04-103411 w
City of Federal Way Electrical Permit #:04 - 103411 - 00 - EL
Community Development Services
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: EVERGREEN LODGE
Project Address: 31002 14TH\SI Parcel Number: 082104 9088
Project Description: Adding a circuit to connect steamer
Owner Applicant Contractor
HEALTH CARE REIT INC IDEAL CONSTRUCTION SERVICE-ELECTI IDEAL CONSTRUCTION SERVICE-ELECTI
PO Box 1475 3525 S ALDER 3525 S ALDER
TACOMA WA 98409 TACOMA WA 98409
PO Box 1475 !Toledo,OH 43603-1475 (253)671-2160
Electrical Fixtures
I Description Quantity Description (Quantity Description _Quantity!
Circuits- Commercial 1 1
PERMIT EXPIRES February 22,2005.
Permit issued on August 26,2004
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: O/pllp/d y
FINALED
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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#: 04-103411-00-EL
Owner:
Address: 31002 14TH AVE S
FEDERAL WAY, WA 98003-4712
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.
❑ 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) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
0 Rough Electrical(4225) ❑ Ceiling Cover(4020) CI Final-Electrical(4055)
Approved Approved Approved
By Date By Date ByL Date CI---,s/ , ,
❑ Under-slab groundwork(4295)
Approved
By Date
I
73a-3675
RFCE V D
CITY OF n r�(��1 A
Federal Way AUG 2 l6 /11 PERMIT
COMMUNITY DEVELOPMENT SERVICES SF MF CO DE EN FP
33530FIRSTWAYSOLTH p603vr of ) n'--RA f� y'p 'LI CATI O N
FEDER AL R-07 RA 98063- ❑❑ �t1 _
253-661-4115.FAX 253-661-4129 VU)I�..✓li�'6 ,i TD /r(/-
The ollowin• is re.uired in ormation-an incom•lete a••lication will not be acce•ted. Please •rint ie•ibl in ink or t f•e.
3 /y f� J/�
PROPERTY INFORMATION
SITE ADDRESS t 0 0 Z. I�." Y'4VE v SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(s)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal descnpnon)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
-'fLn.- C
ECT DESCRIPTION (Provide detailed description of work included on this 7ermit onl
ET By c �5L----
PROJECT NAME(Name of Business or Owner Last Name) El/—Y-& -2.5E3J 1-06t::-.
PEOPLE INFORMATION
PROPERTY NAME PRIMARYnPHONE —/
OWNER �b-4. (Z Li' -0),. 6
NWT INCL 1nnRl'S' CI TATE ZIP
CONTRACTOR COMPANY NAME APP ICANT NAME OFFICE PHONE
,,flq't-- 5 Y2 ; c ' -4'(--;.? (53) 67/ - 7-1-.60
MA LING ADDRESS Crl I,a'tun,Lir CELL PHONE
' �� 5 �� '�_14� FAX NUMBER)
�
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
lI- 9'61Z056q - B L [2 /3 ( -/ 2.-x3) -67/- -170
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
I , L )1Ls1Q1L S y /2z /off
APPLICANT COMPAA NAME
'/ APPLICANT NAME OFFICE PHONE
oc-reYL ( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME p S PRIMARY PHONE E-MAIL ADDRESS
Z'En (V3) 671 - 2-? 6 0
LENDER Per RCW 19.27.095:'Lender.information is NAME
required if 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? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) -
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
' THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? 7OTALEIaSCma TOTAL PROPOSED 'ro7MLstuarmQAIDPROPOSED
**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(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATTITUBS(o,Til b/S7,owri comiinl SHOWERS WATER CLOSETS rroiiet) MISC(Describe)
UISIIWASIU RS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bade 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 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 to the investigation and defense of
such claim),which may be made by 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 city,inclu• • its officers and e •loyees,upon the accuracy of the information supplied to the city as a part of
this application.NAME/TITLE ., Al / DATE < ) l7/OL)
(Signature e , (Title)
RELATIONSHIP TO PROJECT e4. ~❑ Aft . ontractor ❑ Architect 0 Other
FOR OFFICE USE ONLY
❑NEW ❑ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT-
BUILDING
MPROVEMENTBUILDING SHELL ONLY? a YES a NO BASIC PLAN? . o YES a NO
ZONING DESIGNATION CHANGE OF USE? p YES ci NO
NEW ADDRESS REQUIRED? a YES a NO UPISEPA/SU? o YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? ci YES a NO
•
Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application
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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-$87.00;Each add'n 500 ft2-$28.00) LI 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101-200 amp 117.50 74.00
(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) ❑ 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
LI 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 �r
LI over 600 amp 177.00 110 I #of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
❑ #of circuits to be added/altered
(1-4 circuits-$58.00;Add'n circuits$6.00/ea) COMMERCIAL/INDUSTRIAL PLAN REVIEW
$74.00 plus 35%of Permit Fee
LI Mast or meter repair $43.50 ❑ Service over 200 amps
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
❑.Service Over 400 amps
$74.00 plus 35%of Permit Fee
MOBILE HOMES
LI 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 LI 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
U over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
LI 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 LI Yard Pole meter loops $58.00
❑ Security Alarm System ❑ Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
CI
(Per System(s) 1.12500 ft2-$51.00;
Each add'n 2500 ft2-13.50) Per WAC 296-46-910(50)(i&ii)
Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Permit Application