05-104333 City of Federal Way Electrical Permit#: 05 - 104333 - 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: CHIPOTLE MEXICAN GRILL
Project Address: 31827 PACIFIC S unit C$ Parcel Number: 082104 9126
Project Description: Installing(2)200 AMP Panels.
Owner Applicant Contractor
HARSCH INVESTMENT PROPERTIES LLC EVERGREEN ELECTRICAL SERVICES INC EVERGREEN ELECTRICAL SERVICES INC
HARSCH INVESTMENT PROPERTIES LLC 15103 60TH AVE W 15103 60TH AVE W
1121 SW SALMON ST EDMONDS WA 98026 EDMONDS WA 98026
PORTLAND OR 97205 (425)742-4200
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Service/Feeder: 101-200 amps-Comr, 2
PERMIT EXPIRES February 21,2006.
Permit issued on August 25,2005
b v
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 aws,rules and regulations of the State of Washington and
the City of Federal W'ay.
Owner or agent: •', Date: (f;)4775-��-
4110
•
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104333-00-EL
Owner: HARSCH INVESTMENT PROPERTIES L
Address: 31827 PACIFIC HWY S
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) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) 131 Final-Electrical(4055)
Approved Approved Approved
By Date By Date B1/ Date J ( a5
•
❑ Under-slab groundwork(4295) •
Approved
By Date
C Of .1 ,.."44*S----......, A
c' ipoi4e. mer044) Gvf-4.17
I. Federal Way ARECEIVE — 1 .3 3
COMMUNITY DEVELOPMENT SERVICES PERMIT SF MF CO M: 'L DE EN FP
33325 AVENUESOU771•POBOX 9718 APPLI CATI O NG 2 5 20 �'
FEDERAL WAY,WA 98063-9718 /
253-835-2607•FAX 253-835-2609
'mouw.at ooffederahoay.corn j
CITY OF FEDERAL WAY
The following is required information-an incomplete ap•lication wi1Vii)ep glad. Please •rint legibly(in ink)or type.
MPROPERTY INFORMATION
SITE ADDRESS 3(8 f 1 (1,1-4-6/ • S reirri/ illi( i car SUITE UNIT#
ASSESSOR'S TAX/PARCEL# - _ LOT SIZE(s.9
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desoipaon)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING ❑ MECHANICAL
0 DEMOLITION KELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DCRIPTION(Provide detailed description of work included on this permit onlu)
----17/1S 4 (.2 ) .
.7z.
PROJECT NAME(Name of Business or Owner Last Name) CA 1
?CM Aeit/ti&ilarty tit
U PEOPLE INFORMATION
PROPERTY NA P IMARY PHONE
OWNER /• 7 'o!' TATE, , �C�%1
alletaty
V�v�� (/�/Q� • �/� L�Jy
5�ILING D Ste,
, /_ 0A- l No
CONTRACTOR COMPANY NAME �'��{. ` AJc
NT NAMdLr'
OFFICE PHONE
'ergf� fl i!ed 2r(i. 137y�
AILING AD RESS i, CITY,STATE,ZIP CELL PHONE
4702 l/fl,01 a) . r 167Ck ( s V 1.J -o l'i5
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
�° -O - Qa_ a__ B L /al 3 I l ") , - .Wg
ir
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each applications EXP[RATION DATE
CJR E.60_3_ g'_• _ - ‘_5--Ica 7
APPLICANT COMPANYCNAME �,r ` APPLICANT NAME OFFICE PHONE
MAILING A S VJ\ CITY,STATE,ZIP
CELL PHONE
RELATIONSHIP TO PROJECT - / - FAX NUMBER
❑ Architect ❑ Tenant ❑Agent .ZQ Other(Describe) 0.1:011 i a CI e-3''‘'s-
( ) -
CONTACT NAME �- „ PRIMARY PHONE
��� E-MAIL ADDRESS
(4s,
e Cir--i Nix-- 74f, IlgOO ice. ee5 d uer�'an•re4
LENDER Per RCW 19.27.095: Lender information is NAME 144, / "
required if project value exceeds$5,000 l i.;
MAILING ADDRESS CITY,STATE,ZIP
■- DETAILED BUILDING INFORMATION -
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ • PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 k • • SUPPRESSION SYSTEM PROPOS I •- • • D? 0 YES 0 NO
WATER SERVICE PRO I : • • AKEHAVEN ❑HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVI ; • •OVIDER 0 LAKEHAVEN 0 IIIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS .
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEME`v
FIRST '
SECOND
THIRD Pr
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY" NUMBER OF BEDROOMS_ ES t• TED SELLING PRICE $
Indicate number of each type of fixture to be installed or elocated as part of this .roject. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(comm«riai) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUB (or Tob/sho..«Combo) SHOWERS WATER CLOSETS frou.q MISC : scribe)
DIS. •'ASHERS SINKS DRINKING FOUNTAINS
s•S PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sulks) VACUUM BREAKERS ELECTRIC WATER HEATERS
'- j•_:---:_t '_�DISCLAIMER/SIGNATIIRE 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 /fixers and employees, upon the accuracy of the information supplied to the city as a part of
this application. eh
NAME/TITLE t/1 DATE
(Signature) (Title)
I RELATIONSHIP '• 'ROJECT ❑ Owner o Agent 0 Contractor 0 Architect ❑ Other
I
( FOR OFFICE USE ONLY
a NEW ❑ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? o YES 0 NO
1 ZONING DESIGNATION CHANGE OF USE? a YES a NO
t NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? o YES ❑NO DEMO PERMIT REQUIRED? a YES a NO
1
• 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
Service or Feeder Each./ldd'n
❑ Single Family Square Feet
(First 1300 ft,-$87.00;Each add'n 500 ft,-$28.00) 0 0 to 100 amp $/9 50 $ 58.00
❑ Detached outbuilding or garage (?>)4 101 -200 amp -1 1 �C6.. --7.44)e---63 1 ee
(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) Ci 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 ❑ 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 0 Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fec
MOBILE HOMES
❑ Service or feeder only $58.00 TEMPORARY SERVICE
❑ Service and feeder $94.50
Commercial Residential
MOBILE HOME/RV PARK ❑ 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) ❑ 201 -400 87.00 n/a
❑ 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ ft 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 Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
O Data Cabling
(Per❑ System(s) 1.2500 ft2-$51.00; A t cri rce� lt 5-00
Each add'n 2500 ft2-13.50) .Per WAC 29646-910(5)(b)(i&ii)
Bulletin#100-March 30,2004 l'agc 3 of 4 k\l iandouts-Revised\Pernit Application