04-103892 City of Federal Way Electrical Permit #: 04 - 103892 - 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
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Project Name: JACKSON HEWITT
Project Address: 31811 PACIFICISSuiteB Parcel Number: 082104 9126
Project Description: Installing a new 2 0 amp,3-phase subpanel from existing service,HVAC,receptacles,and light fixtures.
Owner Applicant Contractor
HARSCH INVESTMENT PROPERTIES LLC D RIDDING ELECTRIC D RIDDING ELECTRIC
HARSCH INVESTMENT PROPERTIES LLC 19630 N DANVERS RD 19630 N DANVERS RD
1121 SW SALMON ST LYNNWOOD WA 98036 LYNNWOOD WA 98036
PORTLAND OR 97205 (425)778-1064
Electrical Fixtures
7 Description Quantity Description !Quantity Description Quantity
Service/Feeder: 101-200 amps-Comr 1
PERMIT EXPIRES March 28,2005.
Permit issued on September 29,2004
I hereby certify that the above ' ormation is correct and that the construction on the above described property and
the occupancy and the use ' e in acco;,• ice with the laws,rules and regulations of the State of Washington and
the City of Federal Way.`
Owner or agent: ' Date: ar.z y
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THIS CARD IS TO REMAIN ON-SITE
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CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103892-00-EL ,
Owner: HARSCH INVESTMENT PROPERTIES L
Address: 31811 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.
#
0 Slab/Concrete Floor(4255) 0 Ditch cover(4030) ❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
•
❑ Temporary Power(4275) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
Rough Electrical(4225) ❑ Ceiling Cover(4020) EP 4 Final-Electrical(4055)
Approved Approved Approved
By - ' Date 2j, - . - By_ Date By/ LV1�0 Date . 0
❑ Under-slab groundwork(4295)
Approved
By Date
061 1o33ge
Federal Way PERMIT
SF MF CO M EL P DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8*"AVENUE • 9718
FEDERAL WAY,WA 98063-9718 APPLICATION
To /
253-835-2607•FAX 253-835-2609 /
wtow.dtt o federalwan.com
The following is required information-an incomplete ap•lication will not be acce•ted. Please •rint legibly(in ink)or type.
:• 2 f('• 1.1 PROPERTY INFORMATION
3
SITE ADDRESS 0 PAC Kul sS / IT# 8
ASSESSOR'S TAX/PARCEL# - _ _ LOT'SIZi(
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach uparate page far lengthy legal deuapnon)
- . ■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION K] ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
Zoo A 2 P/l fkll,o.fi✓e TROm 'TA1 ,1 z ci _ "a- / ?eF-4e4 s
if('/r- 7-lLXrAJ2
PROJECT NAME(Name of Business or Owner Last Name) V/I J 9/t /lea eW/T r-
- li PEOPLE INFORMATION
PROPERTY NAME7,k1 ja ��/� PRIMARY PHONE
OWNER j74-4 6S"7/NLr �iv ( ) -
MAILING ADDRESS CITY,STATE,ZIP
P NAME
CONTRACTOR COMPANY APPLICANT NAME OFFICE PHONE
,41,P.. 1Z rop/'j &LEC AAA/6. R,o ofiae ( VZsl -77P -(Q6t�
W tICA
ILIV ADDRESS(7(0J 0 P/1711&' ,499 CITY
1_�N��OC 12 16/4/- (STATE,ZIPCELL PH 1NE -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - - / / ` / `�' _) -7a - /Zs-
CONTRACTORS REGISTRATION NUMBER(copy of card required with each applications EXPIRATION DATE
( -P D ek-0 i5 "? 6r127104
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT • FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( )
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
( ) -
LENDER NAME
�s;�er RCW 19 27 095 Lender information-is
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 a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES a NO
i - WATER SERVICE PROVIDER 0 LAKERAVEN 0 HIGHLINE O TACOMA O PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HTGHLINE a PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
�_ •__�.— - —"��. �— PROPOSED S o.FT. TOTAL
11111111111111
AREA DESCRIPTION EXISTING S FT.
iii1111111111111111=111M II
SECOND
THIRD IIIIIIIIIMIIIIIIIIIIII
FOURTH IIIIIIIIIIIIIIIIIIIIIII
ADDITIONAL FLOORS(DESCRIBE) IIIIIIIIIIIIIIIIIIIIIIIIIII
DECK(COVERED?) 1NNIIIIIMIIIIIIIIIIIImmimm
GARAGE/CARPORTTOTALEXISTING AND PROPOSED
HOW MANY FLOORS?
