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07-100797It City of Federal Way Community Development Services P.O. Box 9718 Federal Way, WA 98063 -9718 Ph: (253) 835 -2607 Fax: (253) 835 -2609 Buildint Commercial Permit #47- 100797 -00 -CO Inspection Request Line: (253) 835 -3050 Project Name: CLEARWIRE DASH POINT ROAD (WA -TAC- 392 -C) Project Address: 29933 3RD AVE SW Parcel Number: 720533 0060 Project Description: NEW - Construction and operation of a personal wireless service facility (PWSF) to be located on a replacement PSE utility pole with ancillary equipment enclosure placed on adjacent private property and camouflaged to appear as a free - standing garden shed. Owner Applicant Contractor Lender JOHN & ANGELA HWANG CLEARWIRE LLC SINE COMMUNICATIONS INC 40RIX"_ 29933 3RD AVE SW 4400 CARILLON POINT SINECI *044RD (4/22/09) FEDERAL WAY WA 98023 -3511 KIRKLAND WA 98033 3011 S FIFE ST SUITE A TACOMA WA 98049 Census Category: 325 - New Public Works and Utilities Building Permit for Building Shell Only 9 ............................ No Plumbing to be Included?....... ............................... No New / Additional Sq. Feet - Total .......................... 0 Occupancy # 1 - Use ............................................... Sheds Zoning Designation ................ ............................... RS 9.6 Mechanical Fixtures Fans................. ............................... 1 CONDITIONS: 1) A right -of -way permit is required for work within the public right -of -way (Dash Point Road). Please contact Kathleen Messinger at 253.835.2725 for further information. PERMIT EXPIRES Friday, April 24, 2009 Permit Issued on Tuesday, April 24, 2007 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. Owner or agent: Date: zfto 0 THIS CARD IVO REMAIN ON -SITE r CITY OF 4A Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050 PERMIT #: 07- 100797 -00 -CO Owner: JOHN & ANGELA HWANG Address: 29933 3RD AVE SW FEDERAL WAY, WA 98023 -3511 This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence On -going inspections are logged on the back of this card. ❑ Footings /Setback (4110) Shear Walls (4245) Approved to place concrete By Date ❑ Slab /Concrete Floor (4255) ❑ Re -steel (4215) By Approved to place concrete or grout By Date ❑ Foundation Wall (4115) Shear Walls (4245) Approved to place concrete By Date ❑ Slab /Concrete Floor (4255) ❑ Approved to place concrete By Date ❑ Drainage/Downspout (4040) Shear Walls (4245) Approved to backfill By Date Approved to install siding ❑ Underfloor Framing (4285) By Date Approved to sheath floor By Date ❑ Floor Sheathing (4105) ❑ Shear Walls (4245) ❑ Roof Sheathing (4220) Approved to install flooring Approved to install siding Approved to install roofing By Date By Date By Date ❑ ❑ Gas Piping (4125) ❑ Mechanical Rough -in (4165) Fire/Draft Stops (4095) Approved Approved to release test Approved By Date By Date By Date ❑ NOTE: Prior to scheduling a Framing (4120) ❑ Framing (4120) Insulation (4150) inspection; Electrical, Plumbing & Mechanical Approved to insulate Approved to install wallboard Rough -in and Fire/Draft Stop inspections must be signed -off and approved. IBC 109.3.41UBC 108.5.4 By Date By Date ❑ ❑ Suspended Ceiling Grid (4265) ❑ Gypsum Wallboard Nailing (4130) Final - Fire Department (4060) Approved to install mud & tape Approved to drop tile Approved By Date By Date By Date ❑ ❑ Final - Planning (4070) ❑ Final - Public Works (4080) Final - Mechanical (4065) Approved Approved Approved By