04-103538 .8►—
City of Federal Way
Community Development Services Electrical Permit #:04 - 103538 - 00 - EL
n
33530 1st Way S
Federal Way,WA 98003-6210 2
Ph:253.661 4000 Fax:253.661.4129 Inspection request line: 253.0O 35.3050
Project Name: REYNOLDS-WALSH
Project Address: 30210 23RD,SW Parcel Number: 012103 9005
Project Description: T-Stat wiring
Owner Applicant Contractor
Jean M Walsh AIR SUPPLY SYSTEMS INC AIR SUPPLY SYSTEMS INC
30210 23RD AVE SW P.O.BOX 331 P.O.BOX 331
FEDERAL WAY WA BUCKLEY WA 98321 BUCKLEY WA 98321
98023-2351 (360)829-5384
Electrical Fixtures
Description !Quantify] Description Quantity Description Quantity
Thermostat 1
PERMIT EXPIRES March 2,2005.
Permit issued on September 3,2004
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: CP1 l
,F,1` THIS CARD IS TO REMAIN ON-SITE .> v
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103538-00-EL
Owner: JEAN M WALSH
Address: 30210 23RD AVE SW
FEDERAL WAY, WA 98023-2351
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) 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
.( Rough Electrical(4225) ❑ Ceiling Cover(4020) • Final-Electrical(4055)
Approved Approved Approved
•
`By di'_( ...i Date q 144 By Date By !`t Date ,5Q S (c6
� •
❑ Under-slab groundwork(4295)
Approved
By Date
04
Federal Way �.IVED - - - -
kF PERMIT SF MF CO MEv L DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8n'AVENUE SOUTH•PO BOX 9718
253D8 607•FAX 253 JS-2609FEERAL WAY,WA 989718
SEP o 3 TOA P P LICAT I O N - TD / /
www.atuollederdwau.corn
pERAL-WAY
The following is t , Y A`F, ,;suL *.&-an `,. omplete ap.lication will not be accepted. Please •rint legibly(in ink)or type.
%I PROPERTY INFORMATION
SITE ADDRESS l/ -10 2 , Q, ✓ ) SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# O / Z 1 0 1 - 9 D o Ss LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desoiption)
.1 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 in luded on this permit only)
`ii�cs /-f-
PROJECT NAME(Name of Business or Owner Last Name) iep:(1�lR S "v el I 511\I PEOPLE((INFORMATION
PROPERTY NAME / PRIMARY PHONE
OWNER WE IS fQyl lel v l ( ) -
MAILING ADDRESS l CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME - I OFFICE PHONE
/rir Supply SIS4ery S Inc JVlctrt_ ftia_u_loirn (3!00) 829 -53,Pil
MAILING AD S , ( CITY,STATE,e)lccactC � S'3 CELL PHONE -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
20 -OIL- ( O 2 `?® / -B L f? / - , / o / ( ) -
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
I 4Su s / q7 -7 Sc- 1 / 1 3 / 0 4:'---
APPLICANT XIMPANY NAME APPLICANT NAME OFFICE PHONE
ir S 0 pp[y Sys 1-e-M S VvtcL(k frlcccc f n (3(ro)g'2y -53k
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
06�Arrchitect ❑ Tenant ❑Agent 0 Other(Describe) ( ) -
CONTACT )►ai t k `I f yi G{. �C�l n PkIM( tRY Q H SI QjvIE
- CJ?j 6 E-MAIL ADDRESS
LENDER PerrRCW 19127 095:Lender information is
required ifpraject value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
91 DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED US
EXIT ' I G ASSESSED/APP••I SED VALUE $ VALUE OF • •OPOSED WO• $
SPRIN• ERED BUILDIN : ❑YES 0 NO F l• SUPPRESSION SYS M PROPOSED/REQ I• . •? 0 YES 0 '0
WATER ` RVICE P• • 0 ER 0 LAKEHAVEN 0 RIG I INE ❑ COMA 0 PRIVATE(WELL)
SEWER SE• a • •OVIDER ❑ LAKEHAVEN 0 BIGHL• • 4 PRIVATE(SEPTIC)
•
• . PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST j
1
SECOND 1w
THIRD
1
FOURTH
ADDITIONAL FLOORS(DESCRI:-
DECK(COVERED?)
GARAGE/CARPORT
11Prjr TOTAL PROPOSED TOTAL y7D$TDIG MD PROPOSEDI
HOW MANY FLOORS?
