06-104805 City of Federal Way Electrical Permit #: 06-104805-00-EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: CHECKMATE
Project Address: 28722 PACIFIC HWY S Parcel Number: 332204 9119
Project Description: Make(1)electrical connections to existing signs that was relocated,and make electrical
connections to(2)new pole lights in parking lot.
Owner Applicant Contractor
GABRIEL G POLL FULLER ELECTRIC FULLER ELECTRIC
8915 SE 44TH ST 37107 12TH AVE S FULLEEI027BK 1/12/08
MERCER ISLAND WA FEDERAL WAY WA 98003 37107 12TH AVE S
98040-4113 FEDERAL WAY WA 98003
•
Additional Permit Information
Electrical Fixtures
Circuits- Commercial ... 't Sign ...:... 1
PERMIT EXPIRES Tuesday, rch 20, 2007
Moo' Isrsue on Thursda September 2 2
I hereby certify that the aboveinformation ormatiobt,Woorrect and that the construction on the above described prop rtyand
the occupancy and the use will be in accord., e with the laws, rules and regulations of the State of Washington
the City of Federal Way.
Owner or agent: �� g - ' Date: / Z/
/\e 'k. -C‘jr -C14
, A.
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-104805-00-EL
Owner: GABRIEL G POLL
Address: 28722 PACIFIC HWY S
FEDERAL WAY, WA 98003-3224
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.
13Slab/Concrete Floor(4255) �[� Ditch cover(4030) ❑ Pool Bonding(4195)
Approved to place concrete Approved .Approved
By Date B `ii,;, Date 2 By Date
❑ Temporary Power(4275) .❑ Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
0 Rough Electrical(4225) 0 Ceiling Cover(4020) I Final-Electrical(4055)
Approved Approved ,`\ Approved
•It
By Date By Date By 'V J Date Ci 2$ 6tp
❑ Under-slab groundwork(4295)
Approved
By Date
• miks ARECEIVED
urs SEP 2 1 2006 - v`f SZ =
Federal Wary PERMIT
coxiwwrrnsysLO?M F FEDERAL WAY SF MF CO ME® PL DE EN FP
333451714AL WAY,
Y,WA50Urf1•95063
?OCeILDI NG DEPL-1P P L1 C AT I O N T'
PBOBRAL •
- 453-8354607•PAX 453435.4609
WilltailatIldWWLSEM
The oilowi • is • fired in ormation-an inco -late • - •iication will not be acce• -d. Please ,rint • ,1_ it or _j•
D
I. PROPERTY INFORMATION
SITE ADDRESS .2d ! 2 2-- !a4 Etc i!t✓y 5• 6404/'/ 414`l SUITE/UNIT U .
ASSESSOR'S TAX/PARCEL• 2. -3 2- 2- 0 `4 - / LOT SIZE(If)
•
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) '
Ada&&rawQwfirWON,Meal I •
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING . 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION DESCRIPTION(Provide detailed description of work included on this permit only)
Ai
/' CLICO--
.eec/i
- .c4 / Gorl4ea-1 b /J. 7' e).?ki7.Al ''v ?hit 4141 /ee h c4-
Ace
2. Alta G/cc-/- i 40Av1 epi-,G✓.' 1440 (a-.) .ildld "oh. //C�lr!l /N r a - /i,t, /d t.
PROJECT NAME(Name of Business or Owner Last Name) C G� G241 --•
• PEOPLE INFORMATION
PROPERTYN wl< t
(wMARr)PHONE
OWNER
MAILING ADDRESSCITY,STATE,ZIP
zp7z2-- Pa01ic-1c /417 S. flit-1 / may, wA 98003
CONTRACTOR COMPANY NAME • APPLICANT NAME OFFICE PHONE
Fut/€/1-d/e,L Fl � ` dt .s /'yse,, (243 ) u/ -7/0
MAILING ADDRESS , ATE,ZIP CELL PHONE
/1167 _ P-TAfkgc S. / 1✓47, J,4- 9SUO) (zc4) 9i3 -?Or/
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER TION DATE FAX NUMBER
1. 2_--` 3-./ & 2.. I _B L - /2 1 / d c. (2 53 ) 46 i -4 s�
CONTRACTORS REGISTRATION NUMBER)copy of cart rogairoi with oEoh application) EXPIRATION DATE
f 4( L. i i L 2 2_ LES l IZ 12.008
APPLICANT COMP l7� a t APPLICANT NAME OFFICE PHONE -
MAILINGDRESS �y CITY.STATE,ZIP CELL PHONE
( ) •
RELATIONSHIP TO PROJECT FAX NUMBER
a Architect o:Tenant a Agent 0 Other(Describe) ( )
•
CONTACT ` , : PRIMARY PHONE E-MAILADDRE
7:Pt�rfi' n IA se/j . • (2S3_) G/ -7/V/ Ro llP f‘/1'CA.0-/cc..C.a
LENDER NAME •
MAILI 0 ADDRESS CI Y,STATE,ZIP PHONE
( ) -
NI DETAILED BUILDING INFOP.UTATION'
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $'r VALUE OF PROPOSED WORK $ '
SPRINKLERED BUILDING? 0 YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES O NO _
WATER SERVICE PROVIDER O LAKEHAVEN a HIGHLINE a TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN a HIGHLINE a PRIVATE(SPTIC)
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 EXISTING PROPOSED TOTAL TOTAL EXISTING ST TOTAL PROPOSED SF TOTAL ST
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture ixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS _ EVAPORATIVE •OLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE I •ERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTL: .
