04-102956 f 7 s •6
City of Federal Way
Community Development Services Electrical Permit #:04 - 102956 - 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: ELSNER-MADSEN
Project Address: 32317 10TH\S A,b(k.jParcel Number: 150240 0530
Project Description: Add 25-amp circuit for new air conditioner.
Owner Applicant Contractor
Kathleen Elsner-Madsen WASHINGTON ENERGY SERVICES CO WASHINGTON ENERGY SERVICES CO
32317 10TH AVE S 2800 THORNDYKE AVE W 2800 THORNDYKE AVE W
FEDERAL WAY WA SEATTLE WA 98199 SEATTLE WA 98199
98003-5925 (206)272-4700
Electrical Fixtures
Description Quantity Description` ;Quantity 1 Description Quantity
Circuits-Residential 1
PERMIT EXPIRES January 25,2005.
Permit issued on July 29,2004
I hereby certify that the above informationis 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 Wa /'`
Owner or agent Date: Zq�G(,�
THIS CARD IS TO REMAIN ON-SITEA.
CIYY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-102956-00-EL
Owner: KATHLEEN ELSNER-MADSEN
Address: 32317 10TH AVE S
FEDERAL WAY, WA 98003-5925
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) ElDitch cover(4030) ,❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) .LI Service(4235) �❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) 0 Ceiling Cover(4020) ❑ Final-Electrical(4055) 1
Approved Approved I Approved
` •
By Date By Date , By--1 / Date • Z,♦ 0
❑ Under-slab groundwork(4295)
Approved
By Date
JUL-26-2004 09 tr NE T0: 12536614129 0 4`4 0
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Federal Wa [ ! FEDERAL WAY,WA 91063-9 71 8
PERMIT APPLICATION
253-661-4J15.
l r•e3461- 129
F.ro�e.v«
,Nity O�{ CDER!>�TT�VAY - O -
` BUI Thttrtber: D (4 ro
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The oilowin. is re•aired in or/nation-an ince •late a• •Uication will not be aece•ted. Please •rint Ic•ibl in in or . ,
■ PROPERTY INFORMATION
SITE ADDRESS: 32-3 '7 IV
/Q �e_ SUITE/APT/�`` I
ASSESSOR'S TAX/PARCEL i': 1 c U 2.-VV O- f 3 SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT(This application): o BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
.LECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlut
Dta5 ILIrrot 2S— amps `2- go1/ Y ,
PROJECT NAME(Name of Business/Owner Last Name): e_ISRD r q_dseei
• PEOPLE INFORMATION
PROPERTY NA E: PRIMARY PHONE:
OWNER 44.)r !ILC►'! 5-l S !1! utr..i d-e-A (2_s7)-7-2,9 - 2'i93
MAILING ADDRESS(STREET ADDRESS)); CITY.STATE.ZIP
323 i-7 ►c-\ s ceic1A qt 3
CONTRACTOR.: NA COMPANY OFFICE PHONE:
MAILING ADDRE ST ET D I: a; QSTAT .Z vi Q CELL PHONE: _
CITY OF FEDE WAY BUSINESS LICEI�S FNUMBEEXPIRATION DATE: FAX NUMBER:
-o5"-L6— V R.Ooac. c / �- 'ir ( ) -_
CONTRACTORS REGISTRATION NUMBER //�EXPIRATION DATE:
loopy of card required with each appucatlon) W�q-,AFL l_S1�7 Lo..-0_ `y
_ / Z / or
LENDER NAME: DAYTIME PHONE:
prr..p..I V.I..>$8.wO1 ( ) -
MAILING ADDRESS(STREET ADDRESS;): CITY.STATE,ZIP
APPLICANT: NAME:�_o . r,v`ta / COMPANY OFFICE PHONE:
+� -l- IF_„1-yam-• ( )
MAILING ADDRESS)STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 Architect o Tenant ❑ Other(Describe): ( ) _
CONTACT PERSON FOR THIS PROJECT: 0 Property Owner ? Contractor 13 Applicant E-MAIL ADDRESS:
■ 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 0 NO
WATER SERVICE PROVIDER ci LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
JUL-26-2004 09:53 FROM: TO: 12536614129 P.7
• I
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL ausnso TOTAL PROPOSED Tow.wasneiQ AND PROPOSED
"NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ FIXTURES
Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECEIANICAL
Value of Mechanical Work $
--AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
_COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(rr.b/eho.aCombo) SHOWERS WATER CLOSETS frea.q MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES _ URINALS HOSE BIBBS
LAYS VACUUM BREAKERS ELECTRIC WATER HEATERS
• DISCLAIMER/SIGNATURE BLOCK:
I certify under penalty of perjury that the informaition fundsbed by me is true and correct to the best of my
knowledge, and further,that I am autiiorized by the owner of the abo�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 e yees,upon the curacy of the in./formation supplied to the city as a art of this application.