Ai
TIMATED SELLING PRICE $
"NEW HOMES ONLY" NUMBER OF BEDROOMS 1
..FIXTURES
Indicate number of each type offacture to be ' tailed or relocated as part of th oject. Do not include existing fbdures to remain_
MECHANICAL
Value of Mechanical Work $
GAS LOGS REFRIG.SYSTEMS
AIR HANDLING UNITS EVAPORATIVE COOLERS WOODSTOVES
BBQS FANS HOODS(comm<rtiat) MISC(Describe)
COMPRESSORS
FIREPLACE INSERTS RABNGES
FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING WATER CLOSIrIS Roa�q MISC(Describe)
BAT BS(or Tub/Shower Combo) SHOWERS
SINKS DRINKING FOUNTAINS
D S WASHERS RAINWATER SYST
AS PIPE OUTLETS SUMPS
URINALS HOSE BIBBS
f WASHING MACHINES ELECTRIC WATER HEATERS
,
LAVS(Bathroom Sulks) V CUUM BREAKERS
-`-:7-,-. -;DISCLAMER/SIGNATURE BLOCK
I certify under penalty of perjury that the i ;r rmation 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 prem es 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.
Sec/( k/t IDATE q/�/�C
NAME/TITLE '�/ (Title
(Signature) (
RELATIONSHIP TO PROJECT 0 Owner 0 Agent )(Contractor o Architect o Other
FOR OFFICE USE ONLY
( a NEW o ADDITION o ALTERATION o REPAIR 6 TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES o NO
BASIC PLAN? ❑YES o NO
{ ZONING DESIGNATIONCHANGE OF USE? ❑YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? o YES o NO
i
i
— Pa c 2 of 4 k\I-Iandouts—Revised\Permit Application
Bulletin#100—March 30,2004 g
t ELECTRICAL PERMIT INFORMATION
"� COMMERCIAL
RESIDENTIAL -
NEW C MMERCIAL/INDUSTRIAL SERVICE ;
NEW RESIDENTIAL SERVICE
Service or Feeder Each A,•'n
❑ Single Family Square Feet ❑ 0 to 10 amp $ 94.50 $ 58•
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00)
❑ 101-201 amp 117.50 7 .00
00
❑ Det(Iithisg or garage ❑ 201-400 : p 220.50 .7.00
(Innspespectteded wwith service) $36.50
CI Detached
401-600 ., p 256.50 03.00 Detached outbuilding or garage 332.00 140.50
(Inspected separately) $58.00 ❑ 601-800 ••
0 801 - 1000 am. 405.50 169.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 442.00 236.00
\ Service Feeder
❑ Up to 200\amp $ 94.50 $ 28.00 ❑ Over 600 volts su harge 74.00
❑ 201 -400 ar1M[� 117.50 ' 58.00 CI Mast or meter repai $80.00
❑ 401 -600 amp 161.00 80.00
❑ 601 -800 amp \ 206.00 110.00 ALTERED COMMERC • , IN 0 USTRIAL
❑ Over 800 amp \ 294.50 294.50 220.50 S ce or Feeders
94.50
ALTERED SINGLE/MITI CI 0 to 200 amp TI FAMILY 0 201 -600 amp 2'0.50
\ 33'.00
Semi' or Feeder ❑ 601 - 1000 amp
❑ 0 to 200 amp
$ 7 0 ❑ over 1000 amp 369. 0
❑ 201 -600 amp 117.
1CI # of circ is to be adde. altered
❑ over 600 amp 77.00 (1-5 circuits- '.74.00;Add'n circ 'ts,$6.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/I •USTRIAL PLAN EW
(1-4 circuits-$58.00;Add'n circuits$6.60/\) $74.00 plus 35°/ of Permit Fee
❑ Service over '00 amps
❑ Mast or meter repair $43.50 \ 0 Medical/E. cational/Institutional F. ility
SINGLE/MULTI FAMILY PLAN REVIEW
❑ Service Over 400 amps
$74.00 plus 35°X0 of Permit Fee
MOBILE HOMES TEMPORARY SERVICE
❑ Service or feeder only $58.00
❑ Service and feeder k $94.50 Commercial Residentia.
MOBILE HOME/RV PARI{ ❑ 0 100 $58.00 $51.00
❑ 1t1 -200 74.00 51.00
CI of service or feeders ❑ .1 1 -400 87.00 n/a
(First service/feeder-$58.00;each add'n-$37.50)
❑ •01 -600 117.50 n/a
■ over 600 127.00 n/a
`
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Signs
I 7 #of Therm• s
(First-$43.50;add'n-$13. ii - (First sign-$43. 0; •• n sign$20.50/ea)
❑ S' • tag pool/hot tub $87.00
• Low Voltage (Includes additional circuit,if required)
Squar rved by system(s) tin
❑ Fire Alarm System ••• d Pole meter loops $58.00
- ,eview $87.00/hour
El Security Alarm System ❑ Additions :
❑ Voice Cabling (for modified submitt.
❑ Data Cabling
(Per❑ System(s) 1•,2501 51.00; ,
Each add'n 251$ -13.50) •Per WAC 296-46-910(5)(L)(&ii)
Bulletin#100-March 30,2004 Page 3 of 4
k\(iandouts-Reviscd\Permit Application
t
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