08-103993 • •
'�R„�edA RECEIVE ° - 1 ° -- q 9'3
Feral Way ERMIT
•MUNITYDEVEWPMENT
SERVICES AUG2L
SF MF CO ME� L DE EN FP
8TMAVENUE SOUTH•63 971 9718 PLICATION ID
FEDERAL WAY,WA 98063-9718 / /
253-835-2607 FAX 253-835-2609
wwW.citU°ffederaher Y OF FEDERAL WAY
The following is required infn-an incomplete application will not be accepted. Please print legibly(in ink)or type.
G� • PROPERTY INFORMATION
SITE ADDRESS 3245 'S I L�1 / iJ S �7 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 7 5 O I 5 / - 0 0 G-" 0 LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) -Fra nCfs gess io i/cc I
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION *ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detnilpd description of work included on this permit onlu) /
"-VIC7�u1t On`j r-►.,tv't 11.0,4- Irl e"1 e Nei.. P,...,'v.ttlx.6e-C .. bit.Cc'1A✓�ee._ I- ex,�{.c1')N�
elecl'rl•C e-,14. Rf`CL',),LkCri/1 :✓i filo-. Tl-i^4t.'L.."t— o
PROJECT NAME(Name of Business or Owner Last Name)
• PEOPLE INFORMATION
•OPERTY NAME lIP ` f PRIMARY PHONE
•WNER -Fran ClSca/'1 T'/ Q 1 ! I - `ry/ s /1.e1'vN ( ) -
MAILING ADDRESS CITY,0-18.1 r.,ZIP E-MAIL ADDRESS
CO CTOR COMPANY NAME �y APPLICANT E OFFICE PHONE
n E)ectricc 1 C'ortS+rc tars (Qnc ,r ey (75.31 s39 0 999
'W�'
39Sr:G CITY,STATE,ZIP CELL.PHONE
�` o lc.
suo 0
Tcico.rIa wit gr4'/S' ( 263) cgo3 -7900
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
Zo-o/-/6a%/- C0'3I-- /2-3/-2,0o8' (243)33,- O/o/
COPY of cera te9,area CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E- ADDRESS,,1,�
with each application 7.1i /�cam+ - ,9,1a®TA0o"��n
0/n �FG6o$e 1,-) 2 — /� Zo/o Const, c t-d,5 . co.►1
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 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 ADD CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
41XISTING USE PROPOSED USE
STING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
. IN PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
ASEMENT
IRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR 0 UNCOVERED?)
GARAGE ❑ CARPORT 0
EXISTING PROPOS® TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
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 fixtures to remain.
MECHANICAL
Valve 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(commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
IIIUMMTG
BATHTUBS(orTub�snowerCombo) LA
VS(BathroomsWca) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATERCLOSETS(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify 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 in 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 relic the city,including its officers and employees,upon the accuracy of the Information supplied to the city as a part of
this application. ,. / .f p
NAME/TITLEC /4U� i�r/� i(� DATE D �/— 0�
(Signature) (TIUe)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
o NEW L. 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? o YES o NO
NEW ADDRESS REQUIRED? o YES n NO UP/SEPA/SU? n YES n NO
PLATTED LOT? o YES D NO DEMO PERMIT REQUIRED? o YES o NO
•
Bulletin#100—January 1,2007 Page 2 of 4 k\Handouts\Permit Application
11111
a
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$111.00;Each add'n 500 ft2-$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
❑ 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 Cl 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
U 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- circuits-$94.50;Add'n circuits,$7.00/ca)
❑ #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 U 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
❑ #of Thermostats ❑ #of Signs
(First-$55.00;add'n-$17.00/ea) (First sign-$55.00;add'n sign$26.00/ea)
❑ Low Voltage U Swimming pool/hot tub $111.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
O Fire Alarm System ❑ Yard Pole meter loops $74.00
. 0 Security Alarm System ❑ Additional Plan Review $111.00/hour
0 Voice Cabling (for modified submittals)
❑ Data Cabling
U Automation Fee on all Permits .. $5.00
1st 2500 ft2-$65.00;
Each add'n 2500 ft2-17.00)•Per WAC 296-46-910(5)(12)(181.W
Bulletin#100-January 1,2007 Page 3 of 4 lalandouts\Permit Application