 2. '))--5 1 OS•'
\ vg
I'
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THIS CARD IS TO REMAIN ON-SITE
CITY OF ACommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100641-00-EL
Owner: DU S JUNG
Address: 33505 PACIFIC HWY S Suite A
FEDERAL WAY, WA 998003
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.
O 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
0 Rough Electrical(4225) ❑ Ceiling Cover(4020) ISI Final-Electrical(4055)
Approved Approved Approved
By Date `By Date , Date z_/G.,,p
❑ Under-slab groundwork(4295) ��6
Approved
By Date
THIS CARD IS TO REMAIN ON-SITE
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100641-00-EL
Owner: DU S JUNG
Address: 33505 PACIFIC HWY S Suite A
FEDERAL WAY, WA 998003
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) ❑ 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
0 Rough Electrical(4225) CICeiling Cover(4020) gl Final-Electrical(4055) `
Approved Approved Approved
1
By Date By DateBy or} Date / _/\4
❑ Under-slab groundwork(4295)
Approved
By Date
i
ur,tA. RECEIVED QC - J /2 0 ��
• . Federal Way PERMIT
COMMUNllYDEVELDPMEN7 S 1 0 2005 SF MF CO ME 60'L DE EN FP
3332E D R L WA , A7H•63� p p L I C AT I O N
FEDERAL WAY,WA 98063-9718 - TO
253-835-26o7•PAX2 yo�F FEDERAL A / /
unuwrituo/federd
BUILDING DEPT.
The ollowl • is re• ired in ormation-an inco •fete • ••iication will not be acce•ted. Please •rint le•ibl in in or .
III PROPERTY INFORMATION
SITE ADDRESS Fs-as/4 A 1 '1 c Hu)/ 4 Fed-or, l pat7 a k)/ `/S TTU E/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
)Attach separate page for lengthy legal description)
a PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 14LECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detaile description of work included on this permit only)
��o�P l Yp S re(ocS c€\\ C,N0
PROJECT NAME(Name of Business or Owner Last Name) f( -1.C T-p y,�-� e I j 'A I l"
N PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER /AI N � WS <1 �.��M )
MAILING ADDRESS U CITY,STATE,ZIP
^-,a_ as 4L OV 49SOV► --Q 0 c c 6 o & _
CONTRACTOR COMPANY NAME APPLICANT} NAME Gut OFFICE PHONEL, /yQf
M ADDRESS ltt4
�Vc 11:[in V `TY,STATE,ZIP ELL ONE "
Allb
CITY OF FEDE L�US SS litlLICENSE NUMBER EXPIRATION DATE FAX NUMB
ER `to
— — —
B L I / (
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
G i4E15EL*- 73vs ,D. 10 ' b7
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
e.MAILING DDRF S v �1n/N —AGI ( )
CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect 0 Tenant ❑Agent ❑ Other(Describe) (
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER
er 9 09s finder �ornur#ion NAME
jai"•if project* ue exceeds SSS 00
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? a YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES- 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE o TACOMA ❑ PRIVATE(WELL) •
SEWER SERVICE PROVIDER 0 LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC)
- PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL. .
SQ.FT. SQ.FT. SQ.FT.
-BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
. �
NUMBER OF FLOORS cusrDtc PROPOSED TOTAL tori=STUDS SR ,tor•v.pgoeoszva, _ ,7oretsr
. ..,.x �= c:
••NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ 'C,
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing factures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(cowmen ial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS�o�rneysn•.<rcomtol SHOWERS WATER CLOSETS(Nile) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
Sinks) VACUUM BREAKERS
LAYS(Bathroom ELECTRIC WATER HEATERS
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,inciudi•g the u " signed,and filed against the City of Federal Way,but only where such claim
arises out of the reliance of the city,including its o ers to s,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE "'� ,L/I /' /`� I DATE ��
,_nature) i (Title)
RELATIONSHIP T. . -OJECT 0 Owner 0 Agent 0 Contractor ❑ Architect 0 Other
�r
ADDITION r p D ALTERATION °. 'a'REPAIR a TENANT IMPROVEMENTa , .
!!'D I G, HELL ONLY?' ::;',.,.4', NO,:; .. ;' • BASIC;PLAN? - a YES , NO a
.;71 ' !ESI NATION * � " CHANGE OF USE? a ',, . ::a YES,. NO .,
' ..,%--RESS` ' •UIRED?a y�a YES NO_,, JP/SEPA/Sj F? . < P �? �r „ 3
.. D ., • YES O DEMO PERIlRIT I21 1[RED? _ O PES O
•
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application
ELECTRICAL PFP_MVIIT INFORMATION
f
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
LiSingle Family Square Feet
Service or Feeder Each Add'n
(First 1300 ft2-$104.50;Each add'n 500(12-$33.50) ❑ 0 to 100 amp $113.50 $69.50
❑ Detached outbuilding or garage ❑ 101-200 amp 141.00 89.00
(Inspected with service) $44.00 ❑ 201-400 amp 264.50 104.00
❑ Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50
(Inspected separately) $69.50 ❑ 601-800 amp 398.50 168.50
❑ 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 530.50 283.00
Service Feeder _
❑ Up to 200 amp $113.50 $33.50 ❑ Over 600 volts surcharge $89.00
❑ 201 -400 amp 141.00 69.50 ❑ Mast or meter repair $96.00
❑ 401 600 amp 193.00 96.00 ALTERED COMMERCIAL/INDUSTRIAL
0 601 -800 amp 247.00 132.00
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ 0 to 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
U 0 to 200 amp $87.00
❑ 201 -600 amp 141.00 ❑ l #of circuits to be added/altered
❑ over 600 amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$69.50;Add'n circuits$7.00/ea) $89.00 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $52.00 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $69.50
❑ Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $61.00
❑ #of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps _ $69.50
❑ 101-200 amps - 89.00
❑ 201-400 amps 104.50
❑ 401-600 amps 141.00
❑ over 600 amps 152.50
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signs
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System U Yard Pole meter loops $104.50
❑ Security Alarm System ❑ Additional Plan Review $104.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
El ❑ Automation Fee on all Permits .. $5.00
(Per System(s) 1•t 2500 ft2-$61.00;
Each add'n 2500 ft2-16.00) •Per WAC 29646-910(5/(bX&dJ
a
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application