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City of Federal Way Electrical Permit #:04 - 103511 - 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: THE PAIN CENTER OF WESTERN WASHINGTON
Project Address: 34509 9TH,S UNIT203B Parcel Number:
Project Description: Altering 5 circuits for recepticals and lights.
Owner Applicant Contractor
TODD ENTERPRISES MERIDIAN CENTER ELECTRIC INC MERIDIAN CENTER ELECTRIC INC
PO BOX 999 11109 66TH AVE E 11109 66TH AVE E
MILTON WA 98354 PUYALLUP WA 98373 PUYALLUP WA 98373
(253)848-5595
Electrical Fixtures
Description Quantity L Description "Quantity Description Quantity
rCircuits- Commercial 5 j
L _ 1
PERMIT EXPIRES March 1,2005.
Permit issued on September 2,2004
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 ay.
Owner or agent: ,(,Qr4ift, VDate: 47/24/
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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 #: 04-103511-00-EL
Owner: TODD ENTERPRISES
Address: 34509 9TH AVE S UNIT 203B
FEDERAL WAY, WA 98003
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) ❑ Ditch cover (4030) ❑ 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
❑ Rough Electrical (4225) i❑ Ceiling Cover (4020) , ] Final-Electrical(4055)
Approved Approved Approved
By Date ` By Date By "�\• Date et
❑ Under-slab groundwork(4295)
Approved
By Date
ENT
R L - JJ530 COMMUNITY WAY SWPM•FO RVICESBOX 9718
crrY of FEDERAL WAY,WA 98063-9718
Federal Way PERMIT APPLIGAeToI1pT ?53x61 41/S FAX 253-6614129
unutu6111,T-oder-alumni mm
For Office Use Only, FW File Number: f" 4 11.0F IEDERykLpy ID'
The ollowin• is re•uired in ormation-art incom•rete a••lication will not be acce•ted. Please •rint le•ibl (in ink)or •-.
_ G/+� - q ■ PROPERTY INFORMATION
50
SITE ADDRESS: i4 9 m PNe, 5 SUITE/APT# 20.5
ASSESSOR'S TAX/PARCEL#: - SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (e.g.:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
. _ ■ PROJECT INFORMATION ,
TYPE OF PERMIT(This application): ❑ BUILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION
ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlv):
PROJECT NAME(Name of Business/Owner Last Name):
■ PEOPLE INFORMATION • . •
PROPERTY NAME:
MCI
(� y D PRIMARY PHONE:
OWNER: l C�C-t cl e I1"-C r p Y 1 '� (7— )CAoip -5%
MAILING ADDRESS(STREET ADDRE S;): CITY,STATE,ZIP
iK— 1'1 til r) 'frOY1 UJa qg 35 q
CONTRACTOR: NAME ) COMPANY OFFICE PHONE:
&4 -5595
MAILING
/lADDRESS(STREET ADDRESS;): 'CITY,STATE,ZIP CELL PHONE:
I (
CITYtOF FEDERAL WAY BUUSIINNESS LICENSE N BER: R)Li� i t E RATION DATE: $313 FAX NUMBER:
2 Q- Q-1_ D z 12- / 3 j / 04 (2S3)e)(Ai -OSGt 2Z
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required with each application)M G i_ D L B 3 1 8 s (21 G / Z-� /O S
LENDER: NAME: DAYTIME PHONE:
(If Proposed Value'$5,000)
( )
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME: COMPANY
OFFICE PHONE:
) -
MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ Architect ❑ Tenant 0 Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner 0 Contractor ❑ Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION
•
EXISTING USE: - PROPOSED USE: •
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? 0 YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ 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? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
**NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ FIXTURES
Indicate number of each type of fixture that is 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(commer I) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
_COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toile) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom sink 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 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 asoma part of this application.
NAME/TITLE: ` L(NDATE: C7 I E I (C5Lt
(Signature) (Title)
RELATIONSHIP TO PROJECT: 0 Property Owner 0 Applicant 0 Contractor 0 Architect 0
FOR OFFICE USE ONLY
a NEW a ADDITION a ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? • ❑YES a NO BASIC PLAN? a YES o NO
:ZONING DESIGNATION: CHANGE OF.USE? a YES o:NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES o NO
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'k •. , • ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet:
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) ❑ 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
CI 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
(Inspected separately from service) ❑ 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 6 #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)
❑ Service over 200 amps
❑ Mast or meter repair $43.50 ❑ Medical/Educational/Institutional Facility
$74.00 plus 35%of Permit Fee
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee • -
MOBILE HOMES TEMPORARY SERVICE
❑ Service or feeder only $58.00
❑ Service and feeder $94.50 Commercial Residential
❑ 0- 100 $58.00 $51.00
MOBILE HOME/RV PARK ❑ 101 -200 74.00 51.00
❑ #of service or feeders ❑ 201 -400 87.00 n/a
•
(First service/feeder-$58.00;each add'n-$37.50) ❑ 401 -600 117.50 n/a
❑ 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)
❑ 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
0
(Per System(s): l•'2500 ft2-$51.00;
•
Each add'n 2500 ft2-13.50)'Per WAC 29646-910(SXWXi&ii)
• • .
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