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09-102139AD • RE cEZ �lr aF f� Federal Way PERMIT �� 5 COMMUNITY DEVELOPMENT SERVICEJUN 10 2009 SF MF CO ME EL PL DE ENO 33325 8T" AVENUE SOUTH • � BOX 9718 FEDERAL WAY, WA 98063 -9718 253- 83207• Fiy 61 F F E E p �� I CATI O N V wu�uacituo((ec i.r nt The following is required tation -an incomplete application will not be accepted. Please print legibly (in ink) or type. PROPERTY •• • SITE ADDRESS ` y �� Tk S I • SUITE /UNIT # " ZO� ASSESSOR'S TAX /PARCEL # Z 6 S 0 % - ®O /0 LOT SIZE (sff) LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Attach separate page for Lengthy legal descriplioN TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION Bb!!8T!!!elffi ❑ ENGINEERING K FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu) IN.s;i-3rr Add;F'CWA( AIL076Crion/ A,-t-4 NOT /AieA.-i©,✓ m 6-X,57-iwc F /fZG' 6c-V ZOL 2/3veZ PROJECT NAME (Name of Business or Owner Last Namel 1_�CIV I Al 5 U & A T!L UC'< CIA/61Z PEOPLE •• • PROPERTY OWNER CONTRACTOR APPLICANT PROJECT CONTACT LENDER EXISTING USE COMPANY NAME MEfL( &AJ , d-96C APPLICANT NAME �� 5ra�%� so,J CITY, STATE, ZIP OFFICE PHONE (25 ) 638 - r 7F4 MAILING ADDRESS P - 6ox 71-71 CITY, STATE, ZIP KffArr Ij A 980eiz CELL PHONE ( ) - RELATIONSHIP TO PROJECT ❑ Architect ❑ Tenant ❑ Agent )(Other l]N %�Gj FAX NUMBER (2$3) 63,63 - ON6 NAME PRIMARY PHONE E -MAIL ADDRESS NAME Per RCW 19.27.095: Lender information is required if project value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP /PHONE l ) — EXISTING ASSESSED /APPRAISED VALUE SPRINKLERED BUILDING? ❑ YES )kNO PROPOSED USE VALUE OF PROPOSED WORK $ Rf c co FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) • • AREA DESCRIPTION EXISTING S . FT. PROPOSED S . FT. TOTAL S . FT. BASEMENT GAS WATER HEATERS MISC (Describe) BOILERS FIREPLACE INSERTS FIRST COMPRESSORS FURNACES RANGES SECOND GAS LOG SETS REFRIG. SYSTEMS CHANGE OF USE? THIRD ❑ NO • YES ❑ NO UP /SEPA /SU? ADDITIONAL FLOORS (DESCRIBE) ❑ NO • YES ❑ NO DEMO PERMIT REQUIRED? DECK (❑ COVERED OR ❑ UNCOVERED ?) ❑ NO GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS Es�sxrnc rnoeoseo zoxnL Tarnrsrnvcsr ToracrxorosFnsF TOTAL SF * *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 fixtures to remain. Value of Mechanical Work (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC (Describe) BOILERS FIREPLACE INSERTS HOODS (Commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG. SYSTEMS BATHTUBS (or l)jb/Sho —r Combo) DISHWASHERS DRINKING FOUNTAINS ELECTRIC WATER HEATERS HOSE BIBBS LAVS (Bathroom Sinks) URINALS MISC (Describe) RAINWATER SYST VACUUM BREAKERS SHOWERS WATER CLOSETS crone) SINKS WASHING MACHINES SUMPS I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certiN 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 sic claim), which may be made by any person, including the undersigned, and filed against the city, but only where such claim arisgs out oft tpefiance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part t applica on` SIGNATURE: ❑ NEW ❑ ADDITION BUILDING SHELL ONLY? ZONING DESIGNATION NEW ADDRESS REQUIRED? PLATTED LOT? & -9 -ZC09 Property Owner and /or Authorized Agent ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT ❑ YES ❑ NO BASIC PLAN? