06-106484 •
City of Federal Way Electrical Permit #: 06-106484-0(P :
Community Development Services
P.O.Box 9718
y, -
Ph:(253)
Federal 835-26Wa07WA Fax98063(253)9718 835-2609 Inspection Request Line: (253) 835-3050
Project Name: ORIGINAL ROADHOUSE GRILL
Project Address: 31525 20TH AVE S Parcel Number: 092104 9019
Project Description: Install L/V for fire alarm system
Owner Applicant Contractor
VERMONT MANAGEMENT,INC. OTI ELECTRICAL SERVICES OTI ELECTRICAL SERVICES
620 N BRAND BLVD FLOOR 6TH PO BOX 982 OTISEED986K9 05/29/08
GLENDALE CA 91203 MCKENNA WA 98558 PO BOX 982
MCKENNA WA 98558
Additional Permit Information
Electrical Fixtures
Low Voltage Fire Alarm-Comma 7,766
PERMIT EXPIRES Tuesday, June 26, 2007
Permit Issued on Thursday, December,28,2006
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 wi lohfe laws,rules and regulations of the State of Washington
a heCityof Federal Way.
Owner or agent: Date:/ 0 " Cll G
I 4"
1
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THIS CARD IS TO REMAIN ON-SITE
CITY OF. Community Development Inspection Record .
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-106484-00-EL
Owner: VERMONT MANAGEMENT, INC.
Address: 31525 20TH AVE S
FEDERAL WAY, WA 98003-5457
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
f❑ Temporary Power(4275) ❑ Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
Q Rough Electrical(4225) ❑ Ceiling Cover(4020) �� Final-Electrical (4055)
Approved Approved Approved
By Date By Date B- s AkJ._ Dates SI i
„-O Under-slab groundwork(4295)
Approved
By Date
kf
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Q� , 006 D - LO g`i
cin of ! ° r n ( n
Federal Way Grc �'% - PERMIT �'(' �`'
COMMUNITY DEVELOPMENT SERE ��I SF MF CO M PL DE EN FP
33325 ell AVENUE
3 PO 89"
FEDERAL Y `` � A.P P L I C AT I O N TD
2538 607FAX ``v / / .
www.diuoNederalwau. ?Mt'
The following is required information-an incomplete application will not be accepted. Please print legibly(iri ink)or type.
�1• PROPERTY INFORMATION
SITE ADDRESS �) 5 Z JJ Z-01/`,\ S SUITE/UNIT}l
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sj)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) •
(Attach separate page far lengthy legal description)
■ PROJECT INFORMATION .
•
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
.❑ DEMOLITIO ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
lied des '
PROJEUEPTNSCRIProvide tion work on this
j / P permit oniu)
v
PROJECT NAME(Name of Business or Owner Last Name) Cr'( 42_11/4,14'Se .
IP
PEOPLE INFORMATION
PROPERTY NAMEtr AA
1 V
OWNER y,e rpt IL rr
� -- /`PRIMARY PHONE
.— . MAILING ADDRESS £ j V�tt CITY STATE,Z E-MAIL ADDRESS •
CONTRACTOR COMPANY i /� APPLICANT NAME OFFICE PHONE `//� ��
. . MAI /A'�DD (..., �/v,Y���(� .. prry,pis,
ZIPyx (/‘..,
_ ` �} r 5;: , 03 / .'
CITY OF FEDERA WAY SINiESPS LICENSE NUMBER EXPIRATION DATE "FAX NUMBER
( ) . _
COPY er oard ragnirid CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE `E-MAIL ADDRESS .
with a:appiieatioa =j
APPLICANT COM NAME APPLICANT NAME OFFICE PHONE. _
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant 0 Agent ❑ Other ( ) •
-
PROJECT NAME PRIMARY PHONE E-MAIL ADbRESS
CONTACT ( • ) _
LENDER NAME Per RCW 19.27.095: •
Lender in(orma• is required if project value exceeds$5,000
• MAILING ADDR CITY,STATE • PHONE _
•
•
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ .VALU' • PROPOSED WORK $ .
