08-100376care.RECE VED PERMIT 3-7
- y_ o
COMWfffYDBMOPWWSERVr.KS JAN 2 2008 SF MF CO Mo PL DE EN FP
33395 STM AVEWA SOUTH • PO BOX 9718 U t.. T T ��y
FBDERAL WAY, WA 94063 {p�J/'1��LJ ,IW -
953435 -9607- FAX 953 439 O F FE A I O N
Luurw.dtun/fedemiwau.com DD
The following is required inforr O- an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS� J �/�Uff01 T i
ASSESSOR'S TAX/PARCEL # 02 .2 0 -3 LOT SIZE (sj) r
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) ; e-qgd
■ PROJECT INFORIIIATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION PLECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTI N (Provide detailed description of work included on
- - - F- L� r`A t e ( ire -w yr e
PROJECT NAME (Name of Business or Owner Last Namele
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING} USE
■ PEOPLE INFORATATION
NAME^
1�•.�J aLkrc�,
PRIMARY PHONE
OFFICE PHONE
( 204 ) 32, -
( ) - 2 Y
MAIUNO ADDRESS �� CITY. STATE, ZIP
E-MAILADDRESS
LV Ll -5L w w i
PAX NUMBER
COMPANY NAME
� 1, Lw .0, Cc.,
APPLICANT NE
UI L T L. �..� sa
OFFICE PHONE
( 204 ) 32, -
MAIUNO ADDRESS
N 3 M
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
PAX NUMBER
CITY OF FEDERAL WAY BUSINESS UCENS NUM ER
EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S REOISTRATION NUKUR
ERPIRATION DATE
EMAIL ADDRESS
v\ICCSc MQ�LtA
k -L-1 k J
ANY NAMNAME
�r�
OFFICE PHONE
) -
MAIUNO ADDRESS ,STATE, ZIP
CELL PHONE
PHONE
-
RELATIONSHIP TO PROJECT
PAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( ) -
NAME PRIMARY PHONE EMAIL ADDRESS
C- �11 AJ C-- 6 r I ( ) -
NAME
Per RCW 29.27095.
Lender Wormation is required(rpr+oje-et varus exceeds $5,000
MAIUNO ADDRESS
CITY. STATE, Zip
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE iSEPTICI
AREA DESCRIPTION
EXISTING
. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
o YES o NO
BASIC PLAN? a YES
a NO
FIRST
CHANGE OF USE? a YES
a NO
SECOND
a YES o NO
IIP/SEPA/SII? a YES
a NO
THIRD
a YES a NO
DEMO PERMIT REQUMD? o YES
a NO
ADDITIONAL FLOORS (DESCRIBE)
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
°
rsorosm
F TOTAL
TOTAL220 "M ar
TOTAL rea+oseoeT
Tarecsr
`*NEW HOMES ONLY"' NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fudures to remain.
Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED W17H APPLICA770N)
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS.
BATHTUBS 1--/si..c."
DISHWASHERS
DRINKING -FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
LAVE (B-. sing
RAINWATER SYST
SHOWERS
SINKS
SUMPS
GAS PIPE OUTLETS
GAS WATER HEATERS
HOODS (commas y
RANGES '
REFRIG. SYSTEMS
URINALS
VACUUM BREAKERS
WATER CLOSETS (www
WASHING MACHINES,
WOODSTOVES
MISC (Describe)
MISC (Describe)
I onto under ponauy of perjury that I am the property owner or authorised agent of the property owner. I cerft that to the best of my
knowledge, the bVbrmation submitted in support of this permit application is true and corrnt. I cert(/t that I will comply with all applicable
City qf hderal Way regulations pertaining to the work authorised by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws.
I further agree to hold harmless the City of lUderal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the
investigation and dofense of such claim), which may be made by any Person, including the undersigned, and filed against the city, but only
where such claim arises out of the reliance of the city, including its offlcem and employees, upon the accuracy of the information supplied to
the city as apart of this application. n
SIGNATURE:
or Authorized
a NEW o ADDITION
a ALTERATION
a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN? a YES
a NO
ZONING DESIGNATION
CHANGE OF USE? a YES
a NO
NEW ADDRESS REQUIRED?
a YES o NO
IIP/SEPA/SII? a YES
a NO
PLATTED LOT?
