03-101277 r ,
City of Federal Way
Community Development Services Electrical Permit#:03 - 101277 - 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: HELLICKSON
Project Address: 29908 3RD St.Ave S Parcel Number: 692860 0420
Project Description: Service upgrade to 200amp plus(2)new circuits
Owner Applicant Contractor
Conn R Hellickson &Teresa W Hellickson MILLER ELECTRIC,INC MILLER ELECTRIC,INC
29908 3RD AVE S PO BOX 66457 PO BOX 66457
FEDERAL WAY WA SEATTLE WA 98166 SEATTLE WA 98166
98003-3619 (206)248-1102
Electrical Fixtures
I .,. f C ni&._`i t * 1& a Qt1atl' t [ sCClptlori U 211 Zi
Alt.Serv./Feeder:0 to 200 amps-Res. 1 Circuits-Residential 2
PERMIT EXPIRES September 29,2003.
Permit issued on April 2,2003
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. .-7
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Owner or agent: i` ./7-4i7/4/- Date: 0
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CONSTRUCTION PERMIT APPLICATION
EDEA APPLICATION"NUMBER:" Q 3 - j OL 2-75- ""Q
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: q 4 08 3.e-1 AqE• S• ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑BUILDING ❑PLUMBING El MECHANICAL ❑DEMOLITION
cgELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION_( i 1Cdetailed deS
�� eRvica C vt)6-. (VPo.R&E
XOD P , PL v 5 (A) J t ) 20 . 12004e
e Ri4rvcN- CtRC 0 tTs
PROJECT NAME: 1A- 6 CIA.)
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
Ctr'N 190 N+ELL.r,a K SO rV (2g3)gy 6 - 5914
MAILING ADDRESS(STREET ADD ;CITY,STATE,ZIPr• g4�f �� �-
2 gi 3 — ta-v E • F • !`. c•J
CONTRACTOR: NAME: DAYTIME PHONE:
MIL LAR t.. C CI ZrVC • (10 )A48 - ilea
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
P• d. 8ox. 66% 7 seer-LE/wA 12160 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE MBER: FAX NUMBER:
t gg t - 444C to s* 3T•6 -UD tL (2o6)244 - 361 t
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card require r M Z L �r R Z 4z g VIAllO
SSP
APPLICANT: NAME: DAYTIME PHONE:
M t isst2 E G.scrR(C i Z A1C. (206)'x(#6 -361 SF
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EEEVENING PHONE:
P.6. Q a x e42.44rj 7 SE AIM 1 AM- crit -
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT ❑TENANT erOTHER(DESCRIBE):CsiarotAeTot (2007.1{1" /10-x
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT �OONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? OYES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:OYES 0 NO
WATER SERVICE PROVIDER: ❑LAKEHAVEN 0 HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑LAKEHAVEN 0 HIGHLINE 0 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 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: 0 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(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 sup ' to the ' as a part of this application.
NAME/TITLE: V V. P. DATE: 03 31 03
❑PROPERTY OWNER 0 APPLICANT PLCONTRACTOR
:FOR OFFICE USE ONLY: ''
❑NEW. ❑'ADDITION v ❑ALTERATION. . ❑REPAIR ❑'TENANT'IMPROVEMENT _
CENSUS CODE. .a..
ZONING DESIGI ATI)I BUILDING SHELLONLY? ❑YES e0 NO
COMP PLAN DESIGNATION _.; , . ;,. BASIC PLAN? . `° DYES ❑NO
SECTION .2 TOWNSHIP,_< . ..°'RANGE NEW ADDRESS REQUIRED? - s,.. :❑YES ">❑'NO "',
PLATTED LOT?. '❑YES; =❑-NO ._ CHANGE OF USE7 .- .4 ❑YES .°❑NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtvoffederalway.com
' • ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $50.00 _#of Thermostats(First-$37.50;add'n-$11.50ea)
(First 1300 ft2-$75.00;Each add'n 500 ft2-$24.00) _Service and feeder $81.00 #of Low voltage fire or burglar alarms
Square Feet: First 2500 ft2-$43.50;Each add'n 2500 ft2-$11.50
_Each outbuilding or garage $31.00 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. $50.00 (First service/feeder-$50.00;Add'n service/ _#of Signs(First sign-$37.50;add'n sign
(Inspected separately) feeder-$32 each) $17.50 each)
_Swimming pool,hot tub,spa $75.00
_Yard Pole meter loops $50.00
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 $ 81.00
Up to 200 amp $ 81.00 $ 24.00 Feeder _201-600 189.00
_201-400 amp 101.00 50.00 _0 to 100 $ 81.00 $ 50.00 _601-1000 284.50
_401-600 amp 138.00 68.50 _101-2Q0 - 101.00 63.50 _over 1000 317.00
_601-800 amp 176.50 94.50 _201-400 189.00 75.00 _#of circuits
_Over 800 amp 252.50 189.00 _401-600 220.50 88.50 (1-5 circuits-$63.50;Add=n circuits,$5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800 284.50 120.50
(When inspected separately from the services.) _801-1000 348.00 145.50 TEMPORARY SERVICE
Service or Feeder _Over 1000 379.00 202.50 Residential/Multi-Family/Commercial/Industrial
i 0 to 200 amp $ 68.50 _Over 600 volts surcharge 63.50 _0-100 $ 50.00
_201-600 amp 101.00 _Mast or meter repair 68.50 _101-200 63.50
_over 600 amp 151.50 _201-400 75.00
_Mast or meter repair 37.50 _401-600 101.00
ZL#of circuits _over 600 109.00
(1-4 circuits-$50.00;Add'n circuits$5 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+$63.50.Add=l plan review for other submissions is$75.00/hr.
FIXTURE DESCRIPTION(A) ' FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C)" TOTAL(D)
4 VICE- LP R DE613 . 0 A IS LIS'•SO
2 i ul BRAt 44 C,RC. 'Sp. a'0 f 4,- * 5b , a>�
•
TOTAL COLUMN(D):. I I 453' . SC
Total Column(D)
Estimated Permit Fee: (12) t5 ' I g •SO
Estimated Permit Fee from ilne 12
Estimated Plan Review Fee: $63.50+( 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)
Total (Pages One&Two): tine(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23 (24)
Bulletin#100-February 19,2002