04-103239 ..
City of eveWay
Commuunityity Development Services Electrical Permit #:04 - 103239 - 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: GORBUN
Project Address: 31014 48TH SW Parcel Number: 184080 0015
Project Description: Electrical service for new single family residence. Installation of low-voltage thermostat.
Owner Applicant Contractor
ANATOLIY&TAYA GORBUN ANATOLIY&TAYA GORBUN ANATOLIY&TAYA GORBUN
13115 111TH AVE CT E 13115 111TH AVE CT E 13115 111TH AVE CT E
PUYALLUP WA 98374 PUYALLUP WA 98374 PUYALLUP WA 98374
(206)427-4372
Electrical Fixtures
pQuantity DescriptionKQuantity Description [Quantity)
Description .
Service: -Residential 3192 Thermostat 1
PERMIT EXPIRES February 12,2005.
Permit issued on August 16,2004
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: /
, THIS CARD IS TO REMAIN ON-.SITE "' -
CITY OF i Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103239-00-EL
Ownpr:t ANATOLIY & TAYA GORBUN
Address: 31014 48TH AVE SW
FEDERAL WAY, WA 98023
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) fr.
Ditch cover(4030) ❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date Date . , By Date
0
El Power(4275) o( Service(4235), 0 Feeders/Sub-panels(4045)
Approved Approved Approved
i
By Date B q O1 Date kU By Date J
4 Rough Electrical(4225) • ❑'. Ceiling Cover(4020) 53 Final-Electrica! (4055) 1
Approved Approved Approved
By Dates - $ ate, By Date By 110,i'I�i Date J
I
Under-slat► groundwork(4295) •
Approved
By Date
cry(/'
Federal Qq_ - n 32 3 ?
P
COMMUNITY DEVELOPMENT SERVICES E R M I'E C E I V E D SF MF CO M s PL DE EN FP
33530 FIRST WAY S,WA 9•PO 3-971818 A P P L I C A T I 6
FEDERAL WAY,WA 98063-9718 rD
/
253-6614115.FAX 2536614129 2 Q 0 4
www.thvoffederalwau.com
The ollowin• is re.uired in ormation-an inco •fete a.•Zt TIWEntErili ' ', ed. Please •rint le•
ibi (in ink)or
PROPERTY INF'L''i 4:Xi/oN
SITE ADDRESS % 1614 / t ' / / ut 0 -/,
SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# _- LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal deseipoon)
PROJECT INFORMATION
TYPE OF PERMIT o BUILDING ❑ PLUMBING 0 MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIQN(Provide detailed description of work included on this permit onlykpA ,,, D
`/( 3Nh& . < 'n�'``"I
PROJECT NAME(Name of Business or Owner Last Name)
PEOPLE INFORMATION
PROPERTY NAME
(14)q � i - PRIM� PHONOWNER
�TJ(`.(/C� ����"'f') Z 7 V3 7z._
MAILING IAcRES%�.� h(ie e, CITY,SATE,ZIPC/�� /�
00
CONTRACTOR COMPANY NAME Cr.U APPLICANTICNAME7OFFICE PHONE
r 6.1)I.,
MAILING ADDRES 1 O�'� TE,ZIP J/ CELL PHONE
ke
CITY V� E L IA BUSINESSLICENSENUMBER • r ' EXPIRA ON 06-TE (FAX N BER7� /5er
— — —
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application( / EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
0 Architect ❑ Tenant 0 Agent 0 Other(Describe)
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
LENDERPer 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? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE ❑ 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 EAISTDIG 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(roller) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
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/TITLC- DATE
signature) 111.111F (Title)
RELATIONSHIP TO PROJECT 0 Owner ❑ Agent 0 Contractor 0 Architect 0 Other
FOR OFFICE USE ONLY
❑NEW ❑ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? ❑YES o NO
Bulletin!1100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application
s
ELECTRICAL • -4' ` • ' ' i •
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet ` ? 191 , Service or Feeder Each Add'n
(First 1300 ft2-$87.00;Each ad n 5V 00 ft2 -$28.0 i ❑ 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 0 401-600 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
(1-4 circuits-$58.00;Add'n circuits$6.00/ea) COMMERCIAL/INDUSTRIAL PLAN REVIEW
$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 U Yard Pole meter loops $58.00
O Security Alarm System U Additional Plan Review
$87.00/hour
❑ Voice Cabling (for modified submittals)
O Data Cabling
(Per System(s) ls,2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) •Per WAC 296-06-910(5)(b)(i&ii)
Bulletin#100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Permit Application