98-103922CITY OF FEDERAL_
33530 First Way
Federal Way, WA
253-661-4000
9a-/a35aa
WAY gg •„y L.
0 "„w p PERMIT NO: EL_E98-1113
South E 16,.,. !I �a.� II R I �, ' ��""�, !I.,�. d"° P !I.;�,. I R:. MI II ISSUED: 10 / 1. 3 / 9 8
98003 Electrical Inspection Requests 253--661-4140 BY: FC2
EXPIRES: 10/07/99
ADDRESS:30810 PACIFIC HWY S
NO.: 735360--0240
PROJECT DESCRIPTi0N:4 PLEX OUTLET INSTALL (4 LINE)
;= OWNER = =w�-----�== =___= =__=___-�_� - CONTRACTOR - ==
PACIFIC DENTAL CLINIC GOLD ELECTRICAL
30810 PACIFIC HWY S 3536 23RD LN, NE.
FEDERAL WAY WA 98003 OLYMPIA WA 98506
946-1417
253-732-8555
GOLDE**O62P4
US CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL NAY. TAX RATE = 8.6%
LENDER
* STRUCTURE INFORMATION x
CONST. TYPE.: V-N
OCC. GROUP..:
OCC. LOAD...: 0
SQUARE FEET.: 0
$ NEW RESIDENTIAL x
NEW SINGLE FAM.:
OUT BUILDINGS..: 0
s MOBILE HOMES x
SERVICE OR FEEDER ONLY:
SERVICE AND FEEDER....:
SERVICE OR FEEDER (PK):
RESIDENTIAL ALTERATIONS #
0 E 0-200 AMPS........: 0
0 i 201-600 AMPS......: 0
0 , OVER 600 AMPS.....: 0
MASTIMETER REPAIR.: 0
NUMBER OF CIRCUITS: 0
MULTI
FAMILY
NEW
SEV
FEED
0-200 AMPS...:
0
0
201-400
AMPS.:
0
... 0
401-600
AMPS.:
0
... 0
601-900
AMPS.:
0
... 0
801 AND
OVER.:
0
... 0
_ - - --.� _- __ - ---� ------ - - ------ ...-.-.------------ --------- --
COMM. ALTERATIONS j TEMP SERVICE MISCELLANEOUS COMM/IND NEW INSPECTION RECORD
0-100 AMPS.....: 0 0 SERVICE DATE
0-200 AMPS....,.: 0 0-100 AMPS....: 0 THERMOSTATS....: 0 101-200 AMPS...: 0 0
201-600 AMPS....: 0 101-200 AMPS..: 0 LOW VOLTAGE....: 0 201-300 AMPS...: 0 0 COVER.. DATE _______—_
601-1000 AMPS...: 0 201-400 AMPS..: 0 SWIMMING POOL..: 0 301-600 AMPS...: 0 0
OVER 1000 AMPS,.: 0 401-600 AMPS..: 0 SIGNS......,,..: 0 601-800 AMPS..,: 0 0 I FINAL.. DATE
NUM. OF CIRCIUTS: 4 OVER 600 AMPS.: 0 TEMP, POLES....: 0 801-1000 AMPS..: 0 0 j COMMENTS:
----1------ - - ------ YARD METER LOOP: 0 OVER 1000 AMPS.: 0 0
TOTAL PERMIT FEES.,.....: 50.00 OVER 600 VOLTS.: 0
MAST/METER RPR.: 0 I
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO MORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED BY NE IS TR COKREC TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS MILL BE NET.
OWNER OR AGENT G . _�___R-_ DATE 3 G'
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ELECTRICAL PERM IT:APPLIC,ATION
BUILDING DIVISION
33530 First Way South
Federal Way WA 98003
(253) 661-4000
Fax (253) 661-4129
1' eueriu TV m DUblumS LICeinic nulllut L` juju _�v —
Job Address /0 G f - / (& s. Job Site Phone
Parcel No I Lot No I Subdivision Name
Owner/tenant
Mail Address
Phone
Electrical Contractor
O
Addresslphone
- �!
n en
�/ z� �lC�l C/�0� �f
� !�/ 4 z
EleCtri °n i<°�� e { py reg ify
�t el7y ` �,{���-
Expiration Bats: f4 / Z 4C / ��
Use of Bldg: 0 SF Res ❑ Comm ❑ Other ❑ Multi
❑ Church/School
Class of Work: ❑ New ❑ Alteration 0 Addition 0 Repair
Describe Work:
`
If service is greater than 200 amp, a
plan review is req'd. Fee is 35% of
permit fee +$50. Add'1 plan review
for other submissions is $60/hr.
MISC EQUIPMENT/TEMP SERVICES
_ # of Thermostats (First t-stat-$30; add'n-$10 ea)
_ # of Low voltage fire or burglar alarms
(Residential: fast 2500 I -$35; Each add'n 500 f -$10)
(Commercial: 1-4 zone-$28, Each add'n zone-$'n
_ # of Signs (First sign-$30; Each add'n sign $15)
_ Progress inspection per hr .......... $60
_ Swimming pool, hot tub, spa ......... 60
_ Temporary Pole ................... 35
Yard Pole meter loops .............. 40
Inspections requested before 3:30pm will be
made the following work day, 253.661.4140.
I hereby certify that I am the owner (or
authorized agent) of the above named property,
or a licensed contractor (or firm's authorized
agent) and am making the installation or
alteration in compliance with all applicable
city, county, and/or state laws.
Applicant's Signature:
I Date: — l0
NEW RESIDENTIAL SERVICES
_ Single Family
(First 1300 ft -$60; Each add'n 500 ft -$20)
Square Feet:
_ Each outbuilding or garage ..... $25
NEW MULTI -FAMILY
(Includes three units or more)
Service
Feeder
Up to 200 amp ....
$ 65 .....
$ 20
201 - 400 amp ....
80 ......
40
401 - 600 amp ....
110 ......
55
_ 601 - 800 amp ....
140 ......
75
801 and over ......
200 .....
150
ALTERED SINGLE/MULTI FAMILY
(When inspected separately from the services.)
Service or Feeder
0 to 200 amp ................ $ 55
_ 201 - 600 amp ............... 80
over 600 ................... 120
Mast or meter repair ........... 30
_ # of circuits .................. 40
(First circuit-$40; Add'n circuit-$5 each)
MOBILE HOMES
_ Service or feeder only ........ $40
Service and feeder 65
MOBILE HOME/RV PARK
_ # of service or feeders
(First service/feeder-$40; Add'n service/
feeder-$25 each)
COMMERCIAL/INDUSTRIAL
Amps
Service or
Add'n
Feeder
0 to 100 ..........
$ 65 ....
$ 40
101-200
........ 80 ......
50
_ 201-400
........ 150 __
60
401-600
........ 175 .....
70
601-800
........ 225 .....
95
801-1000
....... 275 ....
115
_ over1000
........ 300 ....
160
Over 600 volts surcharge ......
50
Mast or meter repair ..........
55
COMMERCIAL/INDUSTRIAL
Altered Service or Feeders
0 to 200 ................... $ 65
201-600 ................. 150
601-1000 ................ 225
over1000 ................. 250
# of circuits
rt (First 5 circuits-$50; Add'n circuit-$5 each)
Temporary Service
0to 100............... I... $40
101-200 .................. 50
_ 201-400 .................. 60
401 - 600 80
over 600 ................... 90
EtEcmc pe
RL m 7/30198