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09-101845 A • Federal W- — — C»MMUl�n DEV " 1J PERMIT SF MF CO ME EL PL DE EN FP 33325F8TMAVBNU6- � 98063-9718 ' APPLICATION BDERAG WAY,WA lorgri / /S5t1/ 253-8352607•FAX 253 B3S26p9 .� 0►Y�X9 2009 The following is required information- • incomplete application will not be accepted. Please print legibly(in ink)or type. • PROPERTY INFORMATION '704r SITE ADDRESS 6 t /S' )/Jr 1 5, �Clt/ k_/ 4lGG 1803 SUITE/UNIT, _l._ ASSESSOR'S TAX/PARCEL it a_ 6_s - 121_ � LOT SIZE(sfi LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) •epee fa►Mww+ id II PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION R ELECTRICAL 0 ENGINEERING,"FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) im ` "AL'i As .a i'. " t l' I + 1 "I Sir/Lt 5Prahei rile' 17&ioke eIec is PROJECT NAME(Name of Business or Owner Last Name) frlap leta10c("E' vi I Q f/(l it�l' - Ad/?i" an 7714r5/- J `IJ II PEOPLE INFORMATION PROPERTY NAME M l ' PRIMARY PHONE OWNER U i cn l n),/'j /��L .L.. CITY / �j ( ( ( ) MAQdNGADIM lObtP kil:.\,by*106 `C',lT�e`iL1e 1Ja. CI 4i{ E-MAIL ADDRESS CONTRACTOR COMPANY E y APPLICANT NAME OFFICE PHOIE_ \f‘16, 2 I ag4-?n /A� rm'Tnc, MarK N4dI wc(}) ( 6 ) '6 3 -39a8' MAILINGCITY STATE,ZIP CELL PHONE 0 6: s.� .0(\ St.. .+:le, . 61%1(44 ( ) - 4 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER c)G 60 - 101(006? 00 NUM= 3 l~ 18-31-0q b 1 a �7-wiz/CONTRACTOR'S REGISTRATION NUISEXPIRATION DATE E-MAIL ADDRESS W vi 4 9 C-3 i --0 s-accel mod 11-216 �� .��M APPLICANT COMPANY NAME141Q766 Nrikla"l D reC AA M E ClLi (00t IiN (a06PHONE - ,7d 1i MAILING ADD//RI ESS FI-ulU -S-a, CITY ATE,ZIP CELL PHONE 1953 5,SGcic . k (ec. to I, qi((L+�( ( ) - RELATIONSHIP TO PROJECT FAX NUMBER ❑Architect ❑Tenant 0 Agent 0..Dther C.tY '}(CAr g% )39 ' -779 PROJECTPRIMARY PHONErr� � C� E-„ I ADD-. CONTACT is C. -I, c.77U - .I g U r.. 0..tl ill ,.rb'• r . .N LENDER NAME Per RCW 19.27.095: Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - • DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE (� r � EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 1, ?fC Ob SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES ❑ NO WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE a TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a PRIVATE(SEPTIC) PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL BAS 2200%00% r SQ.FT. SQ.FT. SQ.FT. itt48441is FIRST SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(0 COVERED OR 0 UNCOVERED?) GARAGE 0 CARPORT 0 NUMBER OF FLOORS ®121 II0 PROPOSED TOTAL TOTAL AZZEIDNIsr TOTAL PROPOSED sr Toretsr *'NEW 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 WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(cammeci ) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(erT b/mosar combo) LAVE Malmo= be URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS _ WATER CLOSETS(rte ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS • SIGNATURE I Certify under penalty of perjury that I can the property owner or authorised 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 ail 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,orfederal 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 arty 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 application. SIGNATURE: DATE Property Owner and/or Authorized Agent a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT BUILDING SAaIT.ONLY? a YES a NO BASIC PLAN? o YES o.NO ZONING DESIGNATION CHANGE OF USE? a YES a NO NEW ADDRESS REQUIRED? o YES a NO IIP/SEPA/SU? a YES o NO PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? a YES o 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 ❑ Single Family Square Feet Service or Feeder Each Add'n (First 1300 tt2-$121.00;Each add'n 500 ft2-$39.00) 0 0 to 100 amp $131.50 $80.00 O 101-200 amp 163.00 103.00 ❑ Detached outbuilding or garage(w/service) $51.00 ❑ 201-400 amp 305.50 120.50 ❑ Detached outbuilding or garage(inspected separately) $80.00 0 401-600 amp 356.00 142.50 ❑ Swimming pool(w/service) $80.00 0 601-800 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 0 Over 1000 amp 613.00 327.00 ❑ Hot tub/spa/sauna(inspected separately) $80.00 0 Septic pumping system(w/service) $51.00 0 Over 600 volts surcharge $103.00 ❑ Septic pumping system(inspected separately) $80.00 ❑ Mast or meter repair $111.00 NEW MULTI-FAMILY(three units or more) ALTERED COMMERCIAL/INDUSTRIAL Service Feeder (Does not include circuits.) Service or Feeders ❑ Up to 200 amp $131.50 $39.00 0 0 to 200 amp $131.50 0 201 -400 amp 163.00 80.00 ❑ 201-600 amp 305.50 ❑ 401 600 amp 223.00 111.00 0 601- 1000 amp 460.50 ❑ 601 -800 amp 285.50 152.50 0 over 1000 amp 513.00 ❑ Over 800 amp 408.50 305.50 ❑ #of circuits to be added/altered ALTERED SINGLE/MULTIFAMILY (1-5 circuits-$103.00;Add'n circuits,$8.00/ea) Service or Feeder COMMERCIAL/INDUSTRIAL PLAN REVIEW 0 0 to 200 amp $100.50 $103.00 plus 35%of Permit Fee ❑ 201 -600 amp 163.00 ❑ Service- 1,000 amps or greater CI over 600 amp 245.50 ElMedical/Educational/Institutional Facility ❑ Additional plan review for CI of circuits to be added/altered modified submittals $115.00/per hour (1-4 circuits-$80.00;Add'n circuits$8.00/ea) ❑ Mast or meter repair $60.50 TEMPORARY SERVICE Service or Feeder Each Add'n MANUFACTURED HOMES 0 0 to 60 amp $ 71.00 $32.00 ❑ 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 0 401-600 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 ISI Low Voltagedp. (First sign-$60.50;add'n sign$28.50/ea) Square Feet to be served by system(s) 3,©O O 0 Yard Pole/meter loops/pedestal $80.00 Fire Alarm System ❑ Portable Generator(transfer equipment) $100.50 Security Alarm System ❑. Ditch cover/inspection only $120.50 ❑ Voice Cabling ❑ Data Cabling 0 1a 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\Pemvt Application