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06-103780CITY OP' h'�deralwby ' 1MYYD$VBGOA1t81YTdtBJtVIGBa �JJS6 a�AVBNU880p1f /• ro BOx 971a MRS&WAI P % 98069 -9716 • SSJ•aJ&,2607• AAX RU- 835.2609 iaw�o.divamdgmaimy,tym . RECEIVED JUL 3 12006 GITPIIWNt�. I APPLICA:TION . �.L - .0 3- Z EL. SF MP CO ME EL PL DE LN FF LEGAL DESCRIPTION (e.g, Acme Estates; Lot 1) '�� LtJrA `�f I r, t (Aaaah &W—PWjbrl -rapt kA "� . LOT SIZE (s� 1c16 TYPE.OF•PERMIT O BUILDING . ❑PLUMBING ❑MECHANICAL O DEM6LITION Cl ELECTRICAL ❑ ENGINEERINQFIRE PREVENI`ION SYSTEM PROJECT. DESCRIPTION g vide detailed des 10" oof work fnclluded'on this nerm.ft on�� 1 �i0 °ti i9AA o or �� 4- vt_ rlv� /il d�ssc if,f Csvl b _ PROJECT NAME (Name of Business or Owner Last Name) Q S PROPER_ TY NAME N� PRIMAPOWNER HNE E'gt� LI , CITY, STATE Z[P S/1(� CONTRACTOR COMPANY NAME AID. r•� APPLICANT NAME OFFICE PHONE ��, MAILING ADDRESS ��t 4Lk-e ca m) ��- 3 tyr 7 R% VA, A/ � .CITY, ST P � pp CELL PHONE CITY OF FED RAL WAY BUSINESS LICENSE NUMBER EXPIRATION BATE FAX NvMBpR CONTRACTOR ER S REGISTRATION NUMB lcepy of card':$ uired with e}ch appucaUaa� D G r Sy y? S P u E}CPIRATION DATE APPLICANT CMPANY t(/►M; fiJ fl /i OFFICE PHONE AD' ES/_ J` /emu CITY, ST%A�TE " % ZIP CELL PHONE.. RELATIONSHIP TO PROJECT ❑ Architect MTenant o Agent, ❑Other (17escribef c FAX UMBER CONTACT NAH ((� PRIMARY PHONE E E -MAIL ADDRESS 3 t�l LENDER _ - - PHONF ( --- -,• —_ EIISTING USE' PROPOSED USE EXISTING ASSESSED /ApPRAiSED VALUE $ . VALUE OF PROPOSED WORK 1� aI 6 UV • ^U-). ISPRINKLERED.BUILDING? Ct YES NO FIRE SUPPRESSION SYSTEM PROPOSED %PPA)TTTT?V.no n VW40 number of each type of fixture to be installed or relocated as part of this'projed. Do not include I certVy under penalty of pedury that the information furnished by nee 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. 1 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 bg dny 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 of . cars and employees, upon the accuracy of the Information supplied to the city as a part of this application. NAME /TITLE DATE -� 46 (Signature) Mae) RELATIONSHIP TO PROJECT • wner a Agent 0 Contractor p Architect o Other Value of Mechanical Work $ AIR HANDLING UNITS EVAPORATIVE COOLERS OAS LOOS REFRIO. SYSTEMS BBQS FANS HOODS iCommercbQ WOODSTOVES BOILERS '.FIREPLACE INSERTS RANGES MISC ( Describe) FURNACES GJ WATER HEATERS DUCTS GAS PIPE OUTLETS PLLl=YAVG BATHTUBS (or Tubphower combo) SHOWERS WATER CLOSETS (nim MISC (Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS .tLroem BtrJcs) VACUUM BREAKERS ELECTRIC WATER HEATERS I certVy under penalty of pedury that the information furnished by nee 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. 