03-105169 tCtty of Federal Way
Community Development Services Electrical Permit #:03 - 105169 - 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: SOUND CHIROPRACTIC CENTER
Project Address: 1717 S 324THNSuiteB Parcel Number: 250120 0080
Project Description: Install low-voltage burglar alarm
Owner Applicant Contractor
SOUND CHIROPRACTIC CENTER BRINKS HOME SECURITY INC BRINKS HOME SECURITY INC
2007 152ND AVE NE 19115 WEST VALLEY HWY SUITE H-106 19115 WEST VALLEY HWY SUITE H-106
REDMOND,WA KENT WA 98032 KENT WA 98032
98052 (425)251-9727
PERMIT EXPIRES May 17,2004.
Permit issued on November 19,2003
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 t td
the City of Federal Way. c �1
Owner or agent Sete Annl�c�tin>r. Dater NOV 1 9 2003
CITY OF FEDERAL WAY
BUILDING DEPT.
j �•. t±. r 11 - c) P . a
C- 14, ,b
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—¢ RECEIVED BY CONSTRUCTION PERMIT APPLICATION
COMMUNITY nEVEI.OP "En T r17PeR nArRIT Q c (2� -Da
CITY OF APPLICATION NUMBER: -
Federal ay Nov 1 8 2003 APPLICATION NUMBER: -
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: 1717 S 324TH STREET#B ASSESSOR'S TAX/PARCEL
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING o PLUMBING o MECHANICAL ❑ DEMOLITION
XX ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): INTRUSION ALARM
PROJECT NAME:
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
SOUND CHIROPRACTIC CENTER ( 253 ) 838-6909
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
1717 S 324TH ST#B,FEDERAL WAY,WA 98023
CONTRACTOR: NAME: DAYTIME PHONE:
BRINK'S HOME SECURITY ( 425 ) 251 - 9727
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
19115 W VALLEY HWY#H106, KENT,WA 98032 ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
19-98-105789-00-BL ( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) BRINK HS L48 LE
APPLICANT: NAME: DAYTIME PHONE:
f>Pr v .€_ A 5 C-O t r LA C..T-O2 ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
o ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER o APPLICANT o CONTRACTOR
• PROJECT INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o PRIVATE(SEPTIC)
**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 EVAPORATIVE GAS LOG(S) REFRIG.SYSTEM(S)
UNIT(S) COOLER(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: o ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER VACUUM BREAKER(S) ❑ ELECTRIC o GAS
SYS.
DRINKING SHOWER(S) WASH MACHINE
FOUNTAIN(S) 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 II supplied to the city as a part of this application.
NAME/TITLE: ‘1) Qii a (.. 1727/107,0/7",/// /D/7", DATE:
o PROPERTY OWNER ❑ APPLICANT [CONTRACTOR
FOR OFFICE USE ONLY:
o NEW ❑ ADDITION o ALTERATION ❑ REPAIR ❑TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? o YES o NO
COMP PLAN DESIGNATION BASIC PLAN? o YES o NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? o YES o NO
PLATTED LOT? o YES o NO CHANGE OF USE? 0 YES o NO c
126.00 +{ X$9.00/fixture}= (8)Estimated Permit Fee
• Estimated Permit Fee
X .65 = (9)Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
Sub Total (Page One): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)= (11)
• ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUI'MENT/TEMP SERVICES
Single Family Service or feeder only $57. i #of Theri ostats(First-$43.00;add'n-$13.00ea)
(First 1300 tt2-$85.50:Each add'n 500 ft'--$27.50) _Service and feeder $93. 0 14 of Low oltage tire or burglar alarms
Square Feet: First 2500 .2-$50.00;Each add'n 2500 ft2-$13.00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK 1800 SP T
(Inspected with service) #of service or feeders P- •I AC 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 COMMERCIAUINDUSTRIAL COMMERCIAUINDUSTRIAL
(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 1 15.50 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 (I-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 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
_#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):
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)
• OTHER FEES
Mitigation Fee: (18) (20) (22)