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08-101833RECENF «� APR 17 2008 '' :. _ z) Federal way PI'I` Eax+uulvrrrnEVE R -' I ' -- SF MF CO ME EL PL DE EN 9FPFE®E,�.IH:L _ �'"I.. N FEDERAL WAY, WA 98063-9718 253-835-2607• FAX 253-835-2609 C®S 'rl""+-era i emh�wr mm •.s , 1 � The following is required information - an incomplete applica 'on will not be accepted. Please print legibly (in ink) or type. SITE ADDRESS 336G/-5- Z07qA Ave � pp SUITE/UNIT # ASSESSOR'S TAX/PARCEL 0 27 / z: / Q - 1 Q d LOT SIZE (sfl LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) 5e.-- We (Attach separate page for lengthy legal description) PROJECT• • TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ir`FIR, PREVENTION SYSTEM description of work included on this Dermit onlu) PROJECT NAME (Name of Business or Owner Last Name) [�N✓1A N f u / G �1'h`�� PROPERTY OWNER CONTRACTOR APPLICANT PROJECT CONTACT LENDER EXISTING USE E PEOPLE INFORMATION NAME • '/ PRIMARY PHONE WILLNG ADDRESS Z - A �� . CITY. STATE, ZIP klx MAIL ADDRESS m -6 � C014PANY NAME 6e r APPUCANT NAME �� o ce OFFICE PHONE (z53) `/35 - 3 _� 9Z n . sT�� ZIP e CEILLPHONE I-I59 artr � e Wil (03-3) - RCI,ATIONSHIPTO PROJECT Tenant �rlt Other FAX NUMBER (7-53 ) tiVK - 3/S ❑ Architect ❑ ❑ NA34EE PRIMARY PF O E E-MAIL ADDRESS NAME Per RCW 19.27.095. Lender information is required Uprojeet value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP PHONE PROPOSED USEG`k^J"1IV1 ti EXISTING ASSESSED/APPRAISED VALUE $ G S VALUE OF PROPOSED WORK $ oco SPRINKLERED BUILDING? © NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? et>lf�S- ❑ NO WATER SERVICE PROVIDERN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER N 0 HIGHLINE ❑ PRIVATE (SEPTIC) f PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING S . FT. PROPOSED S . FT. TOTAL S . FT. BASEMENT FIRST SECOND Idair"n«� rQ i✓e tt. [ /7,9?7 987 THIRD ADDITIONAL FLOORS (DESCRIBE) DECK (❑ COVERED OR ❑ UNCOVERED?) GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS Exec PROP08ED TOTAL Z 10M, E?W TOTAL PROPOSED SF /�7Or SF **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ AIM Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. Value of Mechanical Work AIR HANDLING UNITS BBQS BOILERS COMPRESSORS DUCTS BATHTUBS (or'hb/Shower Combo) DISHWASHERS DRINKING FOUNTAINS ELECTRIC WATER HEATERS HOSE BIBBS (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) EVAPORATIVE COOLERS FANS FIREPLACE INSERTS FURNACES GAS LOG SETS LAVS (Bathroom Sinks) RAINWATER SYST SHOWERS SINKS SUMPS GAS PIPE OUTLETS GAS WATER HEATERS HOODS (Commemiai) RANGES REFRIG. SYSTEMS URINALS VACUUM BREAKERS WATER CLOSETS (rmiet) WASHING MACHINES WOODSTOVES MISC (Describe) MISC (Describe) I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized 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 Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense 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 officers and employees, upon the accuracy of the information supplied to the city as a part of this application. SIGNATURE: and/or Authorized FOR OFFICE USE ONLY ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑ YES ❑ NO BASIC PLAN? ❑ YES ❑ NO ZONING DESIGNATION CHANGE OF USE? ❑ YES ❑ NO NEW ADDRESS REQUIRED? ❑ YES ❑ NO UP/SEPA/SU? o YES ❑ NO PLATTED LOT? ❑ YES ❑ NO DEMO PERMIT REQUIRED? ❑ YES ❑ NO Bulletin #100 - January 1, 2008 Page 2 of 4 k\Handouts\Permit Application RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCLAL/INDUSTRLAL SERVICE ❑ Single Family Square Feet Service or Feeder Each Add'n (First 1300 ft2- $115.50; Each add'n 500 ft2 - $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 ❑ 601 - 800 amp 439.00 186.00 ❑ 801 - 1000 amp 536.50 224.50 NEW MULTI -FAMILY (three units or more) ❑ 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 ❑ 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 ❑over 1000 amp 489.00 ❑ 0 to 200 amp $ 96.00 ❑ 201 - 600 amp 155.50 ❑ # of circuits to be added/altered ❑ over 600 amp 234.00 (1-5 circuits - $98.00: Add'n 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 35% of Permit Fee ❑ Service - 1,000 amps or greater ❑ Mast or meter repair $57.50 ❑ Medical/Educational/Institutional Facility MANUFACTURED HOMES ❑ Service or feeder only $76.50 ❑ Service and feeder $125.50 TEMPORARY SERVICE MOBILE HOME/RV PARK Residential/Multi-Family $67.50 ❑ # of service or feeders (First service/feeder-$76.50; each add'n-$50.00) Commercial/Industrial 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'n-$17.50/ea) (First sign-$57.50; add'n sign $27.00/ea) ❑ Low Voltage ❑ Swimming pool/hot tub ................ $115.00 Square Feet to be served by system(s) (Includes additional circuit, if required) ❑ Fire Alarm System ❑ Yard Pole meter loops ..................... $76.50 ❑ Security Alarm System ❑ Additional Plan Review $115.00/hour ❑ Voice Cabling (for modified submittals) ❑ Data Cabling ❑ Automation Fee on all Permits .. $5.50 11 lst 2500 ft2-$67.50; Each add'n 2500 ft2 - $17.50) • Per WAC 296-46-910(5)(bJ(i & U) Bulletin #100 -January 1, 2008 Page 3 of 4 k\Handouts\Pennit Application