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City of Federal Way Electrical Permit #: 06-100191-00-EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: TERIYAKI BISTRO
Project Address: 27400 PACIFIC HWY S Suite B Parcel ber: 33 109
Project Description: Low-voltage wiring for fire alarm system.
Owner Applicant tract
BALDRIDGE-FEDERAL WAY LLC MARK LAROQUE S k ' 0 •RD SECURI SYST
11825 MANCHESTER RD SOUND GUARD SECURITY SYSTE DGS984BW
ST LOUIS MO 63131-4620 PO BOX 2444 PO B•
OLYMPIA WA 98507 ' A 98507
Additional Pe Information
C4P•
Elect tures
Low Voltage Fire Alarm-Comme�1,150
• DITTO
PER T EXPIRES Sunday, August 6, 2006
Perm Issued on Tuesday, February 7, 2006.
herfly that the abov- formati. f s c rect and that the construction on the above described property and
upancy and the us- r ,e in cor nce with the laws, rules and regulations of the State of Washington
nd the City of Federal Way.
Ow or agent: Date:
....A ilmos..._
♦ THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Recor u
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-100191-00-EL
Owner:
Address: 27400 PACIFIC HWY S Suite B
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.
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
❑ Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date s ,
❑ Rough Electrical(4225) 0 Ceiling Cover(4020) 0 Final::Electrical(4055)
Approved Approved { 'Approved
F
By Date By Date By Date
❑ Under-slab groundwork£4295)
Approved
By. Date a .
,•
Ssu-e- `J/ Ff -
• r� Iu — 1a L LDEENFP 1. 2. ..E
Federal way PERMIT ,
SF MFCOMEE
COMMUNfIYDEVELOPMENT SERVICES
393258TMAVEMIESOLTIIi'POBOX97' AN '� 7 z°APPLICATION
FEDERAL WAY,WA 98063-97]8'.: Im / .-,
259-835-2807'FAX 259-895-2609
www.cltuof(ederalwau.E,TY,
OF FEDERAL WAY
The ollowi is .,', e,41:,40, ,L A -an laco ,fete , , ,Heaton will not be ' - ,ted. Please •rint . lin ink)or -), .
• PROPERTY INFORMATION
SITE ADDRESS L'''") O O 0 0 I ( I /I-✓4;' O t/ ' SUITE/UNIT 11 P
ASSESSOR'S TAX/PARCEL# 3 3 Z z p - 7 d a LOT SIZE(s-)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
Imo,*mr,..1.powfor de i
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 • • I; I G 0 MECHANICAL
❑ DEMOLITION '4 ELECTRICAL 0 ENGINEERINGFIRE PREVENTION SYSTEM
PR DESCRIPTIO r7vicle detailed.de jsccrrtp of wor t�luded on this permit ofa"i(ow \ i)��
rs t 1 -to ry4
T r'i ak I B S o (
PROJECT NAME(Name of Business or Owner Last Name) Vii 6,e Ir�� )A l G� (/ -, �� ) 1)
MI PEOPLE INFORMATION
PROPERTY PRIMARY PHONE
OWNERMSC' Pcici1 c /Z .s -, , �), Z1Y-7,MAILING ADDJSTA
soy 1 )�` L` ve �:W e
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS`LICENSE NUMBER EXPIRATION DATE FAX NUMBER
�� Q-P LQ J -L3-B L /4-- / ,7i / O( ( )
5 Qu. REGL�_/ cYL/parrthhPRAaU
EXPIRATIONDATE/ /
APPLICANT CO ANY OFFI E PHONE
6t)/ I vk;I;el feeUr7f y ZFly4,069„e (��') -lea/JGV^A/DD `� E, CE[S.PHONE �� �rPS�
REIATION31�TO PRQlECT / �� �. J�, �1 FAX NUMBER
0 Architect o Tenant o Agent Other(Describe) 11,19 CAI/ <• ( ) -
CONTACT Ny�/ ( PHOr�_
4 1 4,667i-e )�a� -3cgxn-r-i9=4)
LENDER Per RCW 19.27.095: Lender Information Is NAME Cl
‘1114-1
required(f project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE P 4)f PROPOSED USE /f
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORE $ / ' 4 O
` `
SPRINKLERED BUILDING? ❑YES }2kNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ANO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS tum PROM= TOTAL. TOTY.Q17ef6Q TOTAL SP TOTAL IT
"NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of f xture 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)CommodaD WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS)or'Mb/Shower Combo) SHOWERS WATER CLOSETS fits.s MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bathroom Smka) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certijk under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and jbrther,that I
am authorised by the owner of the above premises to the work for which the permit application is made. I further agree to hold
harmless the City of Federal Way as to any cirri ing costs,expenses, and attorneys'fees incurred in the investigation and defense of
such claim),which may be made by person, the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the relic o city lading and employees,upon the accuracy of the information supplied to the city as a part of
this application. / /)
NAME/TITLE DATE L/y
igeature) (Title)
RELATIONSHIP TO PROJECT 0 Owner o Agent kontractor ❑Architect ❑ Other
FOR OFFICE USE ONLY
o NEW ❑ADDITION - o ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? a YES ❑NO UP/SEPA/SU? o YES o NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100-January 1,2006 Page 2 of 4 k Handouts\Permit Application
lk . • .
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
❑ 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 U 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)
❑ #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- 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW
U. 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
❑ #of Thermostats U #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
re Feet to be served by system(s) /i /57) (Includes additional circuit,if required)
Fire Alarm System ❑ Yard Pole meter loops $58.00
ecurity Alarm System U Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
0
(Per System(s) ) t 2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) *Per WAC 296-46-910(5)(b)(i&ii)
Bulletin#100-August 19,2004 Page 3 of 4 k\Handouts\Permit Application