1 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 bg dny 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 of . cars and employees, upon the accuracy of the Information supplied to the city as a part of this application. NAME /TITLE DATE -� 46 (Signature) Mae) RELATIONSHIP TO PROJECT • wner a Agent 0 Contractor p Architect o Other O A • ELECTRICAL PERMIT INFORMATION RESIDENTIAL E, W RESIDENTIAL SERVICE ❑ Single Family Square Feet (First 1300 ft2- $107.50; Each add"n 500 fit - $34.50) ❑ Detached outbuilding or garage (Inspected with service) $45.50 ❑ Detached outbuilding or garage (Inspected separately) $71.50 NEW MULTIFAMILY (three units. or ,more) /INDUSTRIAL $E_�IC� Service Feeder ❑ Up to 200 amp .$117.00 $ 34.50 ❑ 201 - 400 amp 145:00 71.50 13 401 - 600 amp 198.50 99.00 Q 601 - 800 amp 254.00 136.00 ❑ Over 800 amp 364.00 272.00 TERED SIN (1L UMULTI FAMILY Service or Feeder ❑ 0 to 200 amp $ 89.50 ❑ 201 - 6-00 amp 145.00 ❑ over 600 amp 218.50 ❑ # of circuits to.be added /altered '(1-4 circuits - $71.50; Add'n circuits $7.00/ ea) ❑ Mast or meter repair $53.50 MOBILE HOMES ❑ Service or feeder only $71.50 0 Service and feeder $117.00 COMMERCIAL NEW COMMERCIAL /INDUSTRIAL $E_�IC� # of service or feeders Service or Feeders (First service / feeder- $71.50; each add$ - x$46.50) Service or Feeder Each Add'n ❑ 0 to 100 amp $117.00 $ 71.50 13 101.- 200 amp 145.00 91.50 ❑ 201- 400 amp 272.00 107.50 ❑ 401-600 amp 317.00 127.00 ❑ 601- 800 amp 410.00 173.50 ❑ 801 - 1000, amp '500.50 209.50 13 Over 1000amp 546:00 291.00 ❑ Over 600 volts surcharge $91.50 ❑ Mast or meter repair $99.00 ❑ # of circuits to be added /altered (1-5 wits - $91.50; Addh circuits, $7:00 /ea) COMMERCIAL /RMUSTRIAL PLAN REVIEW $91.50 plus 35% of Permit Fee ❑ Service - 1,000 amps or greater ❑ Medical /Educational/institutional Facility TEMPORARY SERVICE MOBILE HOME /RV PARK ❑ ALTERED COMMERCIAL /INDUSTRIAL # of service or feeders Service or Feeders (First service / feeder- $71.50; each add$ - x$46.50) ❑ 0 to 200.amp $117.00 ❑ 201 - 600 amp 272.00 ❑ 601 -.1000 amp 410.00 C3 over 1000 amp 456.50_ ❑ # of circuits to be added /altered (1-5 wits - $91.50; Addh circuits, $7:00 /ea) COMMERCIAL /RMUSTRIAL PLAN REVIEW $91.50 plus 35% of Permit Fee ❑ Service - 1,000 amps or greater ❑ Medical /Educational/institutional Facility TEMPORARY SERVICE MOBILE HOME /RV PARK ❑ ResidentiaWultt- Family $63.00 # of service or feeders (First service / feeder- $71.50; each add$ - x$46.50) CommeretaWndustr ial Service or Feeder Ampacity ❑ 0 - 100 amps $ 71.50 ❑ 101- 200 amps 91.50 ❑ 201 - 400 amps 107.50 , 13 401 - 600 amps 145,00 ❑ over 600. amps 157.00 MISCELLANEOUS SERVICE /EQUIPMENT 0 # or Thermostat (First - $55.50; 4dd'n- $16.50 /ea) )Low Voltage /� �� Q Sb uare Feet to be *served by systein(s) --__T- Fire Alarm System Security Alarm System •❑ Voice Cabling Q Data Cabling (Per 8ystem(s) 1•t 2500 fie- $63.00; . Each addh 2500 ft2- 16:50) .per. WAC296- 46.91o(s)itii# m iii ❑ # of Signs (First sign- $53.50; add'n sign. $25.00 /ea) ❑ Swimming pool /hot tub ................ $107.50 enchtdes'additional circuit, if required) ❑ Yard Pole meter loops ..................... $71.50 ❑ Additional Plan 1)teview $107.50 /hour (for modified submittals) ❑ Automation Fee on all Permits .. $5.00