05-104247 444.4
,City of Federal Way Electrical Permit #: 05 - 104247 - 00 - El -
Community Development Services
P.O.Box 9718
' Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax (253)835-2609 Inspection request line: (253) 835-3050
Project Name: FEDERAL WAY RETAIL PAD A-2
Project Address: 27400 PACIFIC S Parcel Number: 332204 9009
Project Description: Install(4)L/V thermostats.
Owner Applicant Contractor
BALDRIDGE-FEDERAL WAY LLC EVERGREEN REFRIGERATION EVERGREEN REFRIGERATION
11825 MANCHESTER RD 727 S KENYON ST 727 S KENYON ST
SAINT LOUIS MO SEATTLE WA 98108 SEATTLE WA 98108
63131-4620 (206)763-1744
Electrical Fixtures
Description Quantity Description Quantity ( Description Quantity
Thermostat 4
PERMIT EXPIRES February 18,2006.
Permit issued on August 22,2005
I hereby certify that the above information is correct and that the construction on the above describeddproperty,and
the occupancy and the use will be in accordance with the laws,rules and atiol of'the State of Washington and
the City of Federal Way.
Owner or agent: Date: 0( 571e-
F
J � �
THIS CARD IS TO REMAIN ON-SITE
CIT(OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104247-00-EL
Owner:
Address: 27400 PACIFIC HWY S
FEDERAL WAY, WA 98003-6999
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.
0 Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
Rough Electrical(4225) ❑ Ceiling Cover(4020) 0 F' -Electrical(4055)
Approved Approved Approved
l
B• �, DateCif By Date CS Date (4-2-- / a�
•
❑ Under-slab groundwork(4295)
Approved
By Date
.
0
see cry- 10130e
• RECEIVED
Fit) £J P /° J �-z
Federal ,% .,_
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COMMUNITY DEVELOPMENT SERVICES /i U6 2 2 En SF MF CO ME 'L DE EN FP
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33530 FIRST WAY SOUTX•PO BOX 9718 /`1ll�]�T TT �„� _ ,
FEDERAL WAY,WA 98063-9718 Y Y L (e''%�- I]�:,' bi WAY TD / /
253www.ci
253-661-4115.FAX 253-6614129 9129 T.
www.rituo((ederalwau.eom CITY OF FEDERAL WAY 1.7
BUILDING DEPT.
The ollowin• is re•uired in ormation-an inco •lete a••Iication will not be acce•ted. Please •,Tint le•ibl in ink or •e.
PROPERTY INFORMATION
� STU ,U)1,(3,-- ' CCSITE ADDRESS.�1y(o c)0.Gt/ c ,-,u.N /y .;a7,P&Q, PacoiGk. ll. y / IT
ASSESSOR'S TAX/PARCEL# s .3 2
2 d Y - 7 0 0 7 LOT SIZE(sf
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
/Attach separate Page for lengthy legal description/
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING MECHANICAL
0 DEMOLITION 0 ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed des ' ti n nf,nnrk included on this permit onlu)
/ r I ,
•
1
PROJECT NAME(Name of Business or Owner Last Name) r2---7 Cr YC&C\ - 'Re±Q i
PEOPLE INFORMATION
PROPERTY NAME ' A
`i L , 1 q-, PRIMARY PHONE
OWNER (2-1,?.. 6- �'LU \`C.r VA u 1 \'3 S -ell- ( ) -
MAILING ADDRESS CITY,STATE,ZIP
` (040 2 `Co y Niki R1vc1 i etC.c)�CL, w�A . Cl 09
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
eve cc v e e..)-N(e t c� cx-t- r�-' 0)`-762, - f kL{
--79:MAILINGS , YNt- \ �� Si- ' CSSTATE,
EXP(RATION V-1°`/1 FFAX NUMBER
CITY OF FEDERAL WAY BUSINESS LI�ENSE NUMBERDATE
.O- 60 -1_ CD L (-1 5 3 B L 12- / 3 1 /O5 (ak)`-IL; - $`i
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME
/� OFFICE PHONE
rp.e.,7 /_.e_c••i� X 'fr.� �y %r i�/17aep (2e ) 7E y -�?C
MAILING ADDRHSrS / COYY,STAT/E,ZIP /�J CELL PHONE
72 7 .S'cTI",riy ye'-7 „cp.,/ 4P /_ 1ef/cya ( ) -
RELATIONSHIP TO PROJECT / FAX NUMBER
0 Architect 0 Tenant 0 Agent a Other(Describe) ( ) -
CONTACT iE PRIMARY PHONE E-MAIL ADDRESS
LENDER _Per RCW 19.27.095: Lender inforation is NAME
required if project value exceeds'$5,000 •
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 20 O Up
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
I
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL=WTTxo TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture 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 COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS _ FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS _ _ FURNACES GAS WATER HEATERS
DUCTS _ GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(rosier) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinka) 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,u••• - •.curacy of the information supplied to the city as a part of
this application. f�
NAME/TITLE DATE —
2`' ��S
(Signature) (Title)
RELATIONS 0 PROJECT ❑ Owner gent 0 Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? a YES ❑NO
PLATTED LOT? a YES ❑NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101-200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201-400 amp 220.50 87.00
❑ Detached outbuilding or garage ❑ 401-600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601-800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) ❑ 801 - 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201 -400 amp 117.50 58.00 ❑ Over 600 volts surcharge $74.00
❑ 401 -600 amp 161.00 80.00 ❑ Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50
Service or Feeders
ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $ 94.50
❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ 0 to 200 amp $ 72.50 0 over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ over 600 amp 177.00 ❑ #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$58.00;Add'n circuits$6.00/ea)
$74.00 plus 35%of Permit Fee
( ❑ Mast or meter repair $43.50 ❑ Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑.Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES
• ❑ Service or feeder only $58.00 TEMPORARY SERVICE
❑ Service and feeder $94.50
Commercial Residential
MOBILE HOME/RV PARK 0 0- 100 $58.00 $51.00
❑ #of service or feeders ❑ 101 -200 74.00 51.00
(First service/feeder-$58.00;each add'n-$37.50)
0 201 -400 87.00 n/a
❑ 401 -600 117.50 n/a
❑ over 600 127.00 n/a
(.� MISCELLANEOUS SERVICE/EQUIPMENT
X / #of Thermostats ❑ #of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $58.00
❑ Security Alarm System 0 Additional Plan Review $87.00/hour
0 Voice Cabling (for modified submittals)
❑ Data Cabling
0
(Per System(s) 1•'2500 ft2-$51.00;
Each add'n 2500 ft2-13.50)•Per WAC 296-46-920(5)(b)(i&ii)
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Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Permit Application
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