07-103225 •
•
City of Federal Way Electrical Permit #: 07-103225-00-EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
•
Project Name: WORACEK
Project Address: 29002 19TH AVE SFILL—. Parcel Number: 422300 0180
Project Description: Install Uv burglary alarm system
Owner Applicant Contractor ,
DAVID&HELEN WORACEK CHUBB SECURITY NW.,INC dba SECURE CHUBB SECURITY NW.,INC dba SECURE
29002 19TH AVE S SERVICES SERVICES
FEDERAL WAY,WA 150 12TH AVE CHUBBSN995J3 4/23/09
98003 SEATTLE WA 98122 150 12TH AVE
SEATTLE WA 98122
Additional Permit Information
Electrical Fixtures
Low Voltage Burgler Alarm-Resi 1,300
PERMIT EXPIRES,Monday, December 10, 2007
Permit Issued on Wednesday, June 13,2007
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: _/3 3 ^6 7
`drL
le - I er+ Cw..-
THIS CARD IS TO REMAIN ON-SITE -
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-103225-00-EL
Owner: DAVID & HELEN WORACEK
Address: 29002 19TH AVE S
FEDERAL WAY, WA 98003-3872
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) �❑ Ditch cover(4030) �❑ 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) 0 Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved Approved
By Date By Date ByCkiyo,......._ Date —‘S---it ,-7
❑ Under-slab groundwork(4295)
Approved
By Date
For inspector reference only
o Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
.. ,;--7/10`i'CI)
QTT eP 20 D 7 - / Q `3 oT R 5
FederalWay► JUN 1 3 °j'ERMIT
• COMMUNITY DEVELOPMENT SERVICES
gp SF MF CO MEPL DE EN FP
33325 do RVBNUB SOUTH 980 O 9BOX 718 8 CITY OF F1 i 4
P L I C A T I O N
FEDERAL WAY, X 98063.260 BU LD 1WiC TD / /
253-835-2607•FAX 253.835.2609
www,dtvoffederahunu.a m
The allowing is required information-an incomplete ap.lication will not be accepted. Please print legibly in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 4 2.9 O oz., I "M AU- S SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION ' .
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION X ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only()
1Ntt6OL LOvJ Vo1kA rtZ,.,, A\A \ ,5/ 4e..vvv
PROJECT NAME(Name of Business or Owner Last Name) w 0 Q.Ace
NI PEOPLE INFORMATION
PROPERTY NAME i PRIMARY PHONE
OWNER 4Ui(} £ laF.LEWt/\ce 4 (253 ) 44(a - 0439
MAILING ADDRESS ' CITY,STATE,ZIP
29002 1t. 1 e.. S f c erAA WAy wR C13003
CONT• . . COMPANY NAME APPLICANT NAME OFFICE PHONE
Noss Sgctit: ti AI • K.T. 7orio}•AAe (206 ) C252.-0125-
MAILING ADDRESS CITY,STATE,ZIP CELL.PHONE
?o. B 91113 SFatk WA 921it ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
2.b -4 Q-1 C? 3 1. �cl-B L . lZ / 3( /bA-� ( ) -
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
C 1-1 U 5 13 S N a 61 513 4 / z3 /a'$
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Cru%2, SCcutti N.W. 11. T. l of-tuv_-• (zob) kT2. -091.5-
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
?.0. 13crk RILL-3 - f,itILE WA °8111 ( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑ Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
41 OJtot .0\-0.A.E (2ot..) taSZ. OkL'S
LENDER •!X i ,.„ C'' :` ;ik1:4 -r`. if,r4° {Y:d s rt,q. NAME
w lkai 1 A''r,1'!_.,.6„I# -tiltL. .az 'Y'.10`
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ' ) -
''■;'DETAILED BUILDING INFORMATION 's1'
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE a TACOMA 0 PRIVATE(WELL)
C ITUP.T7 n tTfir•R PRAITTTIFT? n T ATIT:ITATTL,Tr in rTT(STIT net.` r, DDTT7APL,,0'011mTnt
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ.FT.
• BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT❑
L70STn10 PROPOSED TOTAL � ' `• tz '7,,,- { ;',1;117".
NUMBER OF FLOORS
**NEW HOMES ONLY'" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES . '
Indicate number of each type of future to be installed or relocated as part of this project. Do not include existing factures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commrrriuu) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES
— MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(orTab/showercombo) SHOWERS WATER CLOSETS Iroaoq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
• LAVS(Bathroom sinker) 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
am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hole!
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 employees,upon the accuracy of the information supplied to the city as a part of
this application.�
NAME/TITLE 140111110111P" DATE b- I 2..-
(Signature) (Title) _ 1
RELATIONSHIP TO PROJECT q Owner 0 Agent 0 Contractor 0 Architect /4 Other Wet,. �e c-,4
i it)101M +id ,i1g - yOAk_,,i0f impooVroh ffj'
._ 14 111 $ Y�:X€l [1 P ' >1 � l-'<09 ( '.d�441 `)f , : i ).°6 .§ i.-)4
ELECTRICAL PERMIT INFORMATION
IRESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
C7Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft,- S 104.50;Each add'n 500 ft,-$33.50) 0 0 to 100 amp $113.50 $69.50
❑ Detached outbuilding or garage ❑ 101 -200 amp 141.00 89.00
(Inspected with service) $44.00 0 201-400 amp 264.50 104.00
❑ Detached outbuilding or garage 0 401 -600 amp 308.00 123.50
(Inspected separately) $69.50
0 601 -800 amp 398.50 168.50
0 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) 0 Over 1000 amp 530.50 283.00
Service Feeder
❑ Up to 200 amp $113.50 $33.50 0 Over 600 volts surcharge $89.00
❑ 201 -400 amp 141.00 69.50 ❑ Mast or meter repair $96.00
0 401 -600 amp 193.00 96.00
❑ 601 -800 amp • 247.00 132.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 353.50 264.50 Service or Feeders
❑ 0 to 200 amp $113.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50
0 601 - 1000 amp 398.50
Service or Feeder ❑ over 1000 amp 443.50
❑ 0 to 200 amp $87.00
❑ 201 -600 amp . 141.00 0 #of circuits to be added/altered
0 over 600 amp .'212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea)
❑ # of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$69.50;Add'n circuits$7.00/ea) $89.00 plus 35%of Permit Fee
•
❑ Service - 1,000 amps or greater
❑ Mast or meter repair $52.00 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $69.50
O Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $61.00
❑ # of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Arnpacity
❑ 0- 100 amps _ $69.50
❑ 101 -200 amps 89.00
❑ 201 -400 amps 104.50
❑ 401 -600 amps 141.00
❑ over 600 amps 152.50
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats ❑ # of Signs
(First-$52.00;add'n-$16.00/ea) (First sign-$52.00; add'n sign$24.50/ea)
A"
Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s) 1300 (Includes additional circuit,if required)
❑ Fire Alarm System I 0 Yard Pole meter loops $104.50
❑ Security Alarm System ❑ Additional Plan Review $104.50/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
0 ❑ Automation Fee on all Permits .. $5.00
(Per System(s) lee 2500 ftz-$61.00;
Each add'n 2500 ft2-16.00) •Per WAC 29046-910(5)(4(1&ii/
Bulletin#100-January 7,2005 Page 3 of4 k\liandnuts\Permit Annlicatinn