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08-104929 f/,�h i- RECET D / c(� CITY OF d / og — / 0 s ' F Feeral Way OCT 1 2008 — — PERMIT SF MF CO ME EL PL DE EN- FP COMMUNITY DEVEIA VI �/ � 33325 8TM AVENUE S O O FEDERALWAY 71 F FEDE�PI,ICATION 253-835-2607.FAX 253-835-2609 munucituotiedcratwau.rom CDS !� f`7 �p 8 The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. 9 4 .f P PP • PROPERTY INFORMATION SITE ADDRESS_ 3013 15 Th` Ave S. FE Cg . l/br4 V SUITE/UNIT#_ ASSESSOR'S TAX/PARCEL# O Z 101-- - (2J LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates.Lot 1) (Attach separate page for lengthy legal description) • PROJECT INFORMATION TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL // ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING VP'IRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit oniti) it F or �„. / �= -/ PROJECT NAME(Name of Business or Owner Last Name) FE7i :./9L bth.g' f 80 Y S Z' 4/,e1-5 C Lt' II PEOPLE INFORMATION PROPERTY NAME O/� ` C/ j// J PRIMARYP HONE OWNER !/ /// (r(i(/f//'S - MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE 9 ?i�kIP?C A 5£T4 ir`f /2/c) /llg/Z77NE.Z (704 )-7&S - 3SSo ( i MAILING ADDRESS CITY,STATE,ZIP CELL PHONE SZS /�0��2 v� S- 5 w, g8/9Y (Zo6) 396 -6767 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER a( ©--06- 103 g6o Uo-- 5i-. fz/3 213i/ell' (zo6) -7z6 - �I60 CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS tom► ��c/ F'S9 7 3 pa Hof 0/01 i?tccr4e Frs. se APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE OA--NC A's �:e' ( ) - MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect ❑Tenant ❑Agent ❑ Other ( ) - PROJECT NAME PRIMARY PHONE ® E-MAIL ADDRESS CONTACT /f+-ti n OM' iV (Zo 6) 3 C 1 - `!2 9 LENDER NAME Per RCW 19.27.095: Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - ■ DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE CO EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ Ot70 SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) • • • PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. Sg.FT. SQ.FT. BASEMENT FIRST SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(❑COVERED OR ❑UNCOVERED?) GARAGE ❑ CARPORT ❑ EXISTING PROPOSED TOTAL TOTAL=STING SF TOTAL PROPOSED SF TOTAL SF NUMBER OF FLOORS **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ 1.?4: FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL 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 GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(Commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or I ub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS Toilet) ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS SIGNATURE I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local,state,or federal laws regulating construction or environmental laws. 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 • . by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the •ing its officers and employees, upon the accuracy of the information supplied to the city as a part of this application SIGNATURE: DATE !a -/7- c�S Property Owner an r Authorized Agent • a i I< t9 ❑NEW o ADDITION c ALTERATION c REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES c NO BASIC PLAN? ❑YES a NO ZONING DESIGNATION CHANGE OF USE? ❑YES c NO NEW ADDRESS REQUIRED? ❑YES c NO UP/SEPA/SU? c YES o NO PLATTED LOT? c YES c NO DEMO PERMIT REQUIRED? c YES c NO Bulletin#100—January 1,2008 Page 2 of 4 k\.Handouts\Permit Application III ELECTRICAL PERMIT INFORMATION RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE El Single Family Square Feet Service or Feeder Each Add'n (First 1300 ft2-$115.50;Each add'n 500 ft2-$37.00) ❑ 0 to 100 amp $125.50 $76.50 ❑ Detached outbuilding or garage ❑ 101-200 amp 155.50 98.00 (Inspected with service) $48.50 ❑ 201-400 amp 291.00 115.00 ❑ Detached outbuilding or garage ❑ 401-600 amp 339.50 136.00 (Inspected separately) $76.50 ❑ 601-800 amp 439.00 186.00 ❑ 801 - 1000 amp 536.50 224.50 NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 584.50 311.50 Service Feeder ❑ Up to 200 amp $125.50 $37.00 ❑ Over 600 volts surcharge $98.00 ❑ 201 -400 amp P 155.50 76.50 ❑ Mast or meter repair $106.00 ❑ 401 600 amp 212.50 106.00 ALTERED COMMERCIAL/INDUSTRIAL ❑ 601 -800 amp 272.00 145.50 ❑ Over 800 amp 389.50 291.00 Service or Feeders ❑ 0 to 200 amp $125.50 ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 291.00 ❑ 601 - 1000 amp 439.00 Service or Feeder ❑ 0 to 200 amp $96.00 ❑ over 1000 amp 489.00 ❑ 201 -600 amp 155.50 ❑ #of circuits to be added/altered ❑ over 600 amp 234.00 (1-5 circuits-$98.00;Add'n circuits,$7.50/ea) ❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW (1-4 circuits-$76.50;Add'n circuits$7.50/ea) $98.00 plus 35%of Permit Fee ❑ Service- 1,000 amps or greater ❑ Mast or meter repair $57.50 ❑ Medical/Educational/Institutional Facility MANUFACTURED HOMES ❑ Service or feeder only $76.50 ❑ Service and feeder $125.50 TEMPORARY SERVICE MOBILE HOME/RV PARK Residential/Multi-Family $67.50 ❑ #of service or feeders (First service/feeder-$76.50;each add'n-$50.00) Commercial/Industrial Service or Feeder Ampacity ❑ 0-100 amps $76.50 ❑ 101-200 amps 98.00 ❑ 201-400 amps 115.00 ❑ 401-600 amps 155.50 ❑ over 600 amps 168.00 MISCELLANEOUS SERVICE/EQUIPMENT ❑ #of Thermostats ❑ #of Signs first-$57.50;add'n-$17.50/ea) (First sign-$57.50;add'n sign$27.00/ea) t10 Low Voltage ❑ Swimming pool/hot tub $115.00 Feet to be served by system(s) 2, SF (Includes additional circuit,if required) @f Fire Alarm System ❑ Yard Pole meter loops $76.50 ❑ Security Alarm System ❑ Additional Plan Review $115.00/hour ❑ Voice Cabling (for modified submittals) ❑ Data Cabling ❑ ❑ Automation Fee on all Permits .. $5.50 let 2500 ft2-$67.50; Each add'n 2500 ft2-$17.50)+Per WAC 296-46-91 0(51 @)(i&W Bulletin#100-January 1,2008 Page 3 of 4 k\Handouts\Permit Application