Fillable Printable Form 500-094-000
Fillable Printable Form 500-094-000
Form 500-094-000
F500-094-000 Property Owner Electrical Work Permit Application 01-2017
Electrical Program
www.LnI.wa.gov
Property Owner
Electrical Work Permit Application
1
Applying for your Electrical Permit
In Washington, only licensed electrical contractors may perform electrical work. Property owners may apply for
an exemption from these requirements by completing this application and signing the affidavit belowbefore
beginning electrical work:
•Complete all sections & mark the applicable fee item(s) on the FeeWorksheet.
•After receiving your completedpaperwork and payment we will issue a permit valid for 1 year.
•Permits can also be purchased online atwww.ElecInspect.Lni.wa.gov
Is this property within city limits?
YesStop! Some cities perform their own inspections. If you are unsure, verify with the citybefore
continuing.
I have verified that this propertyis not inspected by a city inspection agency -Continue-
No -Continue-
Are you doing electrical work inside a manufactured or mobile home?
Yes Stop!If you are doing electrical work inside the home, use the Manufactured or Mobile Home
Application (F500-134-000).
No -Continue-
2
Affidavit
As authorized under RCW 19.28.261, I, ____________________________________________ hereby apply for an
(Printed Name of property owner, renter, or lessee)
exemption from the electrical licensing and certification requirements of RCW 19.28 by submission of this
affidavit.
Which statement describes you?
(Mark only one - If none apply, you may not take out this permit)
I own this property.
Your name or your company’s name must be shown on the deed to the property. Real estate agents,
property management companies, relatives, etc. cannot purchase permits for theproperty owner.
I rent or lease this property.
We need a copy of your rental agreement showing you have permission to perform electrical work.
I am an officer for a501(c)(3) nonprofit corporation or a nonprofit religious organization.
The total market value of electrical work must be $30,000 or less and all electrical work must be done by a
non-compensatedappropriately certified electrician.
F500-094-000 Property Owner Electrical Work Permit Application 01-2017
Select your property type
(Mark only one - If none apply, you may not take out this permit)
New single family residencethat isnot intended for rent, sale, or lease where I will be living for at least
24 monthsafter completing electrical work.I will be personally doing the electrical work.
New 2, 3, or 4 unitresidential building, owned by me,that isintended for rent, sale, or lease. I will be
living in one of the units for at least 24 months after completing electrical work.I, personally, and/or a
regularly employed employee(s) will be doing the electrical work.
Newplace of business, farmor other property:Any new structure that is not intendedfor rent, sale, or
lease. I, personally, and/or a regularly employed employee(s) will be doing the electrical work.
Existing residential property, place of business or farm.I, personally, and/or a regularly employed
employee(s) will be doing the electrical work.
501(c)(3) or nonprofit religious organization owned property:The total market value of electrical work
must be $30,000 or less and all electrical work will be performed by appropriately certified electricians or
certified and properly supervised trainees who are volunteering and not being compensated for electrical
work per RCW 19.28.091(7).
Your signature is required below
I believe I should be exempt from the requirements to obtain an electrical license or use a certified electrician
as provided under RCW 19.28.261.
By signing below, I certify the information I am providing on this affidavit is true and accurate. I understand that
if I make false statements or misrepresentations I may be assessed penalties.
Printed NameSignature of Property Owner, Renter, or LesseeDate
3
Property owner and inspection site information
Property Owner’s Name (Last, First) or Company Name
Mailing Address
Unit/Apt. #
City
State
Zip
Daytime Phone
Email Address
Inspection site address, if different
Unit/Apt. #
City
State
Zip
County
Electrical Power Company / Serving Utility
Description of work being done (Example: Adding outlets in the kitchen – second floor break area)
Directions to the property L&I will be inspecting (From the nearest main street, highway or intersection)
F500-130-000 Electrical Fee Worksheet Commercial/Industrial01-2017Page 1 of2
Electrical Fees Worksheet
Commercial/Industrial
Fees Effective January1, 2017
Select the largest in Section 1 below if present in your
installation. Only select more than one in Section 1 if
multiple services are being installed. The fees in
Section 2 apply only if a fee from Section1 is
selected
1
New Service, Largest New Feeder or
Transformer Primary or Secondary, (New
service feeincludes circuits, no feeders. Feeder
feesinclude circuits)
Item
Fee
Quantity
0 – 100 amps
$101.60
101 – 200 amps
$123.70
201 – 400 amps
$238.20
401 – 600 amps
$277.60
601 – 800 amps
$359.10
801 – 1000 amps
$438.40
Over 1000 amps
$478.30
2
Additional New Feeder or Transformer
Primary or Secondary(Ifinspected at the same
time
2
as largest new service or feeder)
0 – 100 amps
$62.00
101 – 200 amps
$79.00
201 – 400 amps
$94.20
401 – 600 amps
$110.80
601 – 800 amps
$151.00
801 – 1000 amps
$182.70
1001 + amps
$255.00
Select the largest in Section 3 belowif present in your
installation. Onlyselect morethan one in Section 3if
multiple services are being installed. The fees in
Section 4 apply only if a fee from Section 3 is
selected
3
New Temporary Service or LargestTemporary
Feeder, (Temporary stage,concert productions,
load tests, etc.)
