07-102091 4
City of Federal Way Electrical Permit #: 07-102091-00-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: GOLDENSTONE SUITE 202
Project Address: 33400 9TH AVE S Suite 202 ' Parcel Number: 926501 0060
Project Description: Altering up to(5)circuits.
,.
Owner Applicant Contractor
GOLDEN STONE LLC KIRBY ELECTRIC INC KIRBY ELECTRIC INC
33400 9TH AVE S 4826 B ST NW SUITE 101 KIRBYEI077BN 1/13/07
FEDERAL WAY WA 98003 AUBURN WA 98001 4826 B ST NW SUITE 101 •
AUBURN WA 98001
Additional Permit Information
Electrical Fixtures
Circuits. Commercial 5
PERMIT EXPIRES Tuesday, October 16, 2007
Permit Issued on Thursday, April 19, 2007
I hereby certify that above i;forr'n ahoninformis correct and that the construction on the above described propertyand
the occupancy and the use will be in accordancewith the laws,'rules and regulations of the;,SState of Washington
and the City of Federal Way.
Owner or agent: 4.t " lr1�2�� Date:
Fir :t LT. D
THIS CARD IS TO REMAIN ON-SITE A
CITY of Community Development Inspection Record ..
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 07-102091-00-EL
Owner:
Address: 33400 9TH AVE S Suite 202
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.
O 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) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
I❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) ❑ Final -Electrical(4055)
Approved Approved Approved
By G ___ Date v\ ,_Dz.z,,_p•7 Bye , Date S-1 I.-- 7 /-- Date S�?2 7'
❑ Under-slab groundwork(4295)
Approved
By Date
CITY OF
Federal Way rECEtVED PERMIT - - l 0 2�
COMMUNITY DEVELOPMENT SERVICES
SF MF CO ME PL® DE EN FP
33325 8TH AVENUE SOUTH•PO PDX 9718
p
A
P P L I CATION TD
2F5E3D8E3R5AL
-2 W•
YAXWA 9803.971AffR 9 �OQA
uwu,cttiofederilwau.com' / /
E ERAL WAY
The following isatciP-an incomplete application will not be accepted. Please print legibly(in ink)or type.
0 PROPERTY INFORMATION
SITE ADDRESS- 3 $y d Qb e/ °7 A C1 S. SUITE/UNIT# O„2
ASSESSOR'S TAX/PARCEL# ( 2- CO S. ( - b C) ( Q_ LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for Lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
-rend e * y 14? ecw=tinn e.vi t 12-041›..L c/c5) 5co,14..„ s )2, /i€ .k.1�c,/ Trc i Qfc.-$
PROJECT NAME(Name of Business or Owner Last Name) 71-61,4 4 d d�
PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER ( ) -
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
3) 65t zek o
ArNb�DRCr
CITY,STATE,ZIP CELL PHONE
C a-to 13 St ,c,tv of 4 Lei )- 9crb / ( S3)6 - X 0'
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
!c'/Sf,7 !ai31(e
7 (.253) S-5
- 343
CONTRACTOR'S REGISTRATION NUMBER PIIRA ION DATE E-MAIL ADDRESS
COPY otesrd requiredwith each application 1
4
7
1
2YLE v77 e,l/(3fr
APPLICANT COMPANY NNAME APPLICANT NAME OFFICE PHONE
4_02- 3) ' - —
MAILING CITY,STATE,ZIP E
tlG�G
tiEg'aG )3 sal. viv,0)41/ �4u1�.�r� )4. 9'W 71 (.753�o� - mac' .7
RELATIONSHIP TO PROJECT ' FAX NUMBER
0 Architect ❑ Tenant o Agent 0 Other (. 3)g�cJ -geh 3
PROJECT NAME /JPRIMARY PHONE E-MAIL ADDRESS
CONTACT t pe- (163 )s'5r*Aee)Cirbye%.E,.iscL�®17
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ V OF PROPOSED WORK $ 1/ '-5• vim_
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUP ON SYSTEM PROPOSED/REQUIRED? o YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ . HLINE 0 OMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN . IGHLINE ❑ PRIVA EPTIC)
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.
SQ.FT. SQ.FT. SQ.FT.
