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05-102474CITY OF A �� t•r � • � � - � �� .--I- Federal Way 'PERMIT COMMUNITY DEVELOFMEATSERVICES SF MF CO ME EL PL DE EN FP 333268^IRALWAVENUE SOUTH •PoBOX 9718 App.LI ATI ' 2U�5 FEDERAL WAY, FAX 53-8 3 -260 253-835-2607• FAX 253-835-2609 (iTY OF FEV. 'Gi Y OF f'i06AAL WAS r.-_ The ollourin is uFi13{/S' r�rt pf u6[rirrccai n Iicu#on url�o�ta�ire ted. Please rirzt [e I (in i nr e. PROPERTYI SITE ADDRESS 7 �L17 S a Ofy) -,4v-e Is. ^~ ,�� SUITE/UNIT # ASSESSOR'S TAX/PARCEL # - O LOT SIZE (sf) L S LEGAL DESCRIPTION (e.g. Acme Estates, (Attach aepareta pagefw lengthy legal d—lptlon) TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING •FIRE PREVENTION SYSTEM DESCRIPTION (Provide detailed description of work included on this Permit onlul PROJECT NAME (Name of Business or Owner Last Name) PROPERTY OWNER CONTRACTOR APPLICANT ••••• •••••••-• nrrl.tu9rit nnlnt; OFFICE PHONE f��itae C� r o t°� r• � •�•-(�t s ►�ru r� MAILING A DRESS Cr Y, STATE, ZIP - CELL PRONE )-3 u; Sufi 4,c 4 I ?,Az el [IV _-... .. .... FAX NUMBER j ❑ Architect ❑Tenant AAgent ❑Other (Describe) {� j1V ,� _ -3 /� PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING S . FT. PROPOSED S . FT. TOTAL S . FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS (DESCRIB DECK (COVERED?) GARAGE a CARPORT O i l NUMBER OF FLOORS rMSTING O►*=D TOTAL " nmtR MSTOO TOTAL PROPOs^ Sr TOTAL 6r "NEWHOMES ONLY** NUMBER OF BEDROOMS ESTIMATED LING PRICE $ Indicate number of each type of fixture to be installed or Value of Mechanical Work AIR HANDLING UNITS BBQS BOILERS COMPRESSORS DUCTS PLUMBING BATHTUBS (Tub/shower DISHWASHERS GAS PIPE OIJTL WASHING MA INES LAVS f0xehrnnm si w part of this project. Do not include existing fixtures to remain. EVAPO1; COOLERS GAS LOGS FANS ODDS (Commercial( INSERTS GAS PIPE OUTLETS SHOWERS SINKS SUMPS URINALS VACUUM BREAKERS GAS WATER HEATERS WATER CLOSETS rrnlir] DRINKING FOUNTAINS RAINWATER SYST HOSE BIBBS ELECTRIC WATER HEATERS REFRIG. SYSTEMS WOODSTOVES MISC (Describe) MISC (Describe) I Certify udder 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 the above 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 an claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of such claim), which may be made by any pe on, including the undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of the city, incl ing its officers and employees, upon the accuracy of the information supplied to the city as apart of this application. NAME/TITLEl,L _ J, ,.L#i /V// _ DATE (Signature) ITittcl / RELATIONSHIP TO PROJECT ❑ Owner WAKent ❑ Contractor ❑ Architect ❑ Other F,illt'OFi IC :n..NEw In ADDITION n ALTERATION 6 REPAIR o TENANT IMPROVEMENT` -BUILDING SHELL ONLY? _ .. Li.YES o NO BASIC PLAN? • ❑ YES u NO -- ZONING'DESIGNATION CHANGE OF USE? a YES a NO _ NEW -ADDRESS REQUIRED? ❑ YES n NO UP/S.EPA/Sid? ❑ YES ❑ NO y 4 - :•PLAt"FFT LO i ?, ', .: rg YES LINO — Y -_ DEMO PERMIT REQUIRED?^ ri YES QNO Bulletin #100 —January 7, 2005 Page 2 of 4 k\Handouts\Permit Application I K= = M This is an overview of possible -fees associated with the issuance of permits and is not intended to be inclusive. PERMIT FEES Building, mechanical, and fire prevention system fees are based on the following schedule. ** Electrical and plumbing fees are calculated separately ** TOTAL P�OJECT VALUATION iNCRLMENTAL FEE FACTOR (1) $1.00 to $500.00 (1) $31.00 (2) $501.00 to $2,000.00 (2) $31.00 for the First $500.00 plus $4.00 far each additional $100_00 or fraction tl irrraf, to and including $2,000.00 (3) $2,001.00 to $25.000.00 (3) $91.00 for the First $2,000.00 plus .$]8_50 for each additional $1,000-00 or fi artion thereof, to and including $25,000.00 (4) $25,001.00 to $50.000.00 (4) $516.50 for the first $25,000.00 plus 73-50 for each additional $2,000..00 or fraction thereof, to and including $50,006.00 (5) $50,001.00 to $100,000.00 (5) $854.00 for the fast $50,000.00 plus $9.00 roreach additional $1,000.00 or fraction thereof, to and including $100,000.00 (6) $100,001.00 to $500,000.00 (6) $1,304.00 for the fast $100,000.00 plus $7.50 for each_ odditional $1,000.00 or fraction thereof, to and including $500,000.00 (7) $500,001.00 to $1,000,000.00 (7) $4,304.00 for the Sat $500,000.00 plus $6.00 for each additional $,1,000.00 or fraction thereof, to and including $1,000,000.00 (8) $1,000,001.Ob and up (8) $7,304.00 for the first $1,000,000.00 plus 45_00jar each additional $1.000, 00 or fraction thereof. Table A PLAN REVIEW FEES • Building Permit 65% of Building Permit Fees ■ Mechanical Permit 25% of Mechanical Permit Fees • Plumbing Permit 65% of Plumbing Permit Fees • Additional Building Division Review $63.50/hour PLUMBING PERMIT FEES • $26.50 Permit Fee plus $9.00 per OTHER FEES (Vary according to project typ and scope) • WA State Building Code Council (SBCC)urchargt ■ Fire District #39 review fees (commercial ply) • Public Works review fees • School District impact Fees (new residential gnly) • Automation fee on all permits • Demolition permit fees • Required bond(s)/deposits $4.50/issued permit 15% of building permit fees Hourly/varies by project $3,011.50/single-family residence $950.50/multi-family unit $5.00 If you need assistance completing the permit application form, or have questions concerning the application process, please contact: Com unity Development Customer Service Counter at (253) 835-2607 7 8:00 am to 5:00 pm, Monday through Friday Bulletin #100 —January 7, 2605 Page 4 of 4 k\Handouts\Pefmit Application E.tTRICAL PERMIT INFORMA N RESIDENTIAL ❑ Single F y Square Feet (First 1300 ft $104.50; Each add'n 500 ft2 - $33.50) ❑ Detached outb 'ding or garage (Inspected wi ervice) $44.00 ❑ Detached outbuildin r garage (Inspected separate $69.50 NEW MULTI -FAMILY (three its or more) Serve a Feeder ❑ Up to 200 amp $113.50 $ 33.50 ❑ 201 - 400 amp 141.00 69.50 ❑ 401 - 600 amp 19&00 96.00 ❑ 601 - 800 amp 247.00 132.00 ❑ Over 800 amp 353.50 264.50 ALTERED SINGLE/MULTTI FAMILY Service or Feeder ❑ 0 to 200 amp $ 87.00 ❑ 201 - 600 amp 141.00 ❑ over 600 amp 212.50 ❑ # of circuits to be added/altered (1-4 circuits-$69.50; Add'n circuits $7.00/ea) ❑ Mast or meter repair $52.00 MOBILE HOMES ❑ Service or feeder only $69.50 ❑ Service and feeder $113.50 MOBILE HOMk]/RV PARK ❑ # of service or feeders (First service/feeder-$69.50; each add'n-$45.Ooj COMMERCIAL NEW COAUMMRCIAL/INDUSTRIAL SERVICE ❑ 0 to 100 amp ❑ 101 - 200 amp ❑ 201 - 400 amp ❑ 401 - 600 amp ❑ 601 - 800 amp ❑ 801 - 1000 amp ❑ Over 1000 amp Service or Feeder Each Add'n $113.50 $ 69.50 141.00 89.00 264.50 104.00 30&00 123.50 398.50 168.50 486.50 203.50 530.50 283.00 ❑ Over 600 Vol, surcharge $89.00 It ❑ Mast or meter repair $96.00 ALTEREb .COMMERCIAL) NDiISTRIAL Service or Feeders ❑ 0 to 200 amp $113.50 ❑ 201 - 600 amp 264.50 ❑ 601 - 1000 amp 398.50 ❑ over 1000 amp 443.50 ❑ # of circuits to be added/altered (1-5 circuits - $89.00; Add'n circuits, $7.00/ea) COMMERCIAL/INDUSTRIAL PLAN REVIEW $89.00 plus 35% of Permit Fee ❑ Service - 1,000 amps or greater ❑ Medical/Educational/Institutional Facility 4 TEMPORARY SERVICE ResidentiaVMu-Famiry $61.00 CommerciaWndus'trial Service or Feeder Ampacity ❑ 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 Thermo ats (First-$52.00; ad-$16.00/ea) ❑ Low Voltage Square Feet t he served by system(s) ❑ Fire Al ystem ❑ Security Alarm System ❑ Voice Cabling ❑ Data Cabling 11 (Per System(s) 1•t 2500 ft2-$61.00; Each add'n 2500 W-16.00) `Per WAC 29646-910(5)(6)(i & ii) ❑ # of Signs (First sign-$52.00; add'n sign $24.50/ea) ❑ Swimming pool/hot tub ......'.......... (includes additional circuit, if required) ❑ Yard Pole meter loops. . ................... ❑ Additional Plan Review (for modified submittals) ❑ Automation Fee on all Permits $87.00 $1,04.50 $104,.50/hour $5.00 Bulletin #100 -January 7, 2005 Page 3 of 4 k\Handouts\Permit Application