04-103282 •
City unity Development Services eveWay
CommunityElectrical Permit #:04 - 103282 - 00 - EL
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: MACDONALD
Project Address: 510 S 325TH\Unn�itt..19-L Parcel Number: 132151 0760
Project Description: Replacing 100 a3lip panel
Owner Applicant Contractor
Jacy A Dahlstrom &Gary J Dahlstrom A/C ELECTRICAL INC.*CLINT KING* A/C ELECTRICAL INC.*CLINT KING*
510 S 325TH ST#19L PO BOX 44465 PO BOX 44465
FEDERAL WAY WA TACOMA WA 98444 TACOMA WA 98444
98003-6578 (253)820-8612
Electrical Fixtures
Description 1Quantity Description Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Mut 1
PERMIT EXPIRES February 14,2005.
Permit issued on August 18,2004
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: Date: g//g bGc,
•
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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#: 04-103282-00-EL
Owner: JACY A DAHLSTROM
Address: 510 S 325TH ST Unit 19-L
FEDERAL WAY, WA 98003-5807
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
O Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
•
0 Rough Electrical(4225) .
❑ Ceiling Cover(4020) ►'.i Final-Electrical(4055)
Approved Approved Approved
By Date By Date By • .V Date 8 ilk O
❑ Under-slab groundwork(4295)
Approved
By Date
....
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CITYOFC �U� - ,ji
Federal Way °P E R M I T SF MF COM 'L DE EN FP
COMMUNITY DEVELOPMENT SERVICES { Q o
33530 DR A WAY WA8• 6 BOX 9718 1 Q '' ' / (�R'/ 1 —
FEFIRAL WAY,SOUTH 98063-9718 AUG p � PLICATION TD
253-661-4115•FAX 253-661-4129
www.cit4offederalwaU.com
O1TY OF FEDERALWAY
The of is iftied Pah tnco tete Keation will not be acc ted. Please nt le l in or t
SITE ADDRESS 6!C Ifni Oct /7_^ r ,--a2L f"""y S /UNIT# ! 9_X
r�� 0 Q
ASSESSOR'S TAX/PARCEL# 4 S L- LOT SIZE(s.n
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page farlengthy legal description)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑0�PLLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
Rcakr'c / .qn7,• , me/
PROJECT NAME(Name of Business or Owner Last Name) /// E/r_c /lea'C XIV e
PEOPLE INFORMATION
PROPERTY NAME •
PRIMARY PHONE
OWNER iMej e nRe Do,4/o/ s,153 ) 77 -,..34/ 2
MAILING ADDRESS ,�/ CITY,STATE,ZIP
/piV
�41 la , , E leiffiikiit14 978.3 74/
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Neb,,,sel‘fial.?, -/-/I , S3 )6OW I a),
ICITY,STATE,ZIP CELL PHONE
P v 41�5�/er— /4140//)A ltJi2. 9g� 1 ( ) -
C OFF DERAL WAY BUSINESS LICENSE NUMBER / EXPIRATION DATE FAX NUMBER
/ ( ) -
- B L
CONTRACTOR'S REGISTRATION NUMBER loopy of card required with eachapplication) EXPIRATION DATE
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE -
(
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect o Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
/RIEj�41Z - i '3 j- -(r8�1
LENDER Per eR(W 19.27.096: Lender information is NAME
required 4f project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
QOIOt4D OnDI/Inl'ODntrtTO'D r, I ATZDU* L r, TXWITZTtatp r, ODTITATIP/Qaw•In%
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ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW COMMERCIAL/INDUSTRIAL SERVICE
NEW RESIDENTIAL SERVICE
Service or Feeder Each Add'n
U Single Family Square Feet to❑ 0 100 amp $ 94.50 $ 58.00
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) U 1-200 amp 117.509 74.00
LI Detached outbuilding or garage
(Inspected with service) $36.50 U 201-400 amp 220.50 87.00
U Detached outbuilding or garage U 401-600 amp 256.50 103.00
(Inspected separately) $58.00 U 601-800 amp 332.00 140.50
❑ 801 - 1000 amp 405.50 169.50
NEW MULTI-FAMILY(three units or more)
U Over1000 amp 442.00 236.00
Service Feeder
U Up to 200 amp $ 94.50 $ 28.00 U Over600 volts surcharge $74.00
U 201 -400 amp 117.50 58.00 ❑ Mast or meter repair $80.00
U 401 -600 amp 161.00 80.00
❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
U Over 800 amp 294.50 220.50 Service or Feeders
U 0 to 200 amp $ 94.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 220.50
�� Service or Feeder U 601 - 1000 amp 332.00
le to 200 amp $ 72.50 U over 1000 amp 369.50
❑ 201 -600 amp 117.50
U over 600 amp 177.00 U #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
U Mast or meter repair $43.50
U Service over 200 amps
U Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑.Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES
U Service or feeder only $58.00 TEMPORARY SERVICE
U Service and feeder $94.50 Commercial Residential
MOBILE HOME/RV PARK U 0- 100 $58.00 $51.00
U #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
U 401 -600 117.50 n/a
U over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
U #of Thermostats U #of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
U Low Voltage U 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 U Additional Plan Review $87.00/hour
O Voice Cabling (for modified submittals)
❑ Data Cabling
0
(Per System(s) 1•a 2500 ft2-$51.00;
Each add'n 2500 ft2-13.50)'Per WAC 296-46-910(5Xb//i&ri)
1
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
TOTAL sasrmo TOTAL PROroeID TOTAL WOWING AID rsaVOS=
HOW MANY 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.
I N/CAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commmv in WOODSTOVES
BOILERS
FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING MISC(Describe)
BATHTUBS(or Tub/Shower combo) SHOWERS WATER CLOSETS(Toilet)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(9ewroom sinks)
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 I/ DATE RI !U C/
tint) (Title)
RELATIONSHIP TO PROJECT - • er s Agent ❑ Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? ❑YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO