04-103687 ` • •.
ty of Federal Way
Cotmmunity Development Services Electrical Permit #:04 - 103687 - 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: LISISTYN
Project Address: 32907 7TH\Sti. Parcel Number: 182104 9065
Project Description: Install t-stat wiring
Owner Applicant Contractor
Mikhail N Lisitsyn MIDLAND MECHANICAL MIDLAND MECHANICAL
28134 29TH AVE S MIDLAND MECHANICAL MIDLAND MECHANICAL
FEDERAL WAY WA 11212 SE 179TH ST 11212 SE 179TH ST
98003-3387 RENTON WA 98055 (425)228-4715
Electrical Fixtures
Description IQuantity Description Quantity Description Quantity
Thermostat 1
PERMIT EXPIRES March 13,2005.
Permit issued on September 14,2004
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: 0
e 4\
\\
THIS CARD IS TO REMAIN ON-SITS
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-103687-00-EL
Owner: MIKHAIL N LISITSYN
Address: 32907 7TH CT 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.
0 Slab/Concrete Floor(4255) �❑ Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date I By Date
❑ Temporary Power(4275) �❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
E3 Rough Electrical(4225) 0 Ceiling Cover(4020) Final-Electrical(4055)
Approved Approved Approved
By XL S Date —ly—ok , By Date B •kl Date
❑ Under-slab groundwork(4295)
Approved
By Date
4l
CItY Off,A . y _SF MF COE� DEENFP
off I o 3 6 ?
Fed ,
Federal Way PERMIT - f
COMMUNHY DEVELOPMENT SERVICES
33325 8TM AVENUE SOUTH•PO BOX 9718 APPLICATION
,_TD
FEDERAL WAY,WA 98063.9718
253-835-2607•FAX 253435-2609 / /
www.dtuolfederalwa u.com
The ollowing is required information-an incomplete ap•lication will not be acce•ted. Please .tint legibly(in ink)or type.
. - • PROPERTY INFORMATION
SITE ADDRESS 3 Z9 C7 7 '7 C....-t- 5 SUITE/UNIT#
,
ASSESSOR'S TAX/PARCEL# - _ _ _ _ LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) G 0 +
' I
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION;1KELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
Z-h 5 (/ 1 - T' 15-TA'I w;rre_
PROJECT NAME(Name of Business or Owner Last Name) Li 5i-Psy VI
, IN PEOPLE INFORMATION 1
PROPERTY NAME PRIMARY PHONE
OWNER MIA Vat KC) ( ) -
MAILING ADDRESS CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
d 'oint� /Uec.�Iurll.r,i( -3",e,-3",e, Mkrc,- t- (415)22$ - 117/.-
MAIr�LING ADDRESS ' CITY,STATE,ZIP CELL PHONE
t12-( L s� )79f .5 i Re 10— GJ0 , ?i°55 ( ) - _
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
- - - B L / / ( ) -
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
M I Pt- AMC 97 f 6T / /
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
( )
LENDER IPerRCW 19;27095>,Lender'information is ;^' NAME
'4eK '°semA,;.
required ifPr°45t,Yalue exceeds,j5.000 ,'
MAILING ADDRESS CITY,STATE,ZIP
', .■ DETAILED BUILDING INFORMATION •
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES O NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
. WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE O TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE a PRIVATE(SEPTIC)
;, • PROJECT FLCOR AREAS '
AREA DESCRIPTION EXISTING S..FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
HOW MANY FLOORS?
**NEW HOMES ONLY" NUMBER OF BEDROOMS
a D SELLING PRICE $
,
Indicate number of each type of fixture to be • •lied or relocated as part of this project. Do include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
GAS LOGS REFRIG.SYSTEMS
AIR HANDLING UNITS EVAPORATIVE COOLERS WOODSTOVES
BBQS FANS HOODS(commercial)
BOILERS FIREPLACE INSERTS
RANGES MISE(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING SHOWERS WATER CLOSETS(roue) MISE(Describe)
DIS ' •:S(orTub/Shou<rCombo( DRINKING FOUNTAINS
D1S" 'PIPE OUTLETS SINKS RAINWATER SYST•AS SUMPS
LS HOSE BIBBS
URINALS WASHING MACHINES ELECTRIC WATER HEATERS
LAYS(Bathroom Sulks} ACUUM BREAKERS
DISCLAIMER/SIGNATURE/MOCK .. -
dge, and
her, that I
I certifyunderby
penalty ofof the the i premisesation toperform the work for which the permit application isshed by me is true and correct to the best of ymade.leI further gree to hold
amauthorized he the owner P
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,in ding its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. //�� J
/ 17/".. /�i DATE I �1
NAME/TITLE Ad i
t Irature) (Title(
I RELATIONSHIP TO •'OJECT o Owner 0 Agent 0 Contractor 0 Architect ❑ Other
i
E FOR OFFICE USE ONLY 1
o'TENANT IMPROVEMENT'
❑NEW a ADDITION o ALTERATION o REPAIRo YES ❑NO
i BUILDING SHELL ONLY? o YES a NO BASIC PLAN?
1 ZONING DESIGNATION CHANGE OF USE? o YES o NO
t NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES a NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? o YES a NO
Bulletin 0100—March 30,2004 — Page 2 of 4 I:\Handouts—Revised\Permit Application
. . - • . ELECTRICAL PERMIT INFORMATION ►
1
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
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) ❑ 101❑ 0 to 1 1 200 amp 194.50 74.00
❑ Detached outbuilding or garage
(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
0 801 - 1000 amp 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
❑ 201 -400 amp 117.50 58.00 ❑ Over 600 volts surcharge $74.00
❑ Mast or meter repair $80.00
❑ 401 -600 amp 161.00 80.00
❑ 601 -800 amp 206.00 110.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 294.50 220.50 Service or Feeders
❑ 0 to 200 amp $ 94.50
ALTERED SINGLE/MULTI FAMILY 0 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
❑ Oto 200 amp $
72.50 ❑ over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ #of circuits to be added/altered
❑ over 600 amp 177.00 (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
❑ 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 Residential
MOBILE HOME/RV PARK ❑ 0- 100 $58.00 $51.00
0 101 -200 74.00 51.00
❑ #of service or feeders n/a
(First service/feeder-$58.00;each add'n-$37.50) ❑ 201 -400 87.00
O 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
1 #of Thermostats ❑ #of Signs
Y1,...
(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 Feetserved by system(s) ❑ Yard Pole meter loops $58.00
❑ Fire Alarm m System
m $$7.00/hour
El Security Alarm System ❑ Additional Plan Review
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
(Per System(s) 1't 2500 ft2-$51.00;
Each add'n 2500 ft2-13.50) 'Per WAC 296-069i0(5)(b)(i&ii)
Bulletin#100-March 30,2004
Page 3 of 4 k\l landouts-Revised\Pennit Application