12-104240 V •
i •
Electrical
City of Federal Way Permit #: 12-104240-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p Q
Project Name: BELLA DENTAL
Project Address: 34410 16TH AVE S Unit 109 Parcel Number: 250090 0040
Project Description: Add/alter up to 20 circuits for tenant improvements; low voltage wiring for voice&data,
and security alarm.
Owner Applicant Contractor
BELLA DENTAL NW ELECTRIC SERVICES INC NW ELECTRIC SERVICES INC
34410 16TH AVE S SUITE 109 32419 3RD AVE SW NWELEES925DL (3/27/14)
FEDERAL WAY WA 98003 FEDERAL WAY WA 98023 32419 3RD AVE SW
FEDERAL WAY WA 98023
•
Additional Permit Information
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures
Circuits-ConunerciaL 20 Low Voltage-Other(Commercial 1 Low Voltage-Burglar Alarm(Cor
PERMIT EXPIRES Saturday, March 16, 2013
Permit Issued on Monday,September 17, 2012
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
• e City of Federal Way.
Owner or agent Date: ��- /2 / ?�
ft /g/1Z
THIS CARD IS TO ON-SITE •
CITY of .• ,
Federal Way Construction INSPEC In S: (2o g Record
050 rd
PERMIT#: 12-104240-00-EL Address: 34410 16TH AVE S Unit 109
Project: BELLA DENTAL FEDERAL WAY, WA 98003
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.
❑ UFER Ground (4295) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date .By Date . 'By y C Date Pc'_ I— I Z
CIPool Bonding(4195) #0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
ti Feeders/Sub-panels(4045) .0 Rough Electrical(4225) `0 Ceiling Cover(4020)
Approved Approved Approved
By Date Byes Date 10_ �_ IZ B --�S Date [0 �-1
`
0 Final-Electrical(4055)
Approved
By ,iii .) Date N.1 et_\ ex..'
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
.
CITY OF •` • 1,A /0 (V A 10
Fe ' ELECTRICAL
1r
SEP 20\% PERMIT APPLICATION
WA`l
OFF-9 lost electrical permits may beobtainedonline at www.cityoffederalway.com**
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SITE ADDRESS: ' �//71. / t, /‘-el, /4•v6
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
# C ? 5 o a 1, o _ 0v YO
,tea s x I- *P OJ E C WOJ: N _ Citi g
PROJECT NAME /7 j
(Tenant or Homeowner Last Name) /J�//.i ,0&0 t I �
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PROJECT DESCRIPTION 0 Li() i 'ict - e L �O/
Detailed description of work to c-
be included on this permit only
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NAME / PRIMARY PHONE
PROPERTY OWNER 4",,4er_ g, ( ) -
MAILIN 1.DRESS .. E-MAIL
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
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MAILING ADDRESS // it/C-7
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CONTRACTOR CIS STATE ZIP FAX
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WA STATE CONTRACTOR'S LIC SE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME PRIMARY PHONE
APPLICANT t to €4" .--
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MAILING ADDRESS E-MAIL
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CITY STATE ZIP FAX
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NAMEPRIMARY PHONE
PROJECT CONTACT cul v'►t cLf K' (( ( ' ) �� (- -J '
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
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,
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 the city as a part of this application.
SIGNATURE-- ,/ - _ DATE C / '�/ l,.`.
PRill
INT NAME: x), -Q (c"--?\
33325 8th Avenue South•Federal Way♦WA♦98003-6325•253-835-2607♦fax:253-835-2609•www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 1 of 2 k:\Handouts\Electrical Permit Application
RESIDENTIA• C MERCIAL • '
NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL
Total Square Feet 15r Service/Feeder Additional Feeders
(including attached garage):
0 1f30'inp tr:$ 2:5f3 x$ 80.50
FEES: First 1300 ft2 - $122.00; 101-- 200"amp' x$164.00 x`$103.50
Each additional 500 ft2 -$39.00 4463,2i1311 ki4307=90
121 b0
NEW MULTIFAMILY (3 units or more) 401- 600 amp x$358.00 x$143.50
lir
Service/Feeder Additional Feeders 601-',8Q0 amp "x$463:00
0 200 amp x $132.50 x $ 39.00 801- 1000 amp x$565.00 x$236.50
201 -400 amp x $164.00 x $ 80.50
t her 1(X}0 amp ;° ,; x$616.00 x$328.50
401 -600 amp x $224.00 x $111.50
601 -800 amp x $287.00 x $153.50 Over 600 volts surcharge x$103.50
Over 800 amp x $410.50 r,. x $307.00
ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL
Service/Feeder lsr Service/Feeder Additional Feeders
0- 200 amp x.$101.00 O '200p";r: x$132.50 x:$103.50
201 600 amp x $164.00 201- 600 amp` x$307.00 x$121.00
Over 600 amp X. $246.50
601 ,1000.ani ... x$463 00 . ,.. x'$196.00
, ."3c:$5 S":50 x1328:50
Added or Altered Circuits
1-4 circuits$80.50;each additional$8.00 Added or Altered Circuits
1-5 circuits$103.50;each additional$8.00
Mast or meter repair $60.50
Mast or meter repair $111.50
MANUFACTURED HOMES PLAN REVIEW FEES
Service or feeder only x $ 80.50 Plan Review required only for:
Service and feeder x $132.50
• New,or alteration to, service of 1,000 amps or greater
• Medical/Educational/Institutional Facility
$103.50 plus 35%of Permit Fee
(Permit Fee x 35%_ +$103.50=Plan Review Fee)
Plan review for modified submittals $105.50/hour
MISCELLANEOUS SERVICE/EQUIPMENT
LOW VOLTAGE TEMPORARY SERVICE
0 Fire Alarm System 1st Service/Feeder Additional Feeders
' Security Alarm System
jit Voice/Data Cabling r0' 3100
0 Other
Area to be served by system: 4-0 6,-1, 100 amp X $ 80;50 x $"39.00
lir 2,500 ft2-$71.00;each additional 2,500 ft'-$18.50
201-400;stt-tP."- ' r X $121.00" ,::',y ,$ 60.50
#of Thermostats 40"1 O. ls $'e .,e 1 email
First$60.50;each additional$18.50
Over 600.amp: ,, $184.50" Acw'$ 92.00
FEE CALCULATIONS
Yard Pole/meter loops/pedestal x$ 80.50 • Fees are determined by the scope of work as indicated.
Portable Generator (transfer equipment) x$101.00 • A$6.00 Automation Fee will be added to all permits.
Ditch cover/inspection only x$121.00 • For assistance in calculating fees or completing the
application form,contact the Permit Center at
253-835-2607
33325 8'h Avenue South•Federal Way• WA♦98003-6325♦253-835-2607•fax:253-835-2609•www.cityoffederalway.com
Bulletin#160-January 1,201 I Page 2 of 2 k:\Handouts\Electrical Permit Application