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09-101526 �..� S1' �/ - l O / C/ Federa' V E PERMIT SF - COMM ATTYDEVELOPMENTSERVICES SF MF CO ME EL PL DE E AFP 33325 8TM AVENUE SOUTH•PO BOX 9718 , 2F53 F 2916342761 PR 2 4 2009 APPLICATION / / �.a .om The foil/Calif;COidgif4ARIAtionWellawomplete application will not be accepted. Please print legibly(in ink)or type. al PROPERTY INFORMATION SITE ADDRESS `'i /5 ......57 /cl,/ _ d�`j SUITE/UNIT e ASSESSOR'S TAX/PARCEL• ( `_ ,5— C — / &.f0._ LOT SIZE(sf LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) II PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION el ELECTRICAL 0 ENGINEERING A FIRE PREVEIITION SYSTEM I PROJECT DESCRIPTION(Provide detailed description of Twit•included on this only) rv,5- 1-6,16/4: 2. a cc le c4c 6m'ke c1 jttc{ r z 12 ,-r, 64, e__.. .., 51-x4 el e Mdersicil Ing Ire i Rescue Approved U As Detailed i Ir� f— Cl SUbtec!to t1IlPacli d Iittdll.`-.' PROJECT NAME(Name of Business or Owner Lost Name) l' a ap ie1 ` El PEOPLE INFORMATION PROPERTY NAME /� OWNER 6'" 1 1-30.1C1'F1G L L l_ � /' PHONE J l ) - MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS ' 3t-10p cNe Ave 5, Sfe 9o1/ Rekal lxkry lei �l"6163 CONTRACTO?. ./.,,, R COMPANY NAME - APPLICANT NAME t OFFF•ICE PHO 1„. �'�trK p�1 .,�,��,,,� ( ©6 ) - 34.,,,4_,..„.:_Ak.,,,,,:, n � 1 l(`�,..ia, l 6144 CELL PHONE - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER CZ- - 101& I -o©-?r,L () ) Q -%)/ CONTRACTOR'S REOZSTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS tyilAgiz(94inde,,,, APPLICANT COMPANY NAME pin APPLICANT NAME OFFICE PHO, MAILING AD' >J J 5 ja(kcal ,�, STAT 'ZIP w S c76.,/g4 CELL PHONE - RELATIONSHIP TO PROJECT (/ FAX NUMBER ❑Architect ❑ Tenant a Agent ❑ Other ( ) - PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS CONTACT ( ) - 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 $ i/) gRO Pi° SPR NKLERED BUILDING? ''YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO WATER SERVICE PROVIDER a LAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN a HIGHLINE ❑ PRIVATE(SEPTIC) PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(0 COVERED OR 0 UNCOVERED?) GARAGE 0 CARPORT 0 NUMBER OF FLOORS same PROPOSED TOTAL TOTAL ZEMIN SP TOTAL raorae5DSP TOTAL Sr **MEW HOMES ONLY"* NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ 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 WITHAPPLICATIONJ AIR HANDUNG UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS _ FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(commwa s COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or7Ub/shower Combo) LAVS(anthem=swim URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS(two 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 Wag regulations pertaining to the work authorised 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 be made by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this app SIGNATURE: DATE 9 `Z (oc-A Property Owner and/or Authorized Agent ti a NEW a ADDITION o ALTERATION a REPAIR a TENANT IMPROVEMENT BUILDING SHELL ONLY? a YES a NO BASIC PLAN? o YES o.NO ZONING DESIGNATION CHANGE OF USE? a YES o NO NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? a YES a NO PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES n NO Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Pennit Application • ELECTRICAL PERMIT INFORMATION *NOTE:an automation fee of$6.00 will be charged for all permits. RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE El Family Square Feet Service or Feeder Each Add'n (First 1300 IV-$121.00;Each addh 500 ft2-$39.00) ❑ 0 to 100 amp $131.50 $80.00 U 101-200 amp 163.00 103.00 ❑ Detached outbuilding or garage(w/service) $51.00 ❑ 201-400 amp 305.50 120.50 ❑ Detached outbuiming or garage(inspected separately) $80.00 ❑ 401-600 amp 356.00 142.50 ❑ Swimming pool(w/service) $80.00 U 601-800 amp 460.50 195.00 ❑ Swimming pool(inspected separately) $120.50 ❑ 801- 1000 amp 562.50 235.50 ❑ Hot tub/spa/sauna(w/service) $51.00 El Over 1000 amp 613.00 327.00 ❑ Hot tub/spa/sauna(inspected separately) $80.00 ❑ $epi pumping system(w/service) $51.00 0 Over 600 volts surcharge $103.00 ❑ $epi pumping system(inspected separately) $80.00 ❑ Mast or meter repair $111.00 ALTERED COMMERCIAL/INDUSTRIAL NEW MULTI-FAMILY(three units or more) (Does not include circuits.) Service Feeder Service or Feeders O Up to 200 amp $131.50 $39.00 0 0 to 200 amp $131.50 O 201 -400 amp 163.00 80.00 0 201-600 amp 305.50 O 401-600 amp 223.00 111.00 0 601 - 1000 amp 460.50 ❑ 601-800 amp 285.50 152.50 ❑ over 1000 amp 513.00 ❑ Over 800 amp 408.50 305.50 ❑ #of circuits to be added/altered ALTERED SINGLE/MULTI FAMILY (1-5 circuits-$103.00;Add'n circuits,$8.00/ea) Service or Feeder COMMERCIAL/INDUSTRIAL PLAN REVIEW El 0 to 200 amp $100.50 $103.00 plus 35%of Permit Fee El 201-600 amp 163.00 ElService- 1,000 amps or greater El over 600 amp 245.50 ElMedical/Educational/Institutional Facility ❑ Additional plan review for El of circuits to be added/altered modified submittals $115.00/per hour (1-4 circuits-$80.00;Add'n circuits$8.00/ea) O Mast or meter repair $60.50 TEMPORARY SERVICE Service or Feeder Each Add'n MANUFACTURED HOMES ❑ 0 to 60 amp $ 71.00 $32.00 O Service or feeder only $80.00 ❑ 61-100 amp 80.00 39.00 ❑ Service and feeder $131.50 ❑ 101-200 amp 103.50 51.00 O 201-400 amp 120.00 60.50 MOBILE HOME/RV PARK ❑ 401-600 amp 163.50 80.00 ❑ #of service or feeders ❑ Over 600 amp 183.00 92.00 (First service/feeder-$80.00;each add'n-$52.50) MISCELLANEOUS SERVICE/EQUIPMENT ❑ #of Thermostats (First-$60.50;add'n-$18.50/ea) ❑ #of Signs Oli Low Voltage (First sign-$60.50;add'n sign$28.50/ea) Square Feet to be served by system(s) t$,/`lI Co ❑ Yard Pole/meter loops/pedestal $80.00 ill Fire Alarm System ❑ Portable Generator(transfer equipment) $100.50 ❑ Security Alarm System U Ditch cover/inspection only $120.50 ❑ Voice Cabling O Data Cabling ❑ 1.t 2500 ft2-$71.00; For fees not listed,contact the Permit Center at Each add'n 2500 ft2-$18.50) 253-835-2607 Bulletin#100-January 1,2009 Page 3 of 4 k\Handouts\Pennit Application