Date By Date By Date ❑ F' - Building (4050) Approved B ��j Date 2 y Federal Way REC����D FEB 1 s zoos PERMIT COMMUAMDEVEIAPMENT SERVICES 333258- AVENUESOUTH•POBgc OF FEDER L wA 253-835-2607- 1 AX253� 26440699 BUILDING A • LI CATI ON wu: ur.rituoffederaIwau.cam Mk- - / L)- i2--a a 7- SF MF (CO ME EL PL DE EN FP The following is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type. PROPERTY I •• • SITE ADDRESS 29933 3rd Ave. SW, Federal Way, WA 98013 SUITE/UNIT # N /A ASSESSOR'S TAX /PARCEL # _ 7` 0 5 3 3 - 0 19 6 O LOT SIZE (sf) 12,800 s.f. LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Please see attached sheet for complete legal description) Mxwh wp—m, p.WfJ k Vft kgat deacrlpWW PROJECT •• • TYPE OF PERMIT )kUILDING ❑ PLUMBING 13 MECHANICAL ❑��`���DEMOLITION ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Prouide detailed description of work included on this Dermit onlu) Construction and operation of a personal wireless service facility (PWSF) to be located on a replacement PSE utility pole with ancillary equipment enclosure placed on pe _prorty and camouflaged to appear as a free - standing garden shed. PROJECT NAME (Name of Business or Owner Last Namel PROPERTY OWNER CONTRACTOR Corr of card requked vtth each appRestioa APPLICANT PROJECT CONTACT LENDER nt CLEARWIRE "DASH POINT ROAD" (WA -TAC- 392 -C) PEOPLE INFORMATION NAME John & Angela Hwang PRIMARY PHONE (253) 653 -7522 MAILING ADDRESS 29933 3rd Ave. SW CITY. STATE. ZIP Federal Way, WA 98023 E -MAIL ADDRESS p� (�NE�f%s- MAILING ADDR!� C !%L CELL PHONE - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER Ln� EXPIR42ION DATE /AX NUMBER CONTRACTOR'S REGISTRATION NUMBER EXPUVA40N DATE E- MAILADDRESS COMPANY NAME Clearwire US, LLC APPLICANT NAME (Paul Petersen) OFFICE PHONE (425) 825 -6200 MAILING ADDRESS CITY, STATE, ZIP 5808 Lk. Wash. Blvd., #300 Kirkland, WA 9803_3 RELATIONSHIP TO PROJECT ❑ Architect ❑ Tenant ❑ Agent ❑ Other Proponent CELL PHONE ( l - FAX NUMBER NAME PHONE D. Wilson /PARSONS PRIDdARYPHONE E- MAU,ADDRESs 9 (206) 218 -6940 craicywilson@parsons com NAME N / A (self- financed) Under information 19.27.095: Lender is required ij'project value exceeds $5,000 NLA=G ADDRESS CnY, STATE. ZIP PHONE ( ) - EXISTING USE Single family residence PROPOSED USE PWSF (as ancillary use) EXISTING ASSESSED /APPRAISED VALUE $ 242,000 VALUE OF PROPOSED WORK $ 501000 SPRINKLERED BUILDING? ❑ YES `,<No FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES XNO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAREHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) lei PROJECT ..• AREAS AREA DESC ION ERISTING S . FT. PROPOSED TOTAL S . FT. S . FT. BASEMENT BBQS One FANS GAS WATER HEATERS MISC (Describe) FIRST FIREPLACE INSERTS HOODS (Coin erclaQ COMPRESSORS SECOND RANGES DUCTS GAS LOG SETS THIRD NEW ADDRESS REQUIRED? ❑ YES ❑ NO UP /SEPA /SU? ❑ YES ADDITIONAL FLOORS (DESCRIBE)Equipment enclosure (shed) PLATTED LOT? o YES ❑ NO 64 s.f. 64 s.f. DECK (❑ COVERED OR ❑ UNCOVERED ?) GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS F.7QET010 PROP08ID TOTAL TOTAL FASTIDfO eP TOTALPROP088D 8P TOTAL 8F "NEWHOMES ONLY'* NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ Indicate number of each type ofjixture to be installed or relocated as part of this project. Do not include extsting j%dures to remain. Value of Mechanical Work (A COPY OF BID OR ESTIMATE MUST BE INCLUDED W M APPLTCA7 I0M AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS One FANS GAS WATER HEATERS MISC (Describe) BOILERS FIREPLACE INSERTS HOODS (Coin erclaQ COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG. SYSTEMS BATHTUBS (o Tub /sho combo) DISHWASHERS DRINKING FOUNTAINS ELECTRIC WATER HEATERS HOSE BIBBS LAVS (Bathroom sinks) URINALS MISC (Describe) RAINWATER SYST VACUUM BREAKERS SHOWERS WATER CLOSETS a-.