06-102449RO VE®
Owe' MAY 17 2006
FeaerraI Way. WpE RM IT
CITY O�OINQ �•
• i)OA4YUN1)7'DBVBLOPNENT SSRVi
893158M AVENUE 3OEMi • PO BOR 97/8
6 6VOAYFAX2S3 3 2609 APPLICATION
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SF MF CO ME EL PL DE ENS
not be accepted. Please
or
SITE ADDRESS ZS I - _ _ SUITE /UNIT # ASSESSOR'S TAX /PARCEL # _ , _ _ / _)) /LOT SIZE j(s, )
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) ' i c/°� c / (rt//1 der Si v) 6 ' 13 /` `
(AM°ch eeparete page% -jmVIW k#W deeo"mq
TYPE OF PERMIT ❑ BUILDING . ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING FIRE PREVENVION SYSTEM
PROJECT DE1SCRIIPTION (Provide detailed description o work i�nscluded on this permit onlul f
1 f1 �'t •� 1 +9. . A d ;� art � C, re. f� cIC, V @ 3 S 4 b Pi
PROJECT NAME (Name of Business or Owner Last Name) _ (r03Sl i) G 131elk f I
PEOPLE •• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
�pl�e
NAME
PRIMARY PHONE
U S- (`Pas)
MAILING 0 S 1, � C . CITY AT IP ,.
CO ANY NA
, �
/ .1e r / rK �'��C[��i
APPLICANT NAME
APPLICANT NAME
6ir✓ C� STr
4 C
OFFICE PHONE
(306) �t)!�'
cr
- 3�% /
MAILING ADORE
FAX NUMBER
CITY, STATE, ZI
/- 1%
'd� �•<<
CELL PHONE
( )
_
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER jeopy of card'requ @ell with epch application)
�A
EXPIRATION DATE
'pt�
COMPANY NAME
APPLICANT NAME
OFFICE PHONE '
MAILING ADDRESS
CITY, STATE, ZIP
(`CELL PHONE"
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect El Tenant 0 Agent ❑ Other (Describe)
( ) _
J
each type of fixture to be installed or relocated as part of this project. Do not
Value of Mechanoal Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS
BBQS FANS
BOILERS FIREPLACE INSERTS
COMPRESSORS FURNACES
DUCTS GAS PIPE OUTLETS
BATHTUBS (or7Lbisb"owercombol
SHOWERS
DISHWASHERS
SINKS
OAS PIPE OUTLETS
SUMPS
WASHING MACHINES
URINALS
LAVS paw -=swo
VACUUM BREAKERS
OAS LOOS REFRIG. SYSTEMS
HOODS (commerdeq WOODSTOVES
RANGES MISC (Describe)
GAS WATER HEATERS
WATER CLOSETS lroiieq MISC (Describe)
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
I certVy under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorised 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 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 of Federal Way, but only where such claim
arises out of the reliance of the pity, including its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE DATE
(Signatures
RELATIONSHIP TO PROJECT Owner O Agent contractor O Architect t] Other
0
ELECTRICAL PERMIT INFORMATION
RESIDENTI.A.L
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIAL /INDUSTRIAL SERVICE.
❑ Single Family Square Feet
Service or Feeder Each Add'n
(First 1300 ft2- $107.50; Each addh 500 ft2- $34.50)
❑ 0 to 100 amp $117.00 $ 71.50
❑ Detached outbuilding or garage
❑ 101.7- 200 amp 145.00 91.50
(Inspected with service) $45.50
❑ 201- 400 amp 272.00 107.50
❑ Detached outbuilding or garage
❑ 401- 600 amp 317.00 127.00
(Inspected separately) $71.50
❑ 601- 800 amp 410.00 173.50
❑ 801 - 1000, amp 500.50 209.50
NEW MULTI- FAMILY (three units or more)
❑ Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp .$117,00 $ 34.50
❑ Over 600 volts surcharge $91.50
❑ 201 - 400 amp 145.00 71.50
❑ Mast or meter repair $99.00
❑ 401 - 600 amp 198.50 99.00
Q 601 - 800 amp 254.00 136.00
ALTERED COMMERCIALANDUSTRIAL
❑ Over 800 amp 364.00 272.00
Service or Feeders
❑ 0 to 200 amp $117.00
ALTERED SINGLE /MULTI FAMILY
❑ 201 - 600 amp 272.00
13 601 - .1000 amp 410.00
Service or Feeder
over 1000 amp 456.50
❑ 0 to 200 amp $ 89.50
❑ 201 - 600 amp 145.00
❑ # of circuits to be added /altered
❑ over 600 amp 218.50
(1 -5 circuits - $91.50; Addh circuits, $7.00 /ea)
❑ # of circuits to be added /altered
COMMERCIAL /INDUSTRIAL PLAN REVIEW
(1 -4 circuits - $71.50; Add'ncircuits $7.00 /ea)
$91.50 plus 35% of Permit Fee
❑ Service - 1,000 amps or greater
❑ Mast or meter repair $53.50
❑ Medical /Educational /Institutional Facility
MOBILE HOMES
❑ Service or feeder only . $71.50
Q Service and feeder $117.00
TEMPORARY SERVICE
MOBILE HOME /RV PARK
ResidentlaWulti- Family $63.00
❑ - # of service or feeders
(First service /feeder - $71.50; each addh - $46.50)
Commerciat4ndustrlai Service or Feeder Ampacity
❑ 0 -100 amps $ 71.50
❑ 101- 200 amps 91.50
❑ 201- 400 amps 107.50
❑ 401 - 600 amps 145.00
❑ over 600. amps 157.00
MISCELLANEOUS SERVICE /EQUIPMENT
❑ # of Thermostats
❑ # of signs
(First - $53.50; addh- $16.50 /ea)
(First sign- $53.50; add'n sign $25.00 /ea)
ow Voltage
❑ Swimming pool /hot tub ................ $107,.50
Square Feet to be'served by system(s)
(Includes additional circuit, if required)
Fire Alarm System
❑ Yard Pole meter loops ..................... $71.50
ecurity Alarm System
❑ Additional Plan Review $107.50 /hour
O Voice Cabling
(for modified submittals)
Q Data ablin
❑ Automation Fee on all Permits .. $5.00
(Per System s) In 2500 it2- $63.00;
Each addh 2500 ft2- 16.50) *Per WAC 296.46.910(5)(b)fl & ii)