06-105100 RECEIVED
-. i I
• 0015 rv5 2006
WY OF 41A LWAY - ..—
Feder'aI Way. .c►TY UILD W 1, M T — -- LO ` . �.. ��
• COMNUNIrrDEVELOPMENT SERVICES
. `"' +' SF MF CO ME EL PL DE EN
33325 BTM AVENUE SOUTH.PO BOX 9718 FP
APPLICATION
FEDERAL WAY,WA 98069.9718. _ ,.:.,..,...-....: ,,..
253-835.2607.AL WAY,
FAX 298063. 718 r / / '
Ir1ww.dluofedem1 vaV.tom
The o llowin_ is re•aired i orrnation-an into •fete . ••lication will not be acce•ted. Please •rint le,ibi• n in or •e.
;,,,.: ,...:,:- . ,x..:;.<,r. :.:•• :, , • ■ PROPERTY INFORMATION •
SITE ADDRESS '--ZwC) .n-C;c-c. kw, S /3 �� n U S"
_ _ f SUITE/UNIT# 1'- l
ASSESSOR'S TAX/PARCEL# t 6 .� a` 1 _✓- G ,rr'A LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) / JrrIr 1>V1-y -e 5,5, dS
(Attach separate pagefar ievithy udesafpNon)
PROJECT_ .
•.:• . .' INFORAIATIO .. _
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL ,
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING B FIRE PREVENTION SYSTEM
PROJEC DESCRIPTION(Prole de ailed description of work included on this permit only)
-r� 5/ra-//r.- est, c�Jy .5. e/ rc ill /
de
� � T E1.(-1-f--1/i Ce'c%e:l t`J/�� L-�i f eJ4.
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PROJECT NAME(Name of Business or Owner Last Name) O :w i 5 (2 c1
.r,�..: .,,>�,:. .- ... .. .•:.L.,..:_ r.,,.:;� PEOPLE INFORMATION .. ..
PROPERTY .NAME
OWNER �All� Ni, It PRIMARY PHONE LJ.
MAILING ADDRESS (y�� ` - 7 �
�- CITY,STATE,ZIP
t'/u /ii-W 1 4-114 $.15„,f, ge// ce,VA-- G0 S".
CONTRACTOR COMPANY NAME
APPLICANT NAME OFFICE PHONE
MAILING ADDRESS ✓✓/ CITY,ST ,ZIP
S. �F ,f//c, 4... , /eiv ( CELL PH( )NE
CITY OF FED RAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
10 - ca , c •
D 5 ! 1• 7 B L / / (.a06 ) ?acro - 8/;0
CONTRACTORS REGISTRATION NUMBER(copy of card required with eitch application)
L G 7 ,c- S ? 7 3 P u EXPIRATION DATE
i
APPLICANT PANYYME�- / APPPCANT N OFFICE PHONE
•
MAILING ADDRESS ! -3 0 i /
/ iL5e 7
/ CITY,ST/ALTEf ZIP � CELL PHONE ��
�!— Ace.. . .a Cl!P41 1 (f ( ) -
RELATIONSHIP TO PROJECT
. FAX NUMBER
0 Architect ❑:Tenant 0 Agent (D 0 Other ascribe) co./pr_,,,-,--- (0,6 ) 7,24( _ et'6 U
CONTACT NAM �• PRIMARY PHONE E•MAILADDRESS
�
A-4-1. Ustrce . (.oc.)-7d73 - 381
LENDER fi« rr �r :=z J I
* $•• 0:1 M.84 4,160*4114..1�,�,fili„G yt! k.i4r` u NAME
MAILING ADDRESS ' ' CITY,STATE,ZIP j PHONE
.x . :.. =. . Y wd ..t. ,.- ( )
?. <_ ,, �.� �y uf � s :c , rtie•T;",. +- DETAILEDBULDNGINFORMATION
i 5 V, .4.t{r ri . �'t t r I ' ,
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE .$ VALUE OF PROPOSED WORK $ l'..3 t J"-- •
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
. •
PROJECT FLOOR AREAS
' AREA DESCRIPTION EXISTING PROPOSED. " TOTAL
SQ. FT. SQ.FT. SQ. FT.