PLUMBING
BATHTUBS(or Tub/shower Combo) SHOWE• WATER CLOSE IS Rouen MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUM•' RAINWATER SYST
WASHING MACHINES URIN• HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS 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,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 the city as a part of
this application. Q /
NAME/TITLE D DATE [ '�- O
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner o Agent )ontractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
a NEW o ADDITION ❑ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? a YES ❑NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a'NO
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application
...
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ELECTRICAL PERMIT INFORMATION
RESIDENTIAL • COMMERCIAL
•
FEW RESIDENTIAL SERVICE FEW COMMERCLWINDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$107.50;Each add%500 R2-$34.50) ❑ 0 to 100 amp $117.00 $71.50
❑ Detached outbuilding or garage 0 101.-200 amp 145.00 91.50
(Inspected with service) $45.50
❑ Detached outbuilding or garage 0 201-400 amp 272.00 107.50
(Inspected separately) $71.50 0 401-600 amp 317.00 127.00
0 601-800 amp 410.00 173.50
0 801-1000.amp 500.50 209.50
FEW MULTI-FAMILY(three units or more) 0 Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp $117,00 $34.50 CI Over 600 volts surcharge $91.50
❑ 201-400 amp 145.00 71.50 0 Mast or meter repair $99.00
0 401 -600 amp 198.50 99.00
Q 601-800 amp 254.00 136.00 ALTER COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 364.00 . 272.00 •
Service or Feeders
• ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $117.00
0 201 600 amp 272.00
Service or Feeder ❑ 601-.1000 aim) 410.00
CI to 200 amp $89.50 CI ° 1000P 456.50
0 201-600 amp ' 145.00
#I of circuits to be added/altered
0 over 600 amp 218.50
(1-5 circuits-$91.50;Add%circuit..$7.00/ea)
•
❑ a of circuits to be added/altered COMMERCIAit/INDUSTRLAL PLAN REVIEW
(1-4 circuits-$71.50;Add'n circuits$7.00/ea) $91.50 plus 35%of Permit Fee
❑ Mast or meter air CI Service-1,000 amps or greater
rep $53.50
❑ Medical/Educational/Institutional Facility
MOBILE HOMES •
•
❑ Service or feeder only $71.50
•
0 Service and feeder $117.00
TEMPORARY SERVICE
JI(OBLLE ROME/RV PARK Residentia
❑ I of service or feeders
uiH•lacnti�y $63.00
(First service/feeder-$71.50;each add%-$46.50) ComtnermaMndusMal Service or Feeder Ampacity
❑ 0-100 amps $71.50
❑ 101-200 amps 91.50
❑ 201-400 amps 107.50
0 401-600 amps 145.00
❑ over 600 amps 157.60
.
MISCELLANEOUS SERVICE/EQUIPMENT
CI d of Thermostats
(First-$53.50;addle-$16.50/ea) N of Signs
sign-$53.50;CI Low Voltage -$53.50;add'n sign.$25.00/ea)
Square Feet to be served by systems) ❑ Swimming pool/hot tub $107.50
0 Fire Alarms stem (latitudes additional circuit.if required)
❑
❑ $71.50
Security Alarm System Yard Pole meter loops
•0 Voice Cabling 0 Additional Plan Review $107.50/hour -
Q Data Cabling • (for modified submittals)
❑ ❑ Automation Fee on all Permits .. $5.00
,(
Each 2500 fri 16 50)6' Per WAC?964691