111111111111111116111111.....1....11
"NEW HOMES ONLY" NUMBER OF BEDROOMS
ESTIMATED SELLING PRICE $
FIXTURES
Indicate
number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
• MECHANICAL
Value of Mechanical Work $_____________
GAS LOGS REFRIG.SYSTEMS
EVAPORATIVE COOLERS WOODSTO ST
_ AIR HANDLING UNITS FANS HOODS(commaroial� ----
----
BOILERS
MISC(Describe)
_ BBQSES
RANGES
FIREPLACEINSERTS GAS WATER HEATERS
COMPRESSORSOPRS FURNACES
GAS PIPE OUTLETS
--- DUCTS
-----
PLUMBING WATER CLOSETS(roilal
MISC(Describe)
BATHTUBS(or rub/snow<:comcol SHOWERS DRINKING FOUNTAINS
SINKS INKING R SUT
DISHWASHERS SUMPS
GAS PIPE OUTLETS URINALS HOSE BIBBS
WASHING MACHINES VACUUM BREAKERS ELECTRIC WATER HEATERS
LAVS :ath+oom Sinks - :. --
_ - -
L _ `_:DISCLAID'!ER/ST -
GNATIIREBLOCK . ,�:
(rcation made. I further agree
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
am authorized by the owner of the above premises to perform the work for which the permit app Ted is
the de Iifurt a and defenseohold of
(includingcosts, expenses, and attorney j
includingthe undersigned,and filed against the City of Federal Way,but only where such claim
harmless the City of Federal Way as to any claim
such claim),which may be ade city,by any • ding
arises out of the reliance,• ' + e i �uding its officers and employees,upon the accuracy of the information supplied to the city as a Part of
this application. / Oe(?` d13.Q
DATE
•
NAME/TITLE '4 �`ti`I
Signaturd qr
t Nip
f RELATIONSHIP TO
ECT ❑ Owner O Agent ••Contractor 0 Architect 0 Other
S
E FOR OFFICE USE ONLY. o TENANT IMPROVEMENT
( ❑ALTERATION a REPAIRog o NO
o NEW o ADDITION BASIC PLAN?
` BUILDING SHELL ONLY? o YES o NO a YES o N0
( CHANGE OF USE? YES a NO
� ZONING DESIGNATION Up�SEPA/SU?
I NEW ADDRESS REQUIRED? a YES a NO REQUIRED? o YES o NO
PLATTED LOT? a YES ❑NO
DEMO PERMIT REQ
• '
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Bulletin M I00—March 30,2004 Page 2 of 4
k\[iandouts—RcviseriTermit Application
ELECTRICAL PERMIT INFORMATION
r
RESIDENTIAL r COMMERCIAL
NEW COMMERCIAL/INDUSTRIAL SERVICE
NEW RESIDENTIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet 00 amp $ 94.50 $ 58.00
i (First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) 0 101❑ 0 to 1 1 20 a amp 117.5094 74.00
❑ Detached outbuilding or garage CI 201 -400 amp 220.50 87.00
(Inspected with service) $36.50
❑ Detached outbuilding or garage 0 401-600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601-800 amp 332.00 140.50
0 801 - 1000 amp 405.50 169.50
NEW MULTI-FAMILY(three units or more)
� 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
O 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50 �� Service or Feeders
U 0 to 200 amp $ 94.50
ALTERED SINGLE MULTI FAMILY 0 201 -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
177.00 0 #of circuits to be added/altered
❑ over 600 amp (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
❑ Service over 200 amps
❑ Mast or meter repair $43.50 0 Medical/Educational/Institutional Facility
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 Residenlia!
❑ #of service or feeders MOBILE HOME/RV PARK ❑ 0- 100 $58.00 $51.00
1 0 101 -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)
❑ Swimming pool/hot tub $87.00
❑ Low Voltage (Includes additional circuit,if required)
Square AlarmaSystem be served by system(s) ❑ Yard Pole meter loops $58.00
❑ Secur
0 Fire Security y Alarm
Alarm System ❑ Additional Plan Review $87.00/hour
F ❑ Voice Cabling (for modified submittals)
❑ Data Cabling
(Per❑ System(s) 1•,2500 ft2-$51.00;
Each add'n 2500 ft2-13.501•Per WAC 296-46-9 I0(5)(10&ii1
Bulletin#100-March 30,2004
Page 3 of 4 k\llandouts-Revised\Pernut Application