10-101463 ece. 1111k15)
RMIT , EL
1 O / LI ‘o 3
CITY of
Federal Way D 010 SF MF' CO ME U PL DE EN FT
COMMUNITY DEVELOPMENT SERVICES ` `` -APLjCATION ' )
�._
253 835-2607•FAX 253-835-2609
,,(eclerafwa u.com~
�° ' "` PROPERTY
SITE ADDRESS
33`LDO C Pk a..�c. S. 4\r. fr- .‘ �w �(�T6 3
. ft (2_
SUITE/UNIT# ZONING 1 ASSESSOR' AX/PARCEL#
Z� � / 2 & S--e) 7 _ 49
PROJECT
NAME OF PROJECT
(Tenant or Homeowner Name) (AS D A CU3 Pr;1., --/01-0A-/GI/GZiL4,r)
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
TYPE OF PERMIT ❑ DEMOLITION >(ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
PROJECT DESCRIPTION '�/k.S4'a l( I IN&I- Jtc CI U1I- rti
Detailed description of work to 1
be included on this permit only
PEOPLE
NAME PRIMARY PHONE
PROPERTY OWNER Saimt.‘ Veir c.S ( )
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
111-1()D t II,* AA` ��)' 1t I, 1.5
OWNER IS ALSO: CONTRACTOR ❑ APPLICANT I El PROJECT CONTACT
NAME 1 PRIMARY PHONE
e_1rD L1[ .-rr r c (15� )$S1 ?-�D
CONTRACTOR MAILING A DRESS,CITY,STATE,ZIP FAX
LI 26 ig sI- . 1\1.x. IA (0 I (Lc; )tel - 2313
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
k:rLi el d77g N b i 81 /20I( h-so 101$17-00 -ID-
N AME PRIMARY PHONE
APPLICANT �G"t Alter-015y (ZS 3) �S 1 2000
MAILING ADDRESS,CITY,STATE,ZIP FAX
4r215, (t 1 V _ N- W• COQ (20 ) g'S i ,7 -17
PROJECT CONTACT NAAME PRIMARY PHONE
(The individual to receive and JG•i'Kt_ 1-L43-./1. ( ) -
respond to all correspondence MAILING ADDRESS,CITY,STA P FAX
concerning this application) ( ) _
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
( )
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,C STATE,ZIP PRIMARY PHONE
(RCW 19.27.095) ( )
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses, and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied t he city as a part o this application.
C.,
A...
SIGNATURE: DATE q `lc - 201 V
C
PRINT NAME: 1 G a-e--
Bulletin#100—January 1,2010 Page 1 of 4 k:AHandouts\Permit Application
•
MECHANICAL FIXTURES
Value of Mechanical Work$ IA i• OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be in •lied or relocate. as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLE,ib OTHER(Describe)
AIR CONDITIONER FIREPLACE I = HOODS(Commercial)
BOILERS FURN• ►. HOT WATER TANKS(Gas)
COMPRESSORS G •G SKIS REFRIGERATION SYST
DUCTING GAS PIPING OODSTOVES
PLUMBI G FIXTU ► • S
Indicate number of each type of fixture to be installed or reloca •d as part•' is 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 • UUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen .r ty) WATE• ATERS(Electric)
HOSE BIBBS SUMPS .- WASHING MACHINES TOTAL FIXTURES
GEN ' AL IN ► •RMATION
PROJECT VALUATION WATER PURVEYOR 'WER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) E• ' ING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
o Yes ❑ No -Yes H No
