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09-102685 - 102 (0 SS .m..A • PERMIT S MF CO ME EL PL DE EN Fr-7D • Federal Wary rzI V F r) COMMUNITY DEVELOPMENT SERVICES ii// APPLICATION �Z g /1.- I 253-835-2607•FAX 253-835-2609 / www.athoffederalwaucorn I �nr(1 //`S 1L -" 3,,• `' ' t ,mac - c4,-,-;, '43 # 3, -® W " 14 : a - v z. �iaIDz�Y _._<` >�., 'a ,. '.'.. Cs�! a�R.,. .'�,�,m'1 A.,„;13C�, s� ,.• .,., "}.a.- .m.� �a -_..� a....da.�"��s..�� L•!.�, i:�.�.' _ _a., Z ".a� SITE ADDRESS J ERA! os, /' ( ifi/E- S. FFAs 4)a-/, ti A 1`a9'003 SUITE/UNIT \ZONING ASSESSOR'S TAX/PARCEL i1 , ,I ;CLV, l o ¢ z I o — z NAME OF PROJECT (Tenant or Homeowner Name) 7fl'A/la4 ,..57/9-7/D,J 26-7-,i/L C1 LcNE4e 0 BUILDING 0 PLUMBING 0 MECHANICAL TYPE OF PERMIT 0 DEMOLITIONp�} 0 ELECTRICAL^ ❑ENGINEERING `(FIRE PREVENTION /ta / l9"L�.Ar/0,"J or / bge. 4tA7erki c vS7E4 PROJECT DESCRIPTION Detailed description of work to be included on this permit only " c,� x ��,Zt x, a' " s s o ss'';'. •s i a'I"1'�4,t 0�S i ya%{,.,,4 °` NAME ////� PRIMARY PHONE PROPERTY OWNER VC- /A�(/6,$r!1'.. )r ( ) - MAILING ADDRESS,CITY,STATE,ZIP E-MAIL OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT ❑ PROJECT CONTACT NAME PRIMARY PHONE l fit- T6CN ngrn , )*J( ( ) - ONTRACTOR\ 6( MAILING ADDRESS,CITY,STATE,ZIP FAX 'P®- &)X /8'LP NZ.7- Lin, 7(ro`t3 ( ) - WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# Al.-/(r-e-41.r 9e#V 111S-12 g / l 9 4320/0 NAM PRIMARY PHONE APPLICANT CHR2d /nen2 6Y ( 42f--) XJ/ - 70 LPte MAILING ADDRESS,CITY,STATE,ZIP FAX 7o. "�bX/c 6, n7 c.. Wf 9cf'6y3 ( ..74--) 77,5- - ,5—`1 I v PROJECT CONTACT NAM M('� cP;RIMARY PHONE /� (The individual to receive and /CM/ / r 1 L.v2 a"/ (� ) ,31 - 7o t 'CV respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX concerning this application) 7 2,0x- /V .,-7{7-- W1q 98�ctt3 (1/ ) "Z - sy/0 ALTERNATE CONTACT NAME: /' PRIMARY PHONE icer a E-MAIL (AL)g) 53/- ?out' pi'L/t.tot7 FC,./„d,ofe -A .C N>1_ PROJECT FINANCING NAME 0 OWNER-FINANCED Required for projects with value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE (RCW 19.27.095) ( ) - I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses, and attorneys'fees incurred in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information suppijity as a part of this application. SIGNATURE: / 7(2./7r/f / DATE 7/--c-0/ G PRINT NAME: 7/44tR-2 ,y1 rD /• 1 etl26 y Bulletin#100—4/17/2009 Page 1 of 4 k:\Handouts\Permit Application MECHANICAL FIXTURE Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED) Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial) BOILERS FURNACES HOT WATER TANKS(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING 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. BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES' GENERAL INFORMATION PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes ❑ No ❑Yes ❑ No RESIDENTIAL AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT -- — -- — FIRST FLOOR(or Mobile Home) SECOND FLOOR —. _ ---- — — COVERED ENTRY —._.. -- — -- --- DECK GARAGE ❑ CARPORT El — — OTHER(describe) EXISTING PROPOSED TOTAL -- -- --- — Area Totals **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDITION AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information in Square FeetType Stories NEW BUILDING ADDITION COMMERCIAL - REMODEL/TENhT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information in Square Feet Type Stories TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—4/17/2009 Page 2 of 4 k:\Handouts\Permit Application • ELECTRICAL RESIDENTIAL COMMERCIAL NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL Total Square Feet 1st Service/Feeder Additional Feeders (including attached garage): 0- 100 amp x$131.50, x$ 80.00 FEES: First 1300 ft2-$121.00; 101- 200 amp x$16300,'` x$103.00 Each additional 500 ft2 $39.00 201- 400 amp x$305.50 ` x$120.50 NEW MULTIFAMILY (3 units or more) 401- 600 amp x$356.00 x$142.50 1st Service/Feeder Additional Feeders 601- 800 amp x$460.50 x$195.00 0- 200 amp x $131.50 x $ 39.00 801- 1000 amp x$562.50 x$235.50 201 -400 amp x $163.00 x $ 80.00 Over 1000 amp x$613.00 x$327.00 401 -600 amp x $223.00 x $111.00 601 -800 amp x $285.50 x $152.50 Over 600 volts surcharge x$103.00 Over 800 amp x $408.50 x $305.50 ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL 1st Service/Feeder Additional Feeders 1st Service/Feeder Additional Feeders 0- 200 amp x $100.50 x $ 39.00 0- 200 amp x$131.50 x$103.00 201 -600 amp x $163.00 x $ 80.00 201- 600 amp x$305.50 x$142.50 Over 600 amp x $245.50 x $111.00 601-1000 amp x$460.50 x$235.50 .............._............. Over 1000 amp x$513.00,' x$327.00 Added or Altered Circuits 1-4 circuits$80.00;each additional$8.00 Added or Altered Circuits 1-5 circuits$103.00;each additional$8.00 Mast or meter repair $60.50 Mast or meter repair $111.00 MANUFACTURED HOMES PLAN REVIEW FEES Service or feeder only x $ 80.00 $103.00 plus 35%of Permit Fee;Plan Review required for: Service and feeder x $131.50 ❑ New,or alteration to, service of 1,000 amps or greater ❑ Medical/Educational/Institutional Facility Plan review for modified submittals $120.50/hour MISCELLANEOUS SERVICE/EQUIPMENT LOW VOLTAGE TEMPORARY SERVICE „Bit' Fire Alarm System 1st Service/Feeder Additional Feeders ❑ Security Alarm System ❑ Voice/Data Cabling 0 60 amp x $ 71.00 x $ 32.00 ❑ Other 61 - 100 amp x $ 80.00 x $ 39.00 Area to be served by system: 9,560 /` 101-200 amp x $103.50 x $ 51.00 1st 2,500 ft2-$71.00;each additional 2,500 ft2-$18.50 201-400 amp x $120.00 x $ 60.50 #of Thermostats 401-600 amp x $163.50 x $ 80.00 First$60.50;each additional$18.50 Over 600 amp x $183.00 x $ 92.00 #of Signs **NOTE: an automation fee of$6.00 will be charged First$60.50;each additional$28.50 on all permits** Yard Pole/meter loops/pedestal x$ 80.00 Portable Generator(transfer equipment) x$100.50 For fixtures or fees not listed contact the Permit Center at Ditch cover/inspection only x$120.50 253-835-2607 Bulletin#100-4/21/2009 Page 3 of 4 k:\Handouts\Permit Application