NAME/TITLE: CC . (°
DATE:
(Signature) (Title)
RELATIONSFIIP TO PROJECT: 0 Prope Owner ❑ Applicant 0 Contractor r a Architect( ❑
t/-2r 7 -26 32
�M O F CEp SE�ON�I:Y� •
P IiEW) �A uJ o ADDITION Q ALTERATION o REPAIR. •?; q TENANT IMPROVEMENT
11414,-44-4 4.- 3HEJ.L ONLY? ,b YES v:NO' BASIC PLAN?; o YES u NO
ZONING DESIGNATION CHANGE OF USE? a YES a tjp
NEW ADIDRESS,REQUIRED? o'YES a NO UP/SEPA/SU? o YES a NO
PI:ATTED LOT?`
O YES o NO DEMO PERMIT REQUIRED? o'YES o NO
1)ultetin IOU -slant' I. 2(*-1 Page 2
JUL-26-2004 09:52 FROM: , TO: 12536614129 P.6
V LI Ih-e-r- 1/14- -d
1-e- lY
■ ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
0 Single Family Square Feet: Service or Feeder Each Add'n
(First 1300 ft2-$87.00;Each add'n 500 ft2-$28.00) 0 0 to 100 amp $ 94.50 $ 58.00
❑ 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 ❑ 401 -600 amp 256.50 103.00
(Inspected separately) $58.00
0 601-800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) ❑ 801 - 1000 amp 405.50 169.50
Service Feeder 0 Over 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
❑ 201 -400 amp 117.50 58.00 Cl Over 600 volts surcharge $74.00
❑ 401 -600 amp 161.00 80.00 0 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
(Inspected separately from service) 0 201 -600 amp 220.50
Service or Feeder ❑ 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 0 if of circuits to be added/altered
(1.5 circuits-$74.00;Add'n circuits,$6.00/ea)
. 1)4
COMM
It of circuits to be added/altered
(1-4 circuits-$58.00;Add'n circuits$6.00/ea) ERCIAL/INDUSTRIAL PLAN REVIEW
0 Service over 200 amps
0 Mast or meter repair $43.50 ❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW $74.00 plus 35%of Permit Fee
O 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
❑ o- 100 $58.00 $51.00
MOBILE HOME/RV PARK
0 101 -200 74.00 51.00
❑ It of service or feeders
0 201-400 87.00 n/a
(First service/feeder-$58.00;each add'n-$37.50) .
0 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
O tl of Thermostats ❑ 14 of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s): (Includes additional circuit,if required)
❑ Fire Alarm System 0 Yard Pole meter loops . $58.00
❑ Security Alarm System 0 Additional Plan Review $87.00/hour
0 Voice Cabling (for modified submittals)
❑ Data Cabling
(Per System(s): 1n 2500 ft2-$51_00;
Each add'n 2500 ft2-13.50) •Aer WAC 296-46910(5)(6*&iil
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