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO • YES ❑ NO UP /SEPA /SU? ❑ YES ❑ NO • YES ❑ NO DEMO PERMIT REQUIRED? ❑ YES ❑ NO Bulletin #100 —January 1, 2009 Page 2 of 4 k\Handouts\Permit Application • *NOTE: an automation fee of $6.00 will be charged for all permits. RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCIAL /INDUSTRIAL SERVICE ❑ Single Family Square Feet Service or Feeder Each Add'n (First 1300 ft2- $121.00; Each add'n 500 ftz - $39.00) ❑ 0 t0 100 amp $131.50 $ 80.00 • ❑ 101 - 200 amp 163.00 103.00 Detached outbuilding or garage (w/ service ) ......................... $51.00 L3 201 - 400 amp 305.50 120.50 • Detached outbuilding or garage (inspected separately) ......... $80.00 ❑ 401 - 600 amp 356.00 142.50 • Swimming pool (w /service) .................. ............................... $80.00 ❑ 601 - 800 amp 460.50 195.00 ❑ Swimming pool (inspected separately) ............................... $120.50 ❑ 801 - 1000 amp 562.50 235.50 ❑ Hot ( tub/spa/sauna /service) P/ / ) ................. .........................$51.00 ❑ Hot tub/spa/sauna (ins ected separately) P P P Y) .......................... $80.00 ❑ Over 1000 amp 613.00 327.00 ❑ Septic pumping system (w /service) ...... ............................... $51.00 ❑ Over 600 volts surcharge $103.00 ❑ Septic pumping system (inspected separately) ..................... $80.00 ❑ Mast or meter repair $111.00 NEW MULTI- FAMILY (three units or more) ALTERED COMMERCIAL/INDUSTRIAL Service Feeder (Does not include circuits.) ❑ Up to 200 amp $131.50 $ 39.00 Service or Feeders ❑ 0 to 200 amp $131.50 ❑ 201 - 400 amp 163.00 80.00 ❑ 201 - 600 amp 305.50 ❑ 401 - 600 amp 223.00 111.00 ❑ 601 - 1000 amp 460.50 ❑ 601 - 800 amp 285.50 152.50 ❑over 1000 amp 513.00 ❑ Over 800 amp 408.50 305.50 ❑ # of circuits to be added /altered ALTERED SINGLE /MULTI FAMILY (1 -5 circuits - $103.00; Add'n circuits, $8.00 /ea) Service or Feeder COMMERCIAL /INDUSTRIAL PLAN REVIEW ❑ 0 to 200 amp $100.50 $103.00 plus 35% of Permit Fee ❑ 201 - 600 amp 163.00 ❑ Service - 1,000 amps or greater ❑ over 600 amp 245.50 ❑ Medical /Educational /Institutional Facility ❑ Additional plan review for ❑ # of circuits to be added /altered modified submittals $115.00 /per hour 0 -4 circuits- $80.00; Add'n circuits $8.00 /ea) ❑ Mast or meter repair $60.50 TEMPORARY SERVICE Service or Feeder Each Add'n MANUFACTURED HOMES ❑ 0 to 60 amp $ 71.00 $32.00 ❑ Service or feeder only $80.00 ❑ 61 - 100 amp 80.00 39.00 ❑ Service and feeder $131.50 ❑ 101 - 200 amp 103.50 51.00 ❑ 201 - 400 amp 120.00 60.50 MOBILE HOME /RV PARK ❑ 401 - 600 amp 163.50 80.00 ❑ # of service or feeders ❑ Over 600 amp 183.00 92.00 (First service /feeder - $80.00; each add'n - $52.50) MISCELLANEOUS SERVICE /EQUIPMENT ❑ # of Thermostats (First - $60.50; add'n - $18.50 /ea) ❑ # of Signs ❑ Low Voltage (First sign - $60.50; add'n sign $28.50/ea) Square Feet to be served by system(s) SF ❑ Yard Pole /meter loops /pedestal ....................$80.00 Fire Alarm System ❑ Portable Generator (transfer equipment) ......$100.50 ❑ Security Alarm System ❑Ditch cover /inspection only ........................$120.50 ❑ voice Cabling ❑ Data Cabling ❑ 15! 2500 ft2- $71.00; For fees not listed contact the Permit Center at � Each add'n 2500 W - $18.50) 253 - 835 -2607 Bulletin #100 - January 1, 2009 Page 3 of 4 k\Handouts\Permit Application