04-103967 O. a
City of Federal Way Electrical Permit #: 04 - 103467 - 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: PETERSEN
Project Address: 1403 S 302ND Parcel Number: 025300 0110
Project Description: Install residential service for a new 1767 sqft single-family residence with attached 484 sqft garage.
Owner Applicant Contractor
KENNETH PETERSEN CUSTOM ELECTRICAL SERVICES CUSTOM ELECTRICAL SERVICES
20720 127TH ST E 4726 BROWNS POINT BLVD NE 4726 BROWN'S POINT BLVD NE
SUMNER WA 98390 TACOMA WA 98422 TACOMA WA 98422
(253)952-0480
Electrical Fixtures
Description Quantity L Description Quantity Description Quantity
Service: -Residential 2167
PERMIT EXPIRES March 28,2005.
Permit issued on September 29,2004
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: 4C1-. 4PNADate: LASsiat 2 q 200 14-
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THIS CARD IS TO REMAIN ON-SITE .
CITY OF �` Community Development Irispction Record
Federal ay IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103967-00-EL
Owner: KENNETH PETERSEN
Address: 1403 S 302ND ST
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.
❑ Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
El Temporary Power(4275) ,❑ Service(4235) ❑ Feeders/Sub-panels(4045)
Approved A ov Approved
By Date B... "-:::::, Date/0—ec:_ By Date
0 Rough Electrical(4225) ❑ Ceiling Cover(4020) Final-Electrical(4055)
Approved Approved Approved
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By �� Date \� �� By Date By 'l4 J Date.),(X"' 1 ti1S—
❑ Under-slab groundwork(4295)
Approved
By Date
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Federal Way
PERMIT SF MF
COMMUNIIYDEVELOPMENT SERVICES
CO ME EL PL DE EN FP
.33325 FEDE8T"AVENUEWAYSOUWAT98H•P0130X
063-9718 9718 PLIC mitt el
RAL TD
253-835-2607•FAX 253-835-2609 / /
wwwatuofederalwau.com
CITY OF FEDERAL WAY
DING DFI'T.
The oliowing is -q 11;,; ,;«6 -an ncomplete a:. a on tai not be acce•ted. Please •rint legibly(in ink)or type.
- _ • PRROPERTY INFORMATION
SITE ADDRESS 1403 5
0 t 30 a N 0 ST�1 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# v 2_ 5 3 0 0 - 0 st 10 LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal deso ption)
IN PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 'ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
1i F„w siALv-LE F1( LI D W ELLUA•L&. l 7 67 SQ FT w (TN
400 Sc FT 6-41-446t4
PROJECT NAME(Name of Business or Owner Last Name)
al PEOPLE INFORMATION
PROPERTY NAME ( PRIMARY PHONE
(v1
OWNER IEEETEgs (2.53 )334 - 0cig2
MAILING ADDRESS CITY,STATE,ZIP
20720 IZ ) T E. suh1iJP /2 w 9 $390
CONTRACTOR COMPANY NAME APPLICANT NAMEOFFICE PHONE
cuS1O(t ELEc1Rc 4L
( S&2vtseS .o ,t (�s-I" -Sj ( (253)7S2 - 0et2c)
MAILING ADDRESSPi' CITY,STATE,ZIP CE
LL PHONE
49 zCQ ILS &VIW 'f4C.orn 20(0 34? - 6 I 4'
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - - / / (Z53)(t5Z -0480
B L
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
� t,2 sr o eS 932 K6 5 / 3/ /05
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT • FAX NUMBER
❑ Architect ❑Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT NAME
Jo ( Dg-T s x / (zo(0)RY PHONE34 q- 6 l G9
E-MAIL ADDRESS
'm
LENDER ,°�jer (1W f4':l7 095°��rtder�ii((omrataon is NAME
..4.egutred Xpro ect 'alue,`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? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES O NO
i - WATER SERVICE PROVIDER 0 LAKEHAVEN O HIGHLINE O TACOMA O PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
- __ —.._______ PROJECT FLOOR AREAS
•
•
•
--
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL 2_—
BASEMENT BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EASTD(G MD 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(Comm<mini) WOODSTOVES
' BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(ar Tub/Shower Combo( SHOWERS WATER CLOSETS iroa<q 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/SIGNATIIREBLOCK _ -
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,includi officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE `` A.4,__ __: t.______i_t Ea)
��' "' (Title)
DATE
I RELATIONSHIP TO a' :t ECT 0 Owner 0 Agent o Contractor 0 Architect 0 Other
i
i ,FOR OFFICE USE ONLY -
o NEW` o ADDITION a ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF:USE? o YES o NO
I NEW ADDRESS REQUIRED? ❑YES a NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? o YES o NO
f
i Bulletin#100—March 30,2004 — Page 2 of 4 k\Handouts—Revised\Permit Application
1
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
�] (r_1, r LG � � Service or Feeder Each Add'n
❑ Single Family Square Feet (f/ 0 0 to 100 a $ 94.50 $ 58.00
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) p
❑ Detached outbuilding or garage 0 101 200 amp 117.50 74.00
(Inspected with service) $36.50 0 201 -400 amp 220.50 87.00
❑ Detached outbuilding or garage 51 m
❑ 401 -600 amp 256.50 103.00
(Inspected separately) $58.00 l'-c. ❑ 601-800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more)
5' 0 801 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00
,P-.--......----. 10 amp $ 94.50 $ 28.00 l 2 2.
�`!1 -400 amp 117.50 58.00 v 0 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 0 601 - 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 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
Ii
El Service or feeder only $58.00 TEMPORARY SERVICE
❑ Service and feeder $94.50 Commercial Residential
' MOBILE HOME/RV PARK 0 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) 0 201 -400 87.00 n/a
❑ 401 -600 117.50 n/a
O over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats 0 #of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
U 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 ❑ Additional Plan Review $87.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
I ❑
(Per System(s) 1•,2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) •Per WAC 296-46-910(5/N4'&iil
Bulletin 0100-March 30,2004 Page 3 of 4 k\Handouts-Revised\Permit Application