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
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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