01-102788 City on Federal Way Electrical Permit #:01 - 102788 - 00 - EL
Community Development Services
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: GEORGESON
Project Address: 145 S 358TH Si' Parcel Number: 114001 0030
Project Description: ELE-Alteration of up to(4)circuits for a upper and lower floor addition to existing residence.
Owner Applicant Contractor
Gary E&Lorraine Georgeson ZINC SIDING*DON WAHL* Gary E&Lorraine Georgeson
145 S 358TH ST ZINC SIDING 145 S 358TH ST
FEDERAL WAY WA PO BOX 5272 FEDERAL WAY WA
98003-8616 TACOMA WA 98415 (253)952-4211
Electrical Fixtures
.== Description Quantity Description Quantity Description Quantity
Circuits-Residential 4
PERMIT EXPIRES January 12,2002,IF NO WORK IS STARTED.
Permit issued on
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 Feder. r a .
Owner or agent: ellle Date: Cr) //
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CU.or RES:.. EMITTED CONSTRUCTION PERMIT APPLICATION
N f;,•,:„1 ,i ;i► .L Et uBEPARTME(�j APPLICATION NUMBER: Q I - LO '2.- ?yv - dD -�L
uV FEY V ILtU1tU11
JUL APPLICATION NUMBER: - -
• 2001 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: /({§— Se 3 58a ASSESSOR'S TAX/PARCEL #: .[ L Y U d 1 - L:)._0 3O
LEGAL DESCRIPTION OF SUBJECT,,PROPERTY(A�ACH SEPARATE DESCRIPTION IF LENGTHY): )11gCk 1"V't — aS/ Q4-
l
rY:.._ • PROJECT INFORMATION -. .
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
r-ELECTRICAL LI ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 4dCt '/V Ct 4 y.A QA. �Y all,
s- '((,„ f -6 rec,- 1,, , u ,ya ,c(,„, ,, , e,. .-t.,-,A,t.-fx P,--c,--3,i-e--%,- ,6c...ctveukA4.
i r-1/ �Y WVv- ji3 a_ ✓� n..- 14.-- , igo•A 465-111.-•S e=17"Lx c,l--c c,,4 71-S.
PROJECT NAME: - - 't: "- '\, •
1. .
U PEOPLE INFORMATION
PROPERTY OWN• . NA d DAYTIME PHONE: i
« �t �. - Q a c3),\ (253 ) 2s--d--c-6)-((
MAILING At •ESS(STREET AII n S;CITY • E,ZIP): jrt(
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CONTRACTOR: 11*— _� DA E PHONE:
� � •'' ^� O�/lf� �cee A� r-, ( (V
I ,NG ADDRESS 1•EET ADDRESS'CITY,STATE - EVENING PHONE:
r � - -• " II $ ‘2645-)4
CITY• EDERAL WAY BUSINESS UCENSE NUMBER:— — ) — — FAX NUMBER:
, CONTRACTO-' REGISTRATION NUMBER: _�.,,,E_� EXPIRATION DATE:
(copy of card required) _ ;t_ _ 1i _ _ / /
APPLICANT: NAME: Y. DAYTIME PHONE:
( Zt-3) Zz(Fr- 1(1 '
MAILING ADDRESS(STREET ADORES TTY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: 2', FAX NUMBER:
CI ARCHITECT ❑ TENANT le-OTHER(DESCRIBE): G'er►ti ' 'C'?2— ( ) -
-
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
■ PRO]ECT FLOOR AREAS
FLOOR EXISTING SQ. FT. PROPOSED SQ.FT,' TOTAL
BASEMENT V
i'
/
FIRST /
SECOND 1
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
• -FIXTURES _-
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING U T(S) EVAPORATIVE COOLER(S)
GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) 1 FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) / FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSO,ff(S) FURNACE(S)
DUCT(S) / GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
% PLUMBING
44eCTHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) Cl ELECTRIC 111 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 informatisupplied to the city a a part of this application. �j /
NAME/TITLE:
(______ono ..,
DATE: o 7(6 ( 6
❑ PROPERTY OWNER ❑ APPLIC CONT OR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMI INrrY IFVFLOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX- 253-661-4129
■ E 'CTRICAL .
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $44.25 _N of Thermostats(First-$33.50;add'n-$10.50ea)
(First 1300 ft2-$67.00;Each add'n 500 flr-$21.50) _Service and feeder 572.25 _#of Low voltage fire or burglar alarms
Square Feet: First 2500 I11-$38.75;Each add'n 2500 ft1-$10.50
_Each outhuildingor garage $28.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _#of service or feeders *Per WAC 296-46-910(5)(h)(i cC ii)
_Each outbuildingor garage $44.25 (First service/feeder-$44.25;Add'n service/ #of Signs(First sign-$33.50;add'n sign
(Inspected separately) feeder-$28 each) $16.00 each)
_Progress inspection per 1 hr $33.50
_Swimming pool.hot tub,spa 67.00
_Yard Pole meter loops 44.25
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 $72.25
_Up to 200 amp $72.25 $21.50 Feeder _201-600 169.00
_201-400 amp 89.75 44.25 _0 to 100 $72.25 $44.25 _601-1000 254.50
_401-600 amp 123.25 61.50 _101-200 89.75 56.25 _over 1000 282.75
_601-800 amp 158.00 84.25 _201-400 169.00 67.00 #of circuits
_Over 800 amp 225.25 169.00 _401-600 197.00 78.75 (I-5 circuits-$56.25;Add'n circuits.$5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800 254.50 107.25
(When inspected separately from the services.) _801- 1000 310.75 129.75 Temporary Service
Service or Feeder _Over 1000 339.00 181.00 _0 to 60 $38.75
_0 to 200 amp $61.50 _Over 600 volts surcharge 56.25 _61- 100 44.25
_201-600 amp 89.75 _Mast or meter repair 61.50 _101-200 56.25
_over 600 amp 135.25 _201-400 67.00
Mast or meter repair 33.50 _401-600 89.75
#of circuits _over 600 97.75
(1-4 circuits-$44.25;Add'n circuits$5 ea)
- If service is greater than 200 amp,a plan review is rcq'd.Fee is 35%of permit fee+$56.25.Add'I plan review for other submissions is$67.00/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: $56.25+ 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): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin #100-January 3, 2001 I