06-104026r T
RECEIVED
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PERMIT
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ASSESSOR'S TAX /FARCEL #k Q Q
LBOAL OESCRXPTION (e -fir, Acme Estates; Lot I)
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SUITE /UNIT #E
LOT SIZE
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TYPE OF•PERMIT ❑ BUILDING . ❑ PLUMBING 0 MECHANICAL
❑ DEMOLITION C! ELECTRICAL ❑ ENGINEERING �C FIRE pREVENI+ION SYSTEM
PROJWT D CRIPTION JTi t4de detailed description of rk Included on this rmit onl
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PROJECT NAME (Name of Business or Owner Last Name)
PROPERTY
OWNER'
CONTRACTOR
ss a
:I.. P
I?8- 3 8t 7 1
PAX M 3EP
(ao61 ?aC - a /Go
EXPIRATION DATE
i
Indicate, number of each type of fixture to be installed or relocated as part of this'project. Do not inckide existing fixtures to•remain.
MECIiAIVICAL
'
Value of Mechanical Work $
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS LOGS
REFRIQ. SYSTEMS
BBQS
FANS
HOODS
WOODSTOVES
BOILERS
FIREPLACE INSERTS
RANGES
MISC (Describe)
452#IP)2ESSOR$
FURNACES
GAS WATER HEATERS
DUCTS
GAS PIPE OUTLETS
PLUMBING
BATHTUBS (or Tub /shmverc..wJ
SHOWERS
WATER CLOSETS (roueq
MISC (Describe)
_ DISHWASHERS
SINKS
DRINKING FOUNTAINS
GAS PIPE OUTLETS
SUMPS
RAINWATER SYST
WASHING MACHINES
URINALS
HOSE BIBBS
LAV9 ,&room ftk4
VACUUM BREAKERS
ELECTRIC WATER HEATERS
I cert(fy under penalty of perjury that the Wormation 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 .inade. 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 pled lied agdinst the City of Federal Wag, but only where such claim
arises out of the reliance of the Oty, including officers and employees, upon the accuragy of the itlformation supplied to the city as a part of
this application.
NAM% /TITLE �'Si6� DATE l iG G
(Si ( IC)
RELATIONSHIP TO PROJE q Owner d Agent contractor D Architect 13. Other
RESIDENTIAL
NEW RESIDENTIAL 8ERVICE
❑ Single Family Square Feet
(First 1300 tie- $107.50; Each add'n 500 R2. $34.501
❑ Detached outbuilding or. garage
. (Inspected with service) $45.50
❑ Detached outbuilding or garage
(Inspected separately) $71.50
NEW MULTI- FAMILY• (three units or more)
Residential/112uiti FamfW
Service
Feeder
❑ Up to 200 amp
.$117.00
$ 34.50
❑ 201 - 400 amp
145:00
71.50
❑ 461 - 600 amp
198.50
99.00
Q 601 - 800 amp
254.00
.136.00
❑ Over 800 amp
364.00
272.00
ALTERED SINCiLD /MULTI FAMI7.Y
Service or Feeder
❑ 010 200 amp
$ 89.50
❑ 201 - 600 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
Q Service and feeder $117.00
MOBILE HOME /RV PARK
❑ # of service or feeders
(First service /feeder - $71.50; each ald'n - $46.50)
COMMERCIAL
NEW CO D -MA 0 VICE.
Service or Feeder Each Add'n
❑ 0 to. 100 amp $117.00 $ 71.50
❑ 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
(3,801 - 1000, amp 500.50 209.50
❑ Over 1000 amp, 546:00 291.00
❑ Over 600 volts surcharge $91.50
❑ Mast or meter. reps jr $99:00
ALTERED COARMCIAL/INDUSTRIAL
Service orFeedets
❑ 0 to 200. amp $117.00
❑ 201 - 600 amp 272.00
❑ 601 - .1000 amp 410.00
❑ over 1000 amp 456.50.
❑ -# of circuits to be added /altered
(1 -5 circuits- $91.50; Add'n circuits, $7:00 /ea)
COMMERCIAL /INDUSTRIAL PLAN REVIEW
$91.50 plus 350/9 of Permit Fee
❑ Service - 1,000 amps or greater
❑ Medical /Educatonalf Institutional, Facility
TEMPORARY SERVICE
Residential/112uiti FamfW
$63.00
CommercialAndustriat Service or Feeder Ampacity
❑ 0 =100 amps
$ 71.50
❑ 101- 200 amps
91.50
❑ 201- 400 amps
107.50
❑ 401 - 600 amps
145.00
L3 over 600.amps
157.00
MISCELLANEOUS SERVICE /EQUIPMENT
❑ # or Thermostats
(First - $53.50; add')n- $16.50 /ea)
§" Voltage
Square Feet to be *served by systeiit(s) a 70
KFire Alarm System
❑ Security Alarm System
t) Voice Cabling
0 Data Cabling
gr Sy -e-i; (s) 1+t 2500 ft2- $63,00; .
Each add'n 2500 W- 16:50) • Per WAC 296 - 46.910(5)(6)(1 & ii)
❑ # of Signs
.(First sign- $53.50; addhi sign $25.00 /ea)
❑ Switnming pool /hot tub ................
$107.50
(Includes additional circuit, if required)
❑ Yard Pole meter loops .....................
$71.50
❑ Additional Plan ]Review
$107.50 /hour
(for modified submittals)
❑ Automation Fee on all Permits ..
$5.00