BASEMENT •
FIRST
SECOND •
THIRD \
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
•
NUMBER OF FLOORS swarm P5050550 r•, TOTAL LPBTDro- .TOTAL PROPOSso SF' TOTAL ST
•
"NEW HOMES ONLY" NUMBER OF BEDROOMS / ESTIMATED SELLING P' s $
• FIXTURES
Indicate number of each type offixture to be installed o relocated as part of this p5oject. Do not include existing fixtures to remain.
MECIIANIC4L
Value of Mechanical Work$ (A COPY•` BID OR ESTIMATE M . BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIV::,COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS" FANS GAS WATER HEATERS " MISC(Describe)
BOILERS ' FIREPLACE INSEHOODS(Commercial)
COMPRESSORS FURNACES RANGES •
DUCTS GAS LOG ' REFRIG.SYSTEMS
•
PLUMBING
BATHTUBS(orTub/shower combo) VS(Bathroom sinks) \ URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST \VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS crone()
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS "
•
SIGNATURE
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,including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE .217./<1DATE .e,11--/ —
(Signature)
G�
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent 0 Contractor ❑ Architect o Other
ti3 rj „i ",7 „ai
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES o NO . BASIC PLAN? - o YES n NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? _ a YES o NO
PLATTED LOT? o YES o NO - DEMO PERMIT REQUIRED? o YES o NO
Bulletin#1100—April 2,2007 Page 2 of 4 k\Handouts\Permit Application
• •
At •
ELECTRICAL PERMIT INFORMATION .
•
- RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE • NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet
Service or Feeder Each Add'n
' (First 1300 ft2-'$111.00;Each add'n 500 ft2-$35.50) ❑ 0 to 100 amp $120.50 $74.00
❑ Detached outbuilding or garage ❑ 101-200 amp 149.50 94.50
(Inspected with service) $47.00 ❑ 201-400 amp 280.00 111.00•
❑ Detached outbuilding or garage ❑ 401-600 amp '327.00 131.00
• (Inspected separately) $74.00 ❑ 601-800 amp 423.00 179.00
' ❑ 801 - 1000 amp 516.50. 216.00 •
I NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 563.00 300.00
I Service Feeder
❑ Up to 200 amp $120.50 $35.50 ❑ Over 600 volts surcharge $94.50
❑ 201 -400 amp 149.50 74.00 ❑ Mast or meter repair $102.00
O 401.:600 amp 205.00 102.00 • ALTERED COMMERCIAL/INDUSTRIAL
0 601 -800 amp 262.00 140.50
❑ Over 800 amp 375.50 280.50 Service or Feeders
❑ 0 to 200 amp $120.50
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 280.50
❑ 601 - 1000 amp 423.00
Service or Feeder
0 over 1000 amp 471.00
❑ 0 to 200 amp $92.50 .
�✓
0 201 -600 amp 149.50 0 5 s of circuits to be added/altered
❑ over 600 amp 225.50 (1-5 circuits-$94.50;Add'n circuits,$7.00/ea)
of circuits to be added/altered
0 # COMMERCIAL/INDUSTRIAL.PLAN REVIEW
(1-4 circuits-$74.00;Add'n circuits$7.00/ea) $94.50 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $55.00 • ❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $74.00
❑ Service and feeder $120.50
TEMPORARY SERVICE
MOBILE.HOME/RV PARK •Residentia
(/Mulct-Family $65.00
❑ #of service or feeders
(First service/feeder-$74.00;each add'n-$48.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0-100 amps $74.00
❑ 101-200 amps 94.50
0 201-400 amps 111.00
❑ 401-600 amps 149.50
❑ over 600 amps 162.00
MISCELLANEOUS SERVICE/EQUIPMENT
•
❑ #of Thermostats ❑ #of Signs
(First-$55.00;add'n-$17.00/ea) (First sign-$55.00;add'n sign$26.00/ea)
O Low Voltage ❑ Swimming pool/hot tub $111.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $74.00
❑ Security Alarm System ❑ Additional Plan Review $111.00/hour
❑ Voice Cabling (for modified submittals)
O Data Cabling ❑ Automation Fee on all Permits .. $5.00
1,42500 ft2-$65.00;
Each add'n.2500 ft2-.17.00) •Per WAC 296-46-9)0(5)(b)li A ii)
Bulletin#100-April 2,2007 Page 3 of 4 k\Handouts\Permit Application