a YES a NO
DEMO PERMIT REQUMD? o YES
a NO
Bulletin #100 — January 1, 2008 Page 2 of 4 k\Handouts\Pemtit Application
RESIDENTIAL
COMMERCIAL
NEW. RESIDENTIAL AL ERVICE
NEW COMMERCIAL/IND-USTRIAL SERVICE
(
Single Family Square Feet
Service or Feeder Hach Add'n
(First 1300 ft2- $115.50; Each add% 500 ftl - $37.00)
❑ 0 to 100 amp $125.50 $ 76.50
❑ Detached outbuilding or garage
❑ 101- 200 amp 155.50 98.00
(Inspected with service) $48.50
❑ 201- 400 amp 291.00 115.00
❑ Detached outbuilding or garage
❑ 401- 600 amp 339.50 136.00
(Inspected separately) $76.50
13 601- 800 amp 439.00 186.00
❑ 801 - 1000 amp 536.50 224.50
NEW MULTI -FAMILY (three units or more)
Q. Over 1000 amp 584.50 311.50
Service Feeder
❑ Up to 200 amp $125.50 $ 37.00
❑ Over 600 volts surcharge $98.00
❑ 201 - 400 amp 155.50 76.50
❑ Mast or meter repair $106.00
❑ 401 - 600 amp 212.50 106.00
13 601 - 800 amp 272.00 145.50
ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 389.50 291.00
Service or Feeders
❑ 0 to 200 amp $125.50
ALTERED SINGLE/MULTI FAMILY
❑ 201 - 600 amp 291.00
❑ 601 - 1000 amp 439.00
Service or Feeder
❑ 0 to 200 amp $ 96.00
❑over 1000 amp 489.00
❑ 201 - 600 amp 155.50
❑ # of circuits to be added/altered
❑ over'600 amp 234.00
(1-5 circuits - $98.00; Add% circuits, $7.50/ea)
❑ # of circuits to be added/altered
COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits -$76.50; Add'n circuits $7.50/ea)
$98.00 plus 359/0 of Permit Fee
❑ Service - 1,000 amps or greater
❑ Mast or meter repair $57.50
❑ Medical/Educational/lnstitutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $76.50
❑ Service and feeder $125.50
TEMPORARY SERVICE
NORMS ROME/RV PARK
ResfdentfaVXuit(-Fanny $67.50
❑ # of service or feeders
(First service/feeder-$76.50; each add% -$50.00)
CommereftWndustrlal Service or Feeder Ampacity
❑ 0 -100 amps $ 76.50
❑ 101- 200 amps 98.00
❑ 201- 400 amps 115.00
❑ 401- 600 amps 155.50
❑ over 600 amps 168.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats
❑ # of Signs
(First -$57.50; add%-$17.50/ea)
(First sign -$57.50; add% sign $27.00/ea)
❑ Low Voltage
❑ Swimming pool/hot tub ................ $115.00
Square Feet to be served by system(a)
(Includes additional circuit, if required)
0 Fire Alarm system
❑ Yard Pole meter loops ..................... $76.50
13 Security Alarm system
❑ Additional Plan Review $115.00/hour
13 voice Cabling
17 Data Cabling
(for modified submittals)
13
❑ Automation Fee on all Permits .. $5.50
1- 2500 ft2-$67.50;
Each add% 2500 W - $17.50) • Per WAC 29646.910(5)(b)(t & it)
Bulletin #100 - January 1, 2008 Page 3 of 4 k\Iandouts\Permit Application
This is an overview of possible fees associated with the issuance of permits and is not intended to be inclusive.
BUILDING, MECHANICAL ds FIRE PREVENTION PERMIT FEES
-� Building, mechanical, and fire prevention system fees are calculated based on the following schedule.
—i Project valuation for new construction or additions is based on a set cost per square foot as determined by the
Building Official.
—► Valuation for remodels, tenant improvements, alterations, etc. shall be provided by the applicant based on a
legitimate bid or cost estimate which reflects the fair market value of all elements of the project.
TOTAL PROJECT VALUATION
INCREMENTAL FEE FACTOR
(1) $1.00 to $500.00
(1) $34.00
(2) $501.00 to $2,000.00
(2) $34.00 for the first $500.00 plus $4.50 /breach additional $100.00
or fraction thereof, to and
including $2,000.00
(3) $2,001.00 to $25,000.00
(3) $101.50 forth* first $2,000.00 plus $20.50 for each additional 51.000.00
or fraction thereof, to
and including $25,000.00
(4) $25,001.00 to $50,000.00
(4) $573.00 for the first $25,000.00 plus $14.50 for each additional
51.000.00 or fraction thereof, to
and including $50,000.00
(5) $50,001.00 to $100,000.00
(5) $935.50 for the first $50,000.00 plus 81000 for each additional
S1 000 00 or fraction thereof, to
and including $100,000.00
(6) $100,001.00 to $500,000.00
(6) $1,435.50 for the first $100,000.00 plus $8.00 for each additional
$1.000.00 or fraction thereof,
to and including $500,000.00
(7) $500,001.00 to $1,000,000.00
(7) $4,635.50 for the fist $500,000.00 plus $7.00 for each additional
51.000.00 or fraction th , to
and including $1,000,000.00
(8) $1,000,001.00 and up
(8) $8,135.50 for the first $1,000,000.00 plus $5.50 for each additional
51.000.00 or action thereof.
a""Mn
PLAN REVIEW FEES
-i• Plan review fees are collected in addition to permit fees, based on a percentage ofp g associated permit fee
• Building Permit
• Mechanical Permit
• Plumbing Permit
• Fire Prevention Permit
• Fire review fees
• Additional Building Division Review
PLUMBING PERMIT FEES
• $29.50 Permit Fee: plus $10.00
65% of Building Pe 1Fees
25% of Mechanic Petrmit Fees
65% of Plumb' g Permit Fees
65% of Fire ermit Fees
15% of b ding permit fees
(Com rcial building permits only)
$70 0/hour
OTHER FEES (Vary according to pr ect type and scope)
• WA State Building Code Counc' (SBCC) Surcharge .......................$4.50/issued permit
• Public Works review fees.............................................................. $130.00 for new single family
................$782.00 for new commercial
• Zoning review fees .......................................................................$52.00 (residential only)
• School District im act fees (new residential only)...........................$4,077.00/single-family residence
................ $1.820.50/multi-family unit
• Automation fee on all permits ........................................................$5.50
If you need assistance completing the permit application form, or have
questions concerning the application process, please contact:
Community Development Customer Service Counter at (253) 835-2607
Bulletin #100 — January 1, 2008 Page 4 of 4 k\Handouts\Permit Application