05-105071 City of Federal Way Electrical Permit #: 05 - 105071 - 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: 7-11
Project Address: 104 SW 312TH 61 Parcel Number: 072104 9219
Project Description: Alteration to extend 120v circuit in backroom.Original permit expired.
Owner Applicant Contractor
Chek Kwik MADSEN ELECTRIC MADSEN ELECTRIC
PO Box 711 3939 S ORCHARD ST 3939 S ORCHARD ST
TACOMA WA 98466 TACOMA WA 98466
PO Box 711 !Dallas,TX 75221-0711 (253)383-4546
Electrical Fixtures
Description [Quantity Description Quantity jL Description Quantity
Circuits- Commercial 1
PERMIT EXPIRES April 1,2006.
Permit issued on October 3,2005
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 regulations of the State of Washingtc and �'
the City of Federal Way.
Owner or agent: /y Date: /d` •0 s
FINALED
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-105071-00-EL
Owner: CHEK KWIK
Address: 104 SW 312TH ST
FEDERAL WAY, WA 98023-4609
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.
O 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) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) 0 Ceiling Cover(4020) ❑ Fin lectrical(4055)
Approved Approved Approved
By Date By Date . Date 4--4--8c'
❑ Under-slab groundwork(4295)
Approved
By Date
i
te. : ������ 5— � s
Federal Wa D — I r-- v j
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The ollowi • is'..• s
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■ PROPERTY INFORMATION
SITE ADDRESS l0/ $k2 3/�. Jr,
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach Warm.P /a BIW legal deswfptlm!
IN PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL -
0 DEMOLITION la,ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
fr-fit#71 6 iC (I) C k'(C(A <t- .
PROJECT NAME(Name of Business or Owner Last Name)
al PEOPLE INFORIITATION
PROPERTY NAME
OWNER � i/�� ( y� PRIMARY PHONE -
MAILING ADDRESS �+ CITY,STATE,ZIP ( )
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
MR d SW E/e LrieI e—. Tont (3 3) 383 -4/.5-‘i
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
.8135 9•&J eff/ c c �d.._ 43,4 5Fy CIG (; " 10'08' -137 s''
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
4f-L 0-4 _6,33 _ _-B L / / (1b3)S 4a
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with teach application) EXPIRATION DATE
nt4A le, e_- / 1
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
54M As 4Seat,— ( 1
MAILING ADDRESS CITY,STATE,ZIP — CELL PHONE
RELATIONSHIP TO PROJECT ( )
O Architect ❑Tenant ❑Agent 0 Other(Describe) 6/€t,7itid/dQ 4) FAX
NUM )ER -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
•
'Tt. (Ars)Aof -1'Tit s--
LENDER „, d.' ! , ¢'f:),� r a,r:r, I tY.”)��iiY' t'1,
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE [" l .S�C.d10"4..,. PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? O YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN a HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN 0 HIGHLI E 0 PRIVATE(SEPTIC)
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
EXISTING PROPOSED TOTAL ��i{�+a_•xa.�[.'}+
EXISTING
NUMBER OF FLOORS
**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(cemmarda) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Cembol SHOWERS WATER CLOSETS(ram MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bathrooms 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 b any perso including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance of the incl officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. 2
NAME/TITLE .. DATE '' �3
igttatwre) (Title)
RELATIONSHIP ROJECT ❑ Owner 0 Agent ❑ Contractor ❑Architect 0 Other
dt)e)r 0(4)4 .,',4t •:-.t.(e) �'- E:�qd.Qy'V7;7.. is .. �t't
§^;ii/t)it(a', i t�1t: . ....•.•r na:i (� 's ( ;Tt vTr.) 40'
'. h.t,(c .-1'(cI. .e) [0k(s)::ef
10t)6J;+.0 t a 1 B 7 ;re, '1
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
El Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$104.50;Each add'n 500 ft2-$33.50) ❑ 0 to 100 amp $113.50 $69.50
❑ Detached outbuilding or garage ❑ 101-200 amp 141.00 89.00
(Inspected with service) $44.00 ❑ 201-400 amp 264.50 104.00
❑ Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50
(Inspected separately) $69.50 ❑ 601-800 amp 398.56 . 168.50
0 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 530.50 283.00
Service Feeder _
❑ Up to 200 amp $113.50 $33.50 ❑ Over 600 volts surcharge $89.00
❑ 201 -400 amp 141.00 69.50 ❑ Mast or meter repair $96.00
❑ 401 -600 amp 193:00 96.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ 601 -800 amp 247.00 132.00
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ 0 to 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
❑ 0 to 200 amp $87.00
❑ 201 -600 amp 141.00 ai( / #of circuits to be added/altered
❑ over 600 amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$69.50;Add'n circuits$7.00/ea) $89.00 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $52.00 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $69.50
❑ Service and feeder $113.50
TEMPORARY SERVICE
1 MOBILE HOME/RV PARK Residenttal/IKultf-Family $61.00
❑ #of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Ampacity
❑ o-100 amps _ $69.50
❑ I01-200 amps 89.00
❑ 201-400 amps 104.50
❑ 401-600 amps 141.00
❑ over 600 amps 152.50
•
MISCELLANEOUS SERVICE/EQUIPMENT
U #of Thermostats CI #of Signs
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
Cl Fire Alarm System ❑ Yard Pole meter loops $104.50
Cl Security Alarm System ❑ Additional Plan Review $104.50/hour
0 Voice Cabling (for modified submittals)
CI Data Cabling ❑ Automation Fee on all Permits .. $5.00
0
(Per System(s).1' 2500 ft2-$61.00;
Each add'n 2500 ft2 16.00) 'Per WAC 29646910(5/(6)(&ii)
Bulletin#100-January 7,2005 Page 3 of 4 NHandouts\Permit Application