04-103996 s
City of Federal Way Electrical Permit #: 04 - 103996 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718 .
Ph:(253)835-7000 Fax:(253)835-2609 i- Inspection request line: (253) 835-305C
Project Name: SHELL
Project Address: 28806 PACIFICSH i4J Parcel Number: 042104 9088
Project Description: Altering(5)circuits for fuel equipment changeout
Owner Applicant Contractor
SHELL GAS STATION ALLIED ELECTRIC SERVICES INC ALLIED ELECTRIC SERVICES INC
SHELL GAS STATION PO BOX 3855 PO BOX 3855
28806 PACIFIC HWY S LACEY WA 98509 LACEY WA 98509
FEDERAL WAY WA 98023 \ (360)459-0575
Electrical Fixtures
I Description Quantity Description IQuantity L _ Description Quantity
Circuits- Commercial 5
1
PERMIT EXPIRES March 29,2005.
Permit issued on September 30,2004
I hereby certify that the above informationis 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 W .
Z
Owner or agent: Date: 3a - c9
/
E0
y
ot‘ls400-7.0
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10
**NEW RESIDENTIAL CONSTRUCTION ONLY** �
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLERS) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WdODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGES) ' MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC o GAS ,
PLUMBING
BATHTUBS) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAIER(S) o ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ 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 daim),which may be made by any person,induding the undersigned,and filed against the aty of
Federal Way,but only where such claim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: ,/��/(`r '..40:.zai� DATE: ���jf
a PROPERTY OWNER o APPLICANT )tONTRACTOR
» R O CE SE NLY;
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COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtvoffederalway.com
G REC \JED CONSTRUCTION PERMIT APPLICATION
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3 0 2004 c > i :: : :::�:;;.:::-.:: #.:..
SEP
{{;;�T pF FERAL WAY
**'lTie DEinformation—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
� .�
• PROPERTY INFORMATION
SITE ADDRESS: c J@G� /Op,4 ,ae y ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
,KELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(PTvide detailed description):
..&4 -4-ieas, ��✓ e-"T" 447. 4,74
PROJECT NAME: Ske..4 -
• PEOPLE INFORMATION
?ROPERTY OWNER: NAME: DAYTIME PHONE:
( )
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
,2226-.),:?c,-,, x, S r�zO li�Qv 4.d4
CONTRACTOR: NAME: ✓ ✓ DAYTIME PHONE:
-4LYco S-,Qr!/c.E" /, (3 ) isfr -as-7s-
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
iv4, G�k .C.QI'ey //Af' ( )
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER:
(d3o) s�
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) �1 . � / E GC S Z, S �' 0/ 1
APPLICANT: NAME: DAYTIME PHONE:
( )
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT ❑TENANT ❑OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑PROPERTY OWNER ❑APPLICANT ,'CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS, $
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE 0 PRIVATE(SEPTIC)
THIS CARD IS TO REMAIN ON-SITE k
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103996-00-EL
Owner: SHELL GAS STATION
Address: 28806 PACIFIC HWY S
FEDERAL WAY, WA 98003-3802
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) ❑ Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete. Approved Approved
By Date By Date By Date
0❑ Temporary Power(4275) 10 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
[ .
0 Rough Electrical(4225) ❑ Ceiling Cover(4020) 07 Final-Electrical(4055)
Approved Approved Approved
By Date By Date # By/< Date/0 / —`<1
❑ Under-slab groundwork(4295)
Approved
1 By Date
■ ELECTRICAL
TABLE B
r----4..
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $50.00 _#of Thermostats(First-$37.50;add'n-$11.50ea)
(First 1300 i12-$75.00;Each add'n 500 ft2-$24.00) _Service and feeder $81.00 _#of Low voltage fire or burglar alarms
Square Feet First 25001t2-$43.50;Each add'n 2500 ft2-511.50
_Each outbuilding or garage ... $31.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _#of service or feeders *Per WAC 296-46-910(5)(bXi&ii)
_Each outbuilding or garage $50.00 (First service/feeder.$50.00;Add'n service/ _#of Signs(First sign-$37.50;add'n sign
(Inspected separately) feeder-$32 each) $17.50 each)
_Swimming pool,hot tub,spa $75.00
_Yard Pole meter loops $50.00
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or more) Altered Service or Feeders
Service Feeder Amps Service or Add'n _0 to 200. S 81.00
_Up to 200 amp $ 81.00 $ 24.00 Feeder _201-600 189.00
_201-400 amp 101.00 50.00 _0 to 100 $ 81.00 $ 50.00 _601-1000 284.50
_401-600 amp 138.00 68.50 _101-200......._........_...... 101.00 63.50over 1000 317.00
_601-800 amp 176.50 94.50 201-400.._ 189.00 75.00 6-e#of circuits
_Over 800 amp 252.50 189.00 _401-600 ............_......220.50 88.50 (1-5 circuits-$63.50;Add'n circuits,$5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800.._ 284.50..........120.50
(When inspected separately from the services.) _801-1000 348.00 145.50 TEMPORARY SERVICE
Service or Feeder _Over 1000 379.00 202.50 Residential/Multi-Family/Commercial/Industrial
_0 to 200 amp $ 68.50 _Over 600 volts surcharge...:....._..........._63.50 _0-100... .._. ...... $ 50.00
_201-600 amp 101.00 _Mast or meter repair ... 68.50 _101-200 ......63.50
_over 600 amp ...151.50 _201-400 75.00
_Mast or meter repair 37.50 _401-600......__..„„_ -___101.00
_#of circuits _over 600 ................109.00
(1-4 circuits-S50.00;Add'n circuits$5 ea)
If a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps,a plan review is required.Fee is 35%of
permit fee+$63.50.Add'I plan review for other submissions is$75.00/hr.
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Total Column(0)
Estimated Permit Fee: (12) ‘.17,-0
Estimated Permit Fee from line 12 .
Estimated Plan Review Fee: $63.50+( X.35)=(13)
■ DEMOLITION
Estimated Permit Fee: (14)
Bond Amount(15)
• ENGINEERING
Estimated Permit Fee:(16)
Bond Amount: (17)
• OTHER FEES
Mitigation Fee:(18) (20) (22)
SBCC Surcharge:(19) (21) (23)
Total (Pages One&Two): Une(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)= (241
Bulletin#100-February 19,2002