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07-102017GIA Dp. Federal Way RECEIVE'' PERMIT` MF CO AAW LT PL DE I- COMMUNFIY DEVELOPMENT SERVICES . yr 33325 D AVENUE SOUTH • ➢O BOX 9 P P L I C AT I O N FEDERAL WAY, WA 98063 -9718 (�� R � ° 20A TD .753- 835 -7607• PAX 253435.2609 �- www.dhml%dr..v . iI1xw Of-- FFD €RAL WAY The following is req&4kQ4a QW& -an incomplete application will not be accepted. Please print legibly (in ink) or type. SITE ADDRESS JJ `� S, 3 y �' (/ k^Y , . (ems` i /p`, V l? Gl g0 �3 SUITE /UNIT # IV_ ASSESSOR'S TAX /PARCEL # 2 Z Z O O LOT SIZE (s] LEGAL DESCRIPTION (e.g. Acme Estates, Lot I) w ()A d V IS i a^ T1, (Att -h up—ft prodia'knoW legal dnuWon) PROJECT e- TYPE OF PERMIT O BUILDING O PLUMBING O MECHANICAL Ft �� / T 1CA rM ❑ DEMOLITIOIICAI. ❑ ENGINE�IRE PREVENTION SYSTEM PROJECT /DESCRIPTION (Provide detailed description of work ihcluded on this permit only �- M*e44_`/' P�KSl �Sr -6`rt` . A &r^" -r,, 4tonn -Fa,— /uw I T_ f ®4G�2 PROJECT NAME (Name of Business or Owner Last Name) PROPERTY OWNER CONTRACTOR COPY sf urd req.f.d r+1tA weh gpllentlon APPLICANT PROJECT CONTACT PEOPLE INFORMATION NAME ^. �/_ �B rC l PRIMA PHONE OFFICE PHONE/ _ -70 - (2Tj A-� ` 3 -RY MAILING ADDRESS - 4,00 SO ,39t� Ji—fN Fc,LSS` CITY, STATE, ZIP cry g &t,_�:J, E -MAIL ADDRESS COMPANY A N�✓'�� SyJ +�-J� � APPLICANT NAME , L� �J T.�JfT2 Cam/ /V/_ OFFICE PHONE/ _ -70 - (2Tj A-� ` 3 MAILINOADDRESS D 6� 73) 17,-7 CITY, STATE, ZIP l(L, �3 _73 CELL PHONE 2S3 &ifb RELATIONSHIP TO PROJECT o Architect 0 Tenant o Agent XOther flri: huh"^ JKS. W� - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER 210-0s- 103391 —010 _9Lr I? / 1/0 7 (253 ) 284 -3 -7/"( CONTRACTORS REGISTRATION NUMBER ES CZO PJ 1- 56 3 39- - EXPIRATION DATE 112-Y / n k EMAIL ADDRESS e Fk_ ae -A-S YS tcnl "C COMPANY NAME E'S N�a S f�er'! 1.LL APPLICANT NAME Se-f Lln� OFFICE PHONE (2S3) 28'1 -,1710-7 MAILING DRESS PO 19ax 731 Z2-7 CITY, STATE, ZIP u 1 1. P� a /lu iJ%tl- gF3-7_3 CELL PHONE 2d-3 1086 - lows" 7 RELATIONSHIP TO PROJECT o Architect 0 Tenant o Agent XOther flri: huh"^ JKS. FAX NUMBER ' (yj'3) ZfiH - 3%/L1 NAME PRIMARY PHONE 7-f3 68-b - 6OS-7 E- MAILADDRESS 'e*4ce-e-7'syrfcnsPQc NAME Per RCW 19,37.095: Lender information is required if project value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP PHONE ' EXISTING USE 0 -F19-7 If !! PROPOSED USE EXISTING ASSESSED /APPRAISED VALUE $ (1- VALUE OF PROPOSED WORK $ -7 1 0_ SPRINKLERED BUILDING? YES o NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? WYES o NO WATER SERVICE PROVIDER VLAKEHAVEN o HIGHLINE ❑ TACOMA o PRIVATE (WELL) SEWER SERVICE PROVIDER "AKEHAVEN 0 HIGHLINE o PRIVATE (SEPTIC) cum .[o'•1 AREA DESCRIPTION EXISTING S . FT PROPOSED S . FT. TAL S '. FT. BASEMENT BBQS FANS GAB WATER HEATERS MISC (Describe) FIRST v - FIREPLACE INSERTS HOODS (commmdoq SECOND COMPRESSORS FURNACES RANGES. THIRD GAS LOG SETS REFRIG. SYSTEMS ... ADDITIONAL FLOORS (DESCRIBE) o YES o NO PLUMBING DEMO PERMIT REQUIRED? o YES DECK (D COVERED OR ❑ UNCOVERED ?) BATHTUBS I., Tub /ShovaCombel LAVS IBethr mSinks) URINALS 'MISC (Descr ibe) GARAGE 13 CARPORT Q . RAINWATER SYST VACUUM BREAKERS, DRINKING FOUNTAINS . NUMBER OF FLOORS SAis'ns0 FAOFCSSD TOTAL T6TAL 3XISMe Sr TDTAL rAOPoeSA Sr N.aF —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 GAB WATER HEATERS MISC (Describe) o NOI BOILERS - FIREPLACE INSERTS HOODS (commmdoq CHANGE OF USE? o YES COMPRESSORS FURNACES RANGES. DU g :.,, GAS LOG SETS REFRIG. SYSTEMS ... PLATTED LOT? o YES o NO PLUMBING DEMO PERMIT REQUIRED? o YES o N BATHTUBS I., Tub /ShovaCombel LAVS IBethr mSinks) URINALS 'MISC (Descr