04-103176 I . . e ,.
µ t
City onity Development Services eeWan
CommunityElectrical Permit #:04 - 103176 - 0 EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax 253.661.4129 Inspection request line: 253 5.3050•
Project Name: HANNA
Project Address: 1023 S 296TH Parcel Number: 5151 0380
Project Description: Addition of(4)circuits for kitchen remodel
Owner Applicant Contractor .
Kristen E Johansen KRISTEN HANNA EN HANNA
1023 S 296TH PL 1023 S 296TH PL S 296TH PL
FEDERAL WAY WA FEDERAL WAY WA DERAL WAY
98003-3730 (206)391-
t1451113
Electrical res
Description Quantity _ scription Quantity ription _ Quantity
Circuits-Residential 4
'E' I EXP I' ebr 6, 05.
Permit issue 4 • t 10, 04
I hereby certify that the ., - is c, ect and that the cons• N.
.n on th above described property and
the occupancy and the us- ' 1 be ance with the laws,rules and regulations of the State of Washington and
the City of Fe. .I Way. Q/
O r agent: �� ._if Date: D (010 ,
"THIS-CARD IS TO REMAIN ON-SITE - • '
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103176-00-EL
Owner: KRISTEN E JOHANSEN
Address: 1023 S 296TH FL
FEDERAL WAY, WA 98003-3730
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 CARR
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) p Ditch cov?r(4030) ❑ Pool Bonding(4195) �— '
Approved to place concrete Approved Approved
By Date By Date By Date
1
❑ Temporary Power(4275) ❑ Service(4235) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date ByDate By Date
i - Rough Electrical(422 ,) , Tr Ceiling Cover(4020) I Final-Electrical (:055) - I
Approved Approved . y Appan ed
By G Date 4j By - . Date 1 `By ,111 Date 'i ,'::=�
❑ Under-slab groartdworr.(4295)
Approved
By ..iDate
T
•
City of Federal Way Electrical Permit #: 04 - 103176 - 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: HANNA
Project Address: 1023 S 296TH f I Parcel Number: 515160 0380
Project Description: 200amp panel upgrade
Owner Applicant Contractor
Kristen E Johansen KRISTEN HANNA KRISTEN HANNA
1023 S 296TH PL 1023 S 296TH PL 1023 S 296TH PL
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003-3730 (206)391-7769
Electrical Fixtures
Description Quantity L Description Quantity Description _Quantity
[Alt.Serv./Feeder_0 to 200 amps-Res. 1
PERMIT EXPIRES February 6,2005.
Permit issued on August 10,2004
I hereby certify that the above information is correct and that tie 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:_/6/5 G
Agr
• A
City of Federal Way
Community Development Services Electrical Permit #:04 - 103176 - 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: HANNA
Project Address: 1023 S 296TH Parcel Number: 515160 0380
Project Description: Addition of(4)circuits for kitchen remodel
Owner Applicant Contractor
Kristen E Johansen KRISTEN HANNA KRISTEN HANNA
1023 S 296TH PL 1023 S 296TH PL 1023 S 296TH PL
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003-3730 (206)391-7769
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits-Residential 4
PERMIT EXPIRES February 6,2005.
Permit issued on August 10,2004
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: t� G Date: 0 D?(
THIS CARD IS TO REMAIN ON-SITE ,
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103176-00-EL
Owner: KRISTEN E JOHANSEN
Address: 1023 S 296TH PL
FEDERAL WAY, WA 98003-3730
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 inspectioos or the inspection sequence. On-going inspections
are logged on the back of this card.
•
ElSlab/Concrete Floor(4255) .
❑ Ditch cover(4030) ❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
t By Date By Date By Date
,❑ Temporary Power(4275) #rigt Service(4235) (ETI Feeders/Sub-panels (4045)
Anpioved Approved Approved
By DateB Date By . Date
EF Rough Electrical (4225) ❑ Ceiling Cover(4020) Z4 Final.-Elecxrkal.(4055)
Approved Approved 1 Aoprcvcd
By Date _ ,_o, By Date _i By v. Date Cl.
1. ......=::[
❑ Under-slab groundwork(42 5)
Approved
By Date
s
CI[Y OF I v -- ..P� _ice
Federal Way
COMMUMIYDEVELOPMENTSERVICES PERMIT SF MF CO M.•L DE EN FP
33530 FIRST WAY SOUTH•PO BOX 9718
. 25E3-DERAL 661-4Ws FAX 298063-9718 6 4129 APPLICATION in)
/ /
1
www.dttrolkderulwatl.eom
The ollowin• is re•uired in ormation-an inco •fete a•.lication will not be acce•ted. Please •tint le•ibi (in ink)or • .
• PROPERTY INFORMATION
SITE ADDRESS 10 23 5 • Zig ti-- ST
1111 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desuiptimi
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
❑ DEMOLITION}ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
DEMOLITIONS
_
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
.�/e�� )r e pet-rte. ,s r cam.Y p Lc-� (� ? L l ti at_o. �ef r` C ----
PROJECT NAME(Name of Business or Owner Last Name)
PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER ir 4,,� a ,crt` 111', ...... (200 ) 39 ( - 7,4.7
MAILING ADDRESS CITY STATE,ZIP
' 102s 5 02(36- PP- 1.-"-. -,v 60 3
CONTRACTOR COMPANY NAME APPLICANT NAME t
f OFFICE PHONE
)
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - B L I / ( )
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
f .�' r j
MAILING ADDRESS )
CITY,STATE,ZIP CELL PHONE
(1Ov)34t ,,
RELATIONSHIP TO PROJECT FAX NUMBER
1 0 Architect o Tenant Cent o Other(Describe) ( ) -
I CONTACT NAME PRIMARY PHONE
E-MAIL ADDRESS
- )G-% kr/ 22
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000 /1 ,t
MAILING ADDRESS CITY,STATE,ZIP
DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING S . FT. PROPOSED sq. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL=STING AND PROPOSED
"`NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
_Indicate number of each type offixture 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
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
t. LAVS(Bathroom 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 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 t e-1 r �� J
DATE V Dy
-f, (Signature) (Title)
RELATIONSHIP TO PROJECT 0 caner D Agent ❑ Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
❑NEW o ADDITION 0 ALTERATION n REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES ❑NO i
ZONING DESIGNATION CHANGE OF USE? o YES o NO 1
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES ❑NO
Bulletin#100—March 30,2004 Page 2 of 4 k\I landouts—Revised\Permit Application
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
CI Family Square Feet Service or Feeder Each Add'n
(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) 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)
Kki # 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 ❑ 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
❑ 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
❑ # 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 CI Additional Plan Review $87.00/hour
O Voice Cabling (for modified submittals)
❑ Data Cabling
D
(Per System(s) 1""2500 Et2-$51.00;
Each add'n 2500 ft2-13.50) •Per WAC 296-46-910(5)04i&ii)
Bulletin#100 March 30,2004 Page 3 of 4 k\I landouts-Revised\Pennit Application '