0 – 60 amps
$54.30
61 – 100 amps
$62.00
101 – 200 amps
$79.00
201 – 400 amps
$94.20
401 – 600 amps
$126.30
Over600 amps
$143.30
4
Additional Temporary Feeder: If inspected at
the same time as above.
0 – 60 amps
$27.80
61 – 100 amps
$30.10
101 – 200 amps
$39.20
201 – 400 amps
$46.80
401 – 600 amps
$62.00
Over 600amps
$71.30
Over 600 Volts Surcharge(One feeper permit)
Item
Fee
Quantity
Service or Feeder
$79.00
Altered Service or Feeder (No circuits) (Does
includes circuit alterations within alteredservice or
feeder distribution equipment)
0 – 200 amps
$101.60
201 – 600 amps
$238.20
601 – 1000 amps
$359.10
1001 + amps
$398.90
Circuits (added or altered)
Per Panel (up to 5)
$79.00
Each additional
$6.60
Yard Pole, Pedestal, or other Metering
Each inspected separately
$62.00
Each inspected withthe
service
1
$14.50
Meter/Mast
Meter/mast repair or
maintenance, no service
or feeder alteration
$86.30
Irrigation Machines, Pumps, and Equipment
Each tower: Inspected with
theservice
1
$6.60
1 – 6 towers: Not
inspected withtheservice
1
$94.20
Each additional
$6.60
Signs/Outline Lighting
First sign only
$46.80
Each additional sign
$22.10
Generators - Portable With Permanent Transfer
Equipment. (Use thecorrespondingnew feeder fee
in Section 1 (or 2 whenapplicable)for permanent
generatorinstallations,including wind,photovoltaic,
and other generating systems orforportable
generatorsw/permanenttransfer equipmentlarger
than 100 amps)
Up to 100 amps
$86.30
Berth at a Marina or Dock
First berth
$62.00
Each additional
$39.20
Thermostat (Class 2 low-voltage)
(Low-voltage controls for standalone HVAC systems)
First thermostat
$46.80
Each additional
$14.50
F500-130-000 Electrical Fee Worksheet Commercial/Industrial01-2017Page 2 of2
Alarms, and Other Low-VoltageSystems(Class 2
or 3)
Item
Fee
Quantity
Installations: First 2,500 sq.
ft.
$54.30
Each additional 2500 sq.ft.
$14.50
Enter Total Sq. Ft.
Telecommunications
Installations: First 2,500 sq.
ft.
$54.30
Each additional 2500 sq.
ft.
$14.50
Enter Total Sq. Ft.
Annual Permit: Up to 2 hours
of inspection time
$188.80
Each additional hour$94.20
Carnivals, Concessions, & Rides
First carnival field inspection each calendar year
Carnival:Each ride and
generator truck
$22.10
Each additional
$6.60
If the calculated fee for first
carnival field inspection
above is less than $100.50
the minimum inspection fee
will be:
$118.60
Subsequent carnival inspections
Carnival:First 10 rides,
games, generators, etc.
$118.60
Each additional
$6.60
Concession(s) or ride(s) not part of a carnival
Non-Carnival: 1
st
field
inspection each year of a
single concession or ride,
not part of a carnival
$94.20
Non-Carnival:Subsequent
inspection of a single
concession or ride, not part of
a carnival
$62.00
AnnualIndustrialPermit: (Electrical maintenance
permit for all types of facilities)
Item
Fee
Quantity
1 – 3 Electricians
$2,284.20
4 – 6 Electricians
$4571.00
7 – 12 Electricians
$6,856.20
13 – 25 Electricians
$9,143.00
Over 25 Electricians
$11,429.80
Progress Inspection:Each ½ hour
Progress inspection:
(Use progress inspection
fees to support the number
of inspection trips when
other fee items on the
permit do not support
enough inspection trips.)
$46.80
Emergency Inspection Surcharge
Inspection requested for
outside of normal working
hours. Surcharge in
addition to regular line
item permit fees.
