05-104939 r ►
City of Federal Way Electrical Permit #: 05 - 104939 - 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) 835-305C
Project Name: CHIPOTLE MEXICAN GRILL
Project Address: 31827 PACIFIC S SuiteC Parcel Number: 082104 9126
Project Description: Low-voltage wiring for fire alarm system.
Owner Applicant Contractor
HARSCH INVESTMENT PROPERTIES LLC CLOVER CREEK ELECTRIC *GUY ERI CLOVER CREEK ELECTRIC *GUY ERI
HARSCH INVESTMENT PROPERTIES LLC 1413 CENTER ST 1413 CENTER ST
1121 SW SALMON ST TACOMA WA 98409 TACOMA WA 98409
PORTLAND OR 97205 (253)627-6648
Electrical Fixtures
Description Quantity Description Quantity L Description ,Quantity
Low Voltage Fire Alarm-Commercia 1000
PERMIT EXPIRES April 18,2006.
Permit issued on October 20,2005
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 and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: r, Date: `CD/e�
411111
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A._. THIS CARD IS TO REMAIN ON-SITE -
CITYOF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104939-00-EL
Owner: HARSCH INVESTMENT PROPERTIES L
Address: 31827 PACIFIC HWY S Suite C
FEDERAL WAY, WA 98003-5409
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
r Rough Electrical(4225) ❑ Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved Approved
By e_1.4+._el Date to� _z,. By Date B /�� Date,- 3/- ------
❑ Under-slab groundwork(4295)
Approved
By Date
RECEIVEDA_ .
FederalVllay SEP 2 6 2005 PERMIT. , .
0. -` i O , y_22 "
COAPINAnYDEVELONBNFSERVICES
"� I 1 SF MF CO � 'L DE EN FP
asaasaTMAVsnrtrssourrr•rosog( aOF FEDER 11r
IEDERALWAY,WA 9d06J•9 BUILDING D LI CAT I0 N
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The olio • is -- ire. n ormation-an ince •late , ••lication will not be acce•ted. Please •rint le• •1 or j• .
IN PROPERTY INFORMATION
SITE ADDRESS '�' ."E'' , \ 'Ss /�
// SUITE/UNIT# l�
•
ASSESSOR'S TAX/PARCEL# .0 1 A ! I) - .L 2 LOT SIZE(sJ
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
Parofir wwQvr legal deroWdanr
• ■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 P UMBING 0 MECHANICAL -
•
• 0 DEMOLITION
N.+- ECTRICAL 0 ENGINEERING)(FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION vide detailed description of wor •, on this permit only)
.k" + " R _A)-s_,,... :c .alp 4 , :ti . ,"" `
PROJECT NAME(Name of Business or Owner Last Name) C.,ki No J Q t. Sti t J P.Q.
Ni PEOPLE INFORMATION
PROPERTY NAME •
PRIMARY PHONE
OWNERS ' SI.D*; '*` (Z-- S reLl' ) VSs( - I`1 S S
MAILING ADD CITY,STATE,ZIP
41.Alt,
CONTRACTOR COMPANY NAME
APPLICANT NAME OFFICE PHONE
e,\c c ) f2 ( i7- e
MAILING ADDRESS CITY,STATE,rAP CELL PHONE
CITU GIPPED wAf IiUSUrESS LIcNNSE NUMBER _
EXPIRATION DATE = FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER(copy et card rgalred with(rack applicatley EXPIRATION DATE
C t_. Q U.0 2.-0.-5 LA. 91-3C) /tea
APPLICANT COMPANY NAME _ T NAME APPLICANT OFFICE PHONE
- .
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
a Architect a Tenant a Agent a Other(Describe) ( ) -
CONTACT NAMEPRIMARY PHONE E-MAIL ADDRESS
CQ Lc---.:-., C- 2531G2--/ - (' . . yc.,c. p U2 At.t.,kr`
LENDER ,: i , #,4,,,,,,i-o....1,,,,• �B A!J/�
e . ri f t"1
MAILING ADDRESS . .
art STATE,ZIP ,
• • • • ■ DETAILED BUILDING INFORMATION
EXISTING USE _ . PROPOSED USE
CD
•EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ ,'2 'd ..J -----' -
SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE o TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN o HIGHLINE a PRIVATE ISEPTT(SI
•
•
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
CUSTOM PlOPO8!D TOTAL ,{ .'o_r. v,,•. O [}* :4 tf{'
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 Ic mm.ci,q WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)..
t.,
•COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS OAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/ShowvGmbo, SHOWERS WATER CLOSETS(macs MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVE patlueomawo) 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 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
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.
NAME/TITLE DATE
1Bn uKl
(Mk)
RELATIONSHIP TO PROJECT a Agent a Contractor a Architect 0 Other
Ev(r)4rfe)
• ;(ia.1.. ... . ........................... :) I;�i:tf�." i5. TO)
J
�. , ('`�(el �'� '�° ilFk!r' bair `;��l; ri 41-6Cz'
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Bulletin#100—January 7,2005 Page 2 of 4 laHandouts\Pamit Application
r
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE HEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 tt2-$104.50;Each add'500 R2-$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 398.50•_ . 168.50
O 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 0 Mast or meter repair $96.00
❑ 401 -600 amp 193,00 96.00 ALTERED COMMERCIAL/INDUSTRIAL
0 601 -800 amp 247.00 132.00 -
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ Oto 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50
❑ 601 - 1000 amp 398.50
Service or Feeder
0 over 1000 amp 443.50
❑ 0 to 200 amp $87.00
•
❑ 201-600 amp 141.00 ❑ #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
0 Mast or meter repair $52.00 - 0 Medical/Educational/Institutional Facility
MOBILE HOMES
r : 0 Service or feeder only $69.50
❑•Service and feeder $113.50
TEMPORARY SERVICE
• MOBILE HOME/RV PARK Resfdenttai/Muiti Fanef(r/ $61.00
O #of service or feeders
(First aervlce/feeder-$69.50;each add'n-$45.00) ConunerciaVlndustrlal Service or Feeder Aenpacity
❑ 0-100 amps ._ $69.50
O 101-200 amps 89.00
❑ 201-400 amps 104.50
❑ 401-600 amps - 141.00
❑ over 600 amps 152.50
•
•
• . MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats CI #of Signs
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00;addh sign$24.50/ea)
Low Voltage �G ❑ Swimming pool/hot tub $87.00
=4";i - Feet to be served by system(s) r
(Includes additional circuit,if required)
L Fire Alarm system 0 Yard Pole meter loops $104.50
• Security Alarm System 0 Additional Plan Review
$104.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling li Automation Fee on all Permits 1110
(Per System(s).let 2500 ft2-$61.00;
Each addh 2500 ft2-16.00)'Per WAC 296-16910(5)(01&NI
i Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Pertnit Application