07-100957 REDEIVED
F@ rt3lVaS FEB 2 2 X007 D 2
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95
PERMIT OF FEDERAL WK
COMMUNTY
DEVELOPMENT S E R V I C E S gu►LDING DEPT. SF MF COMEPLDEEN h
99325 8TM AVENUE 501)111•PO BOX 9718
2 07FAX2530 52609 APPLICATION TD
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The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
PROPERTY INFORMATION
SITE ADDRESS ii 13 30VTH- 3344$Q l.� f rr SUITE/UNIT# t.Ott
ASSESSOR'S TAX/PARCEL# / -6L- 5 J c / 5 - (J 76 LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate pa9efar lengthy legal desoipeon1
PROJECT INFORMATION
TYPE OF PERMIT El BUILDING ❑PLUMBING ❑ MECHANICAL
El DEMOLITION IXELECTRICAL ID ENGINEERING El FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
iosrlvt.perta+) O F I1/4-0 D rr ) To eic-I4 T A-G, 4 v cc 14{.A- AA Si -re-^-.-
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PROJECT NAME(Name of Business or Owner Last Name) 4u61)(Lis) I41'EOLCA'L
• PEOPLE INFORMATION
PROPERTY NAME - PRIMARY PHONE '
OWNER OPUS 0 1 ( LC_ (yz- )q,-3 -AO00
MAILING ADDRESS CRY;STATE.ZIP E-MAIL ADDRESS
Ris /is - Arm Se 3C0 6gatvoe 1 avi4 RYcr
CONTRACTOR COMPANY NAME I' APPLICANT NAME OFFICE PHONE
/ IFic f Inc ' Secu a1 (iZ-. Tat eAsT?4,0 (26(.. )781 -3$06
MAILING ADDRESS CRY,STATE,ZIP CELL PHONE
828 POPLAR PLAA0-e 1,4- $'tM7t.e i vo)- q$/t/t' (- 1 —
CrIY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
Z0 -o2 - toSLI 9 7 (-Lo6 17 z6 - 81(aa
COPT of card required CONTRACTORS REGISTRATION NUMBER EXP TIO DATE E-MAIL ADDRESS
""" .PPIe.a°" b PRC/ f5 973 p 60/30/07 -)ihee.PFS. 6z.
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
PA✓C Fie c n. ._ k S€etATI- awl
57iwilid (7 640 78'8 -38'06
MAILING ADD C ,STATE,ZIP CELL PHONE
828 oPLA-2. {9th $,' .} 5-t u ) ark 98/y'/ ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect 0 Tenant ❑Agent ❑ Other 'O614-•9'LTi (7-0 )7Zb - 8-1(00
PROJECT NAME PRIMARY PHONE - E-MAIL ADDRESS
CONTACT TIM FhSTNI A1J (zoo, ) 7 88 - 3806 -Li ate PFS .62
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
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ COO
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGH LINE ❑ TACOMA L7 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
1
U PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS I MEMO PROPOSED TOTAL TOTALE[BM•e SF TOTAL PROPOSED SF TOTAL SF
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type offixture to be Installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Vah1a of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODETOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSI EMS
PLUMBING
BATHTUBS for rub/Shower Combo) LAVS(Bathroom Sinks) URINALS - MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSLIS(Rues
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that the j. ormation 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 -- to perform the work for which the permit application is made. I further agree to hold
harmless the City of •, rat Way • to • •in(including costs,expenses, and attorneys'fees incurred in the investigation and defense of
such claim),whit •_ • made by f' ,r' including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out oft - •• .�.3 • ,1CI r- ers and employees,upon the accuracy of the information supplied to the city as a part of
this applica - ��////.p/1 t��,�f,ll�' �7
NAME/ / !4!.Latino DATE P'-2•2-�
.74. )• , , Rule) _RELATIONSHIP TO PROJE ' ❑/s, ❑Agent o Contractor ❑Architect ❑ Other
k /
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? ❑YES o NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? o YES a NO
PLATTE])LOT? n YRS n NO Tinian innaMTT nannmVT9 r,Vl■a „Nn
FEES
This is an overview of possible fees associated with the issuance of permits and is not intended to be inclusive.
BUILDING, MECHANICAL& FIRE PREVENTION PERMIT FEES
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ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
Service or Feeder Each Add'n
❑ Single Family Square Feet
(First 1300 ftt-$111.00;Each add'n 500 ftt-$35.50) ❑ 0 to 100 amp $120.50 $74.00
❑ Detached outbuilding or garage ❑ 101-200 amp 149.50 94.50
(Inspected with service) $47.00 ❑ 201-400 amp 280.00 111.00
LI 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 ALTERED COMMERCIAL/INDUSTRIAL
❑ 601 -800 amp 262.00 140.50
❑ 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
❑ 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 COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$74.00;Add'n circuits$7.00/ea) $94.50 plus 35%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-$48.00) 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
I
❑ #of Thermostats ❑ #of Signs
(First-$55.00;add'n-$17.00/ea) (First sign-$55.00;add'n sign$26.00/ea)
Low Voltage �/)y { ❑ Swimming pool/hot tub $111.00
uare Feet to be served by system(s) 1 C.(,-s--9r! (Includes additional circuit,if required)
Fire Alarm System ❑ Yard Pole meter loops $74.00
curity Alarm System ❑ Additional Plan Review $111.00/hour
❑ Voice Cabling
❑ Data Cabling (for modified submittals)
❑ ❑ Automation Fee on all Permits .. $5.00
bd 2500 ft2-$65.00;
Each add'n 2500 ft2-17.00)•Per WAC 296-46-910(51(bl(t&Ii •
Bulletin#100-January 1,2007 Page 3 of 4 k\Handouts\Permit Application