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08-105438 • RECElfEDNOV 12 le° • nry OF �. A Federal wa � DL ERAL MIT SF MF CO ME EL PL DE ENO COMMUNITY DEVE PM n st' VIAD 3332FEDERAL WAY,W 0633 9O 189718 CD AP P LI CATI O N S 253-835-2607 FAX 253-835-260.9 WWW.ilgolfederoiwatl.corn The oUowin r is re•wired i ormation-an incom•lete •y•lication will not be acce•ted. Please • int le f.'•I (in ink)or � ^ • PROPERTY INFORMATION SITE ADDRESS 10 V 0 5 SUITE/UNIT# )i Ar ASSESSOR'S TAX/PARCEL# 9 q If y 14 q - 0./24)0.14,30 D 0 CC LOT SIZE(Si? LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) U I�`i#1t e 1?J 0 1- 6' Wi !Attach septi ale lepage',Ienyu•y Legal descriprmmtl ■ PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION ,ELECTRICAL 0 ENGINEERINGCFIRE PREVENTION SYSTEM P OJECT DESCRIPTION(Prde detailed description of work included on this permit only r I NL,.. A awe-ton �a✓t G �Ga.G.a_wteeal AM. Milli n PROJECT NAME(Name of Business or Owner Last Name) ``'' ti. ♦ i . PEOPLE INFORMATION PROPERTYN E PR MARY PHONE OWNER / Qizoi ovtoo (A53) 9N6-0320 MAILING ADDRF. CITY,STATE,ZIP �l$360 1 tj 4 t, .4 ue S raOera 1 w..}r LJ i1 , 98D0 3 CONTRACTOR COMPANY NAME APPLICANT NAME V K `FFICE PHON E OA& „L. c 64e veye� `�H03// MAILING ADDRESS SE.ZIP CELL PHONE /�/ W � , J CITY OF FEDERAL AY;U _wLICENSE NUMBER �rNu., leJA N ' FAX NUMBER -B L / / (253) 735'9976 CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE / / APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE MAILING *e.o�. M (i0r)5 75 -03U A ' va CELL PHONE 107 ✓ASklii..0L " 8fv) At2 0.4. (^14 /1961°1 RELATIONSHIP TO PROJECT V FAX NUMBER 0 Architect ❑Tenant ❑Agent XOther(Describe c25lj 735-11176 CONTACTPRIMARY PHONE N E MAIL AD NESS v� e ex 0.0(1) 5'1 ' 03!! A yt y� F;.c.-0 ..0 2. NAME LENDER ` ° c� t mi n ;x fa�[�itoa' 'W MAILING ADDRESS CITY.STATE.ZIP • DETAILED BUILDING INFORMATION EXISTING USE �y • PROPOSED USE ~` EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ (IPF L 7' So SPRINKLERED BUILDING? 0 YES (eNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES /NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) 1 • • PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. S9.FT. Sc).FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) 1 DECK(COVERED?) GARAGE 0 CARPORT❑ EXISTING PROPOSED TOTAL , NUMBER OF FLOORS4� t ?^r **NEW HOMES ONLY NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not Include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIC.SYSTEMS BBQS FANS HOODSIc,mmercu t WOODSTOVES BOILERS — FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCls GAS PIPE OUTLETS PLUMBING BATHTUBS Or Tub/Shower Combo) SHOWERS WATER CLOSETS rrmuen MISC(Describe) DISHWASHERS SINKS _ DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS TANS(Bathroom Sinks) VACUUM BREAKERS F.LRCTRIC 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 I • am authorized by the owner of t • he above premises to perform the work for which the permit application is made. 1 further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys fees incurred in the iiwe.stigation 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 ��t lel (/1Y DATE /V— 7-C t nature) (llt RELATIONSHIP T PROJECT 0 Owner 0 Agent "(Contractor ❑Architect ❑ Other ; ,r4,iza ti Inv i3--` Rti C l® *a'" t Pik§ , "� $ © 'hSCS. .v,ttwo t ..((�� ,F 6 as' ' .'" �* 6 v_ .k a yr Fna t SS� .: �n.M'-7a 3 sn st zx p ie ` ..".. .. �." "� i fiso�p d., Fitt ° .� �.r e s... a a '�,... �i.t: ✓ "� ...'�.'f :. ..aKx. ' Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts�Permit Application • ELECTRICAL PERMIT INFORMATION RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE 411 NEW COMMERCIAL/INDUSTRIAL SERVICE ❑ Single Family Square Feet Service or Feeder Each Add'n (First 1300 ft1-$104.50;Each add'n 500 fta-$33.50) ❑ 0 to 100 amp $113.50 $69.50 ❑ Detached outbuilding or garage ❑ 101-200 amp 141.00 89.00 (Inspected with service) $44.00 ❑ 201-400 amp 264.50 104.00 ❑ Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50 (Inspected separately) $69.50 U 601-800 amp 398.50 168.50 U 801-1000 amp 486.50 203.50 NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 530.50 283.00 Service Feeder ❑ Up to 200 amp $113.50 $33.50 ❑ Over 600 volts surcharge $89.00 ❑ 201-400 amp 141.00 69.50 ❑ Mast or meter repair $96.00 ❑ 401 -600 amp 193.00 96.00 ALTERED COMMERCIAL/INDUSTRIAL ❑ 601 -800 amp 247.00 132.00 ❑ Over 800 amp 353.50 264.50 Service or Feeders ❑ 0to200amp $113.50 ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 264.50 ❑ 601- 1000 amp 398.50 Service or Feeder ❑ over 1000 amp 443.50 ❑ 0 to 200 amp $87.00 ❑ 201 -600 amp 141.00 ❑ #of circuits to be added/altered ❑ over 600 amp 212.50 (1-5 circuits-$89.00:Add'n circuits,$7.00/ea) ❑ #of circuits to be added/altered COMMERCLAL/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 ❑ 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) Comm.ercial/Industrial Service or Feeder Ampacity U 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 lrst-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea) ❑ Swimming pool/hot tub $87.00 (Includes additional circuit•if required) 0 Yard Pole meter loops $104.50 • Secu Y.r` ystem ❑ Additional Plan Review $104.50/hour ❑ Voice Cabling (for modified submittals) 0 Data Cabling ❑ Automation Fee on all Permits .. $5.00 Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application