BASEMENT
FIRST '
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE) .
DECK(COVERED?)
GARAGE 0 CARPORT 0
t�gaTpia pRO.gal° tofu, cr E 1- az i Sc' '� aAti+ sr, x g s R t y t
NUMBER OF FLOORS .'....,
**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 factures to remain..
MECHANICAL
Value of Mechanical Work $`
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercieq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING •
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS irou.q MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
• LAVS(sobroom sink.) VACUUM BREAKERS ELECTRIC WATER HEATERS
•
..t..,..., .;<"€:s ..S �Lr'Y�•:s✓.;':J+.:..` :i✓•• .t.li+9r ii._ :..n..<• , ':::.. �, - •DISCLAIMER/SIGNATURE$LOCK• :
f cert(fy under penalty of perjury that the information 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 premises to perform the work for which the permit application is.Made. 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 of Federal Way,but only where such claim
arises out of the reliance of the city, including its offic rs and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE C (�� ;r u r 3.;_ :. . DATE r° s C
(Signature) (Title)
RELATIONSHIP TO PROJECT q OWner 0 Agent 0 Contractor 0 Architect ❑ Other •
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,.���,4-�N.«... 33:.•rs t k t h k ,- .y•E, xrr, n� $ � �,-:�.. t b, y� ,,:.�ax �n�'� � �aY Tx�.� �ih .
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ELECTRICAL PERMIT INFORMATION,
RESIDENTIAL . COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE.
❑ Single Family Square Feet•
Service or Feeder Each Add'n
(First 1300 fig-$107.50;Each add'n 500 ft2-$34.50) ❑ 0 to 100 amp $117.00 $71.50
❑ Detached outbuilding or garage ❑ 101.-200 amp 145.00 91.50
(Inspected with service) $45.50 0 201-400 amp 272.00 107.50
❑ Detached outbuilding or garage 0 401-600 amp 317.00 127,00
(Inspected separately) $71.50 ❑ 601-800 amp 410.00 173.50
0 801 - 1000,amp 500.50 209.50
NEW MULTI-FAMILY.(three units or more) 0 Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp $117,00 $34.50 ❑ Over 600 volts surcharge $91.50
❑ 201 -400 amp 145.00 71.50 0 Mast or meter repair $99.00
0 401 -600 amp 198.50 99.00
E 601 -800 amp 254.00 136.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 364.00 272.00 Service or Feeders
❑ 0 to 200 amp $117.00
ALTERED SINGLE/MULTI FAMILY ❑ 201 600 amp 272.00
Service or Feeder ❑ 601 -.1000 amp 410.00
❑ over 1000 amp 456.50
❑ 0 to 200 amp $89.50
❑ 201 -600 amp 145.00
0 # of circuits to be added/altered
❑ over 600 amp 218.50 (1-5 circuits-$91.50;Add'n circuits,$7.00/ea)
0 #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$71.50;Add'n circuits$7.00/ea) $91.50 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $53.50 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
0 Service or feeder only $71.50
O Service and feeder $117.00
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/fulti-Family $63.00
❑ #of service or feeders
(First service/feeder-$71.50;each add'n-$46.50) CommerciaWndustrial Service or Feeder Ampacity
❑ 0- 100 amps $71.50
❑ 101-200 amps 91.50
❑ 201-400 amps 107.50
❑ 401-600 amps 145.00
❑ over 600 amps 157.00
,
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats . ❑ # of Signs
(First-$53.50; add'n-$16.50/ea) (First sign-$53.50;add'n sign$25.00/ea)
Low Voltage ❑ Swimming pool/hot tub $107.50
Square Feet to be served by system(s) 5.tai (Includes additional circuit,if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $71.50
❑ Security Alarm System ❑ Additional Platt Review
❑ Voice Cabling $107.50/hour
(for modified
Q Data Cabling submittals)
0 ❑ Automation Fee on all Permits .. $5.00
(Per Systems) 1st 2500 ft2-$63.00;
Each add'n 2500 ft2-16.50) *Per WAC 296.46-910(5)(b)(i&ii)