ibe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS, DRINKING FOUNTAINS SHOWERS - - WATER CLOSETS pbueq - ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS - SUMPS _ I certify 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 authorized 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 city, including its ofjlcers and employees, upon the accuracy of the information supplied to the city as a part of this application. NAME /TITLE RELATIONSHIP VO PROJECT o Owner o Agent o Contractor o Architect TE /A(A/()% �fu,iC�4,Xv_1/ o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT. BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NOI ZONING DESIGNATION CHANGE OF USE? o YES o NO' NEW ADDRESS REQUIRED? o YES o NO UP /SEPA /SU? o YES o NO PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o N Bulletin 11100 — January If 2007 Page 2 of 4 MilandoutsTermit Application RESIDENTIAL ❑ Single Family Square Feet (First 1300 ft2- $111.00; Each add'n 500 ftr - $35.50) ❑ Detached outbuilding or garage (Inspected with service) . $47.00 ❑ Detached outbuilding or garage (Inspected separately) $74.00 NEW MULTI- FAMILY (three units or more) Service or Feeders Service Feeder ❑ Up to 200 amp $120.50 $ 35.50 ❑ 201 - 400 amp 149.50 74.00 ❑ 401 - 600 amp 205.00 102.00 ❑ 601 - 800 amp 262.00 140.50 ❑ Over 800 amp 375.50 280.50 ALTERED SINGLE /MULTI FAMILY ❑ 0 to 200 amp ❑ 201 - 600 amp ❑ over 600 amp Service or Feeder $ 92.50 149.50 .:225..50 Cl # of circuits to be added /altered (1 -4 circuits - $74.00; Add'n circuits $7.00 /ea) ❑ Mast or meter repair $55.00 MANUFACTURED HOMES ❑ Service or feeder only $74.00 ❑ Service and feeder $120.50 COMMERCIAL NEW COMMERCIAL/INDUSTRIAL SERVICE ❑ 0 to 100 amp ❑ 101 - 200 amp ❑ 201 - 400 amp ❑ 401 - 600 amp ❑ 601 - 800 amp ❑ 801 - 1000 amp ❑ Over 1000 amp Service or Feeder $120.50 149.50 280.00 327.00 423.00 516.50 563.00 Each Add'n $ 74.00 94.50 111.00 131.00 179.00 216.00 300.00 ❑ Over 600 volts surcharge $94.50 ❑ Mast or meter repair $102.00 ALTERED COMMERCIAL/INDUSTRIAL ❑ # of circuits to be added /altered (1 -5 circuits - $94.50; Add'n circuits, $7.00 /es) COMMERCIAL /INDUSTRIAL PLAN REVIEW $94.50 plus 351/o of Permit Fee ❑ Service - 1;000 amps or greater ❑ Medical /Educational /Institutional Facility TEMPORARY SERVICE MOBILE HOME /RV PARK Service or Feeders ❑ 0 to 200 amp $120.50 ❑ 201'- 600 amp 280.50 ❑ 601 - 1000 amp 423.00 ❑ over 1000 amp 471.00 ❑ # of circuits to be added /altered (1 -5 circuits - $94.50; Add'n circuits, $7.00 /es) COMMERCIAL /INDUSTRIAL PLAN REVIEW $94.50 plus 351/o of Permit Fee ❑ Service - 1;000 amps or greater ❑ Medical /Educational /Institutional Facility TEMPORARY SERVICE MOBILE HOME /RV PARK Resident ctVMulti- Family $65.00 ❑ # of service or feeders (First service /feeder - $74.00; each add'n - $48.00) CommerciaVTndustrial Service or Feeder.Ampacity ❑ 0 - 100 amps $ 74.00 ❑ 101 - 200 amps 94.50 ❑ 201 - 400 amps 111.00 ❑ 401 - 600 amps 149.50 ❑ over 600 amps 162.00 MISCELLANEOUS SERVICE /EQUIPMENT ❑ # of Thermostats )First - $55.00; add'n- $17.00 /ea) Low Voltage qu Feet to be served by system(s) �' G 0-Fire Alarm System ❑ Security Alarm System ❑ Voice Cabling ❑ Data Cabling 1.12500 ft2- $65.00; Each add'n 2500 1`0417.00) • Per WAC 29fr46.91 M)jbJ(i b ii) ❑ # of Signs (First sign- $55.00; add n sign $26.00 /ea) ❑ Swimming pool /hot tub ................ (Includes additional circuit, if required) ❑ Yard Pole meter loops ..................... ❑ Additional Plan Review (for modified submittals) ❑ Automation Fee on all Permits .. $111.00 $74.00 $111.00 /hour $5.00 Bulletin {i 100 -January], 2007. Page 3 of 4 k \Handouts \Permit Application