03-105112 City of Federal Way
Community Development Services Electrical Permit #:03 - 105112 - 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: BERNSTON
Project Address: 123 SW 307TH �1,1�' Parcel Number: 556000 1100
Project Description: Upgrading existing service to 200 amp service
Owner Applicant Contractor
Elwood A Bemston MR ELECTRIC OF TACOMA MR ELECTRIC OF TACOMA
123 SW 307TH ST PMB 260 PMB 260
FEDERAL WAY WA 5303 PACIFIC HWY E 5303 PACIFIC HWY E
98023-3978 TACOMA WA 98424 (253)537-5208/74
Electrical Fixtures
Description IQ uantity Description Quantity Description _ Quantity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES May 12,2004.
Permit issued on November 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 accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: See Application Date: I tl i K/OBJ
r• -
A � � ` 2 ,-► off'
RECEIVED BY CONSTRUCTION P MIT APPLICATION
CITY OF COMMUNITY DEVELOPMENT DEPARTMETAPPLICATION NUMBER: Q U Si. L' - o EL.-
Federal Way NOV 14 2003 APPLICATION NUMBER: -
APPLICATION NUMBER: -
*.` l required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
a r��■ PROPERTY INFORMATION
SITE ADDRESS: I Z3 S 1'
Yv O 7 P 2tf ASSESSOR'S TAX/PARCEL#: -56_ 000 - 11 DO
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING o MECHANICAL ❑ DEMOLITION
XELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 2OO() l V LOOJG. .
PROJECT NAME:
• PROJECT INFORMATION
PROPERTY OWNER: NAME DAYTIME PHONE:
� w t4,0& GLV"A-4- '3 w (253 ) Yr? - ►o8S
MAILING ADDRESS(STREET ;CITY,STATE,ZIP):
0-3 S v.! 3o } F"e Ata W itk qgD23
CONTRACTOR: NAME: DAYTIME PHONE:
►h..r� E=1 Leh:\L cC Ta_c ow.r.,, ( 153 )1sZ - X74
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
�E u / E. pm$ �o;c n& 411TsLiaLl ( ) -
C1TY OF FEDERAL WAY BUSINESS LICENEE`FIUMBER: FAX NUMBER:
Leo 2 - I 2Q Z �a - (2a1L.(25? ) 27LI - 9 f
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) M12E (_ E -r i4 g 6J / / 0
APPLICANT: NAME: DAYTIME PHONE:
Sti1tiL ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
o ARCHITECT o TENANT o OTHER(DESCRIBE): ( ) -
EMAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT KCONTRACTOR
• PROJECT INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINIQERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES ❑ NO •
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
**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: ❑ ELECTRIC ❑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(including 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 claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supplied to -city as a part of this application.
NAME/TITLE: %4 L) �N-C/l I�'`l�
` ( / �J y DATE: /1(LT/113
❑ PROPERTY OWNER ,APPLICANT CO CTOR
FOR OFFICE USE ONLY:
❑NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? o YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? o YES o NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? o YES o NO
PLATTED LOT? o YES a NO CHANGE OF USE? ❑YES ❑ NO
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $57.00 _#of Thermostats(First-$43.00;add'n-$l 3.00ea)
(First 1300 R2-$85.50;Each add'n 500 ft-$27.50) _Service and feeder $93.00 #of Low voltage fire or burglar alarms
Square Feet: First 250011?-$50.00;Each add'n 2500 ft-$13.00
_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-$57.00;Add'n service/ -#of Signs(First sign-$43.00;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 more) Altered Service or Feeders
Service Feeder Amps Service or Add'n _0 to 200 $ 93.00
-Up to 200 amp $ 93.00 $ 27.50 Feeder _201-600 216.50
_201-400 amp 115.50 57.00 _0 to 100 $ 93.00 $ 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 ea)
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 metea�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 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+$72.50.Add=1 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):
Tow 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)
• OTHER FEES
Mitigation Fee:(18) (20) (22)
SBCC Surcharge:(19) (21) (23)
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Total (Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)= (24)