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE.SUPPRESSION SYSTEM PRO•. D/REQUIRED? ❑•.YES 0 NO ,
WATER SERVICE PROVIDER ❑ L HAVEN 0 HIGHLINE 0 TACOMA 0 P• • E(WELL)
SEWER SERVICE PROVIDER 0 L. EHAVEN . a HIGHLINE 0 PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL ,
SQ. FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNC VERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL TOTAL 'TIRO SI TOTAL PROPOSED SI TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDRO. 4 S ES ATED SELLING PRICE $
■ FIXTURES
Indicate number of each type of fixture to be installe' or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $ COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
• AIR HANDLING UNITS EVAPORATIVE COOLERS N GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS ODS(commercial)
COMPRESSORS FURNACES RAN S
DUCTS OAS LOG SETS REFRIG. STEMS
PLUMBING
BATHTUBS Tub/Shower Combo) LAVS(Bathroom sinks) URINALS MISC(Describe)
DISHWA ERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS lroaot)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 authorised 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
4 arises out of the reliance of the city,includi its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE �� -� — DATE ' p'(9 6
(Signature) (Title)
-RELATIONSHIP TO PROJECT ❑ Owner ❑Agent 0 Contractor 0 Architect 0 Othet
•
o NEW o ADDITION o ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? • o YES a NO
ZONING DESIGNATION CHANGE OF USE? ❑YES a NO
NEW ADDRESS REQUIRED?. o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
•
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Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\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-$107.50;Each add'n 500 ft2-$34.50) ❑ 0 to 100 amp $1,17.00 $71.50
❑ Detached outbuilding or garage ❑ 101 -200 amp 145.00 91.50 .
(Inspected with service) $45.50 ❑ 201 -400 amp 272.00 107.50
❑ Detached outbuilding or garage ❑ 401 -600 amp 317.00 127.00
(Inspected separately) $71.50 ❑ 601 -800 amp 410.00 173.50
0 801 - 1000 amp 500.50 209.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp $117.00 $34.50 ❑ Over 600 volts surcharge $91.50
❑ 201 -400 amp 145.00 71.50 ❑ Mast or meter repair $99.00
❑ 401 -600 amp 198.50 99.00 ALTERED COMMERCIAL/INDUSTRIAL
El 601 -800 amp 254.00 136.00
❑ Over 800 amp 364.00 272.00 Service or Feeders
❑ Oto 200 amp $117.00
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 272.00
❑ 601 - 1000 amp 410.00
i Service or Feeder
El over 1000 amp 456.50
❑'Oto200amp $89.50
❑ 201 -600 amp 145.00 ❑ 4 of circuits to be added/altered
i ❑ over 600 amp 218.50 (1-5 circuits-$9I.50;Add'n circuits,$7.00/ea)
❑ 4 of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$71.50;Add'n circuits$7.00/ea) $91.50 plus 35%of Permit Fee
❑ Service- 1,000 amps or.greater
❑ Mast or meter repair $53.50 ❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $71.50
❑ Service and feeder $117.00
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $63.00
❑ 4 of service or feeders
(First service/feeder-$71.50;each add'n-$46.50) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $71.50
❑ 101-200 amps 91.5Q
❑ 201-400 amps 107.50
❑ 401-600 amps 145.00
❑ over 600 amps 157.00
1
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ _#of Signs .
First$53.50;add'n-$16.50/ea) (First sign-$53.50;add'n'sign$25.00/ea) •
Low Voltage ,(� ❑ Swimming pool/hot tub $107.50
'
qu re Feet to be served by system(s) t60 (Includes additionalcircuit,if required)
re Alarm System ❑ Yard Pole meter loops $71.50
Security Alarm System • ❑ Additional Plan Review
El Voice Cabling $107.50/hour
(for modified submittals)
❑ Data Cabling ❑ Automation Fee on all Permits .. $5.00
1.t 2500 02463.00; .
Each add'n 2500 ft2-16:50) •Per WAC 296-46-910(S)(b)(ii&ii)
s
Bulletin#100-January 1,2006 Page 3 of 4 k\Handouts\Permit Application