(Inspection must be
prearranged with local
office inspection
supervisor)
$118.60
OtherInspections
Inspectionsof a kindnot
covered by regular
inspection fees are
charged portal-to-portal
per hour:
$94.20
Property Owner Requested Inspection of an
Existing Installation
(Not a permit that allows installation or repair)
Up to one hour of
inspection time
$94.20
City Surcharge
3
City of Auburn
25% of total L&Ifees
City of Shoreline
20% of total L&I fees
Notes:
1
"Inspected with the service"means that a service inspection fee is included on the same electrical work permit.
2
"Inspected at the same time"means all wiring is to be ready for inspection during the initial inspection trip
3
Include city surchargesin addition to L&I feesifinsidethe cities of Auburn orShoreline.
If paying by check, make payable to: Department of Labor and Industries.
Need multiple inspections? Permits where thefeeitemis less than $93.59do not support more thanone inspection trip.
Addprogress inspection fees to support more inspections if your fee does not supportinspections needed to complete the
inspection process.
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F500-133-000 1,2,and Multifamily Residential Electrical Fee Worksheet 01-2017
1, 2, and Multifamily Dwelling Residential
Electrical FeeWorksheet
Fees Effective January 1, 2017
1
1 or 2 Family Dwelling - New Square Footage
(Includes service, feeders &circuitswithindwelling)
Item
Fee
Quantity
First 1,300 sq. ft.
$94.20
Each additional 500 sq. ft.
$30.10
New square footageincludes attached garage, basement,
unfinished spaces, etc.
Enter Total Sq. Ft.
Other Fees/Inspections
*Hot tub, spa, or sauna
$62.00
Inspected with service
1
$39.20
*Septic pumping system
$62.00
Inspected with service
1
$39.20
*Swimming pool
$94.20
Inspected with service
1
$62.00
*Outbuilding or Detached Garage
Inspectedat the same time
2
$39.20
Inspected separately
$62.00
* If not includedon a permitwith dwellingnew square
footage, use appropriate circuit or feeder feelineitem.
2
Each New Service or Largest Feeder (Multifamily
residential, and miscellaneous residential structures)
0 – 200 amps$101.60
201 – 400 amps$126.30
401 – 600 amps
$173.50
601 – 800 amps
$222.70
801 + amps
$317.60
AdditionalFeeder(s)(If inspected at the same
2
time as
a new service or largest feeder)
0 – 200 amps
$30.10
201 – 400 amps
$62.00
401 – 600 amps
$86.30
601 – 800 amps
$118.60
801 + amps
$238.20
3
Otherfee items not included in 1 & 2 above
Altered Service or Feeder (Includes circuits)
0 – 200 amps
$86.30
201 – 600 amps$126.30
601 + amps$190.40
1
"Inspected with the service"means that a service
inspection fee is included on the same electrical work
permit.
2
"Inspected at the same time"means all wiring is to
be ready for inspection during the initial inspection trip
Circuits (Added or altered)
Item
Fee
Quantity
Per Panel (up to 4)
$62.00
Each additional circuit
$6.60
Alarms, Telecommunications, and Other LV Systems
First 2,500 sq. ft.$54.30
Each additional 2,500 sq. ft.$14.50
Square footage includes attached garage, basement,
unfinished spaces, etc.Enter Total Sq. Ft.
Thermostats
(Low voltage control for standalone HVAC systems)
First Thermostat
$46.80
Each additional thermostat
$14.50
Generators
Portable:
Permanent transfer equip.
$86.30
Permanent:0 – 200 ampfeeder
$101.60
Each additional feeder
$30.10
Permanent:201 – 400 ampfeeder
$126.30
Each additional feeder
$62.00
TemporaryService or Feeder
0 – 60 amps
$54.30
61 – 100 amps$62.00
101 – 200 amps
$79.00
Meter/Mast
Meter/mast: Repair or replacement
$46.70
Yard pole meter loop$62.00
Remote meter equipment
(Inspected with service/feeder)
$14.50
Manufactured/MobileHomes
Service & Feeder (Inspected together)$101.60
Service or Feeder only$62.00
First MH/RV PARK site service or
feeder
$62.00
Each additional
2
$39.20
Progress Inspection: Each ½ hour
Progress Inspection$46.80
Property Owner RequestedInspectionof an Existing
Installation
Up to one hour
$94.20
Note: No installation or repair can be made with this permit
•Permit fees must support the number of inspections
needed. Additional progress inspection fees may be
necessary
•City surcharges in addition to L&I fees apply within
Auburn (25%)orShoreline (20%)
•If paying by check, make payable to:
Department of Labor and Industries.
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