&tj SINKS WASHING MACHINES SUMPS I certf jy under penalty of perjury that the hifbrmation 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 casts, 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 o and employees, upon the accuracy of the information supplied to the city as a part of this application. a NAME /TITLE DATE / raig D. W11 on / PARSON as agents for Clearwire US, LLC) RELATIONSHIP TOP CT ❑ qvmer ,Agent ❑ Contractor ❑ Architect ❑ Other I('CIYt os'FICL D� oNLY � ` x� ` ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑ YES a NO ZONING DESIGNATION CHANGE OF USE? ❑ YES ❑ NO NEW ADDRESS REQUIRED? ❑ YES ❑ NO UP /SEPA /SU? ❑ YES o NO PLATTED LOT? o YES ❑ NO DEMO PERMIT REQUIRED? ❑ YES ❑ NO Bulletin #100 — January 1, 2007 Page 2 of 4 MliandoutsTermit Application jW* I . • r ELECTRICAL PERMIT INFORMATION RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCIAL /INDUSTRIAL SERVICE ❑ Single Family Square Feet Service or Feeder Each Add'n (First 1300 ft2- $111.00; Each add'n 500 ft2- $35.50) ❑ 0 to 100 amp $120.50 $ 74.00 ❑ Detached outbuilding or garage X 101 - 200 amp 149.50 94.50 (Inspected with service) $47.00 ❑ 201 - 400 amp 280.00 111.00 ❑ Detached outbuilding or garage ❑ 401 - 600 amp 327.00 131.00 (Inspected separately) $74.00 ❑ 601 - 800 amp 423.00 179.00 ❑ 801 - 1000 amp 516.50 216.00 NEW MULTI - FAMILY (three units or more) ❑ Over 1000 amp 563.00 300.00 Service Feeder ❑ Up to 200 amp $120.50 $ 35.50 ❑ Over 600 volts surcharge $94.50 ❑ 201 - 400 amp 149.50 74.00 ❑ Mast or meter repair $102.00 ❑ 401 - 600 amp 205.00 102.00 ❑ 601 - 800 amp 262.00 140.50 ALTERED COMMERCIAL /INDUSTRAAI. ❑ Over 800 amp 375.50 280.50 Service or Feeders ❑ 0 to 200 amp $120.50 ALTERED SINGLE /MULTI FAMILY ❑ 201 - 600 amp 280.50 El 601 - 1000 amp 423.00 Service or Feeder ❑over 1000 amp 471.00 ❑ 0 to 200 amp $ 92.50 ❑ 201 - 600 amp 149.50 ❑ # of circuits to be added /altered ❑ over 600 amp 225.50 (1 -5 circuits - $94.50; Add'n circuits, $7.00 /ea) ❑ # of circuits to be added /altered COMMI;RCLWINDUSTRML PLAN REVIEW (1 -4 circuits - $74.00; Add'n circuits $7.00 /ea) $94.50 plus 35 0.6 of Permit Fee ❑ Service - 1,000 amps or greater ❑ Mast or meter repair $55.00 ❑ Medical /Educational /Institutional Facility MANUFACTURED HOMES ❑ Service or feeder only $74.00 ❑ Service and feeder $120.50 TEMPORARY SERVICE MOBILE HOME /RV PARK Residential/Multi- Family $65.00 ❑ # of service or feeders (First service /feeder - $74.00; each add'n - $48.001 Commercial/Industrial 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 ❑ # of Signs (First - $55.00; add'n - $17.00 /ea) (First sign- $55.00; add'n sign $26.00 /ea) ❑ Low Voltage ❑ Swimming pool /hot tub ................ $111.00 Square Feet to be served by system(s) (Includes additional circuit, if required) ❑ Fire Alarm System ❑ Yard Pole meter loops ..................... $74.00 ❑ Security Alarm System ❑ Additional Plan Review $111.00 /hour ❑ voice Cabling (for modified submittals) ❑ Data Cabling ❑ Automation Fee on all Permits .. $5.00 ❑ 1 -t 2500 ft2- $65.00; Each add'n 2500 ft2- 17.00) • Per wAC 296- 46- 910(51(b)a & w Bulletin #100 - January 1, 2007 Page 3 of 4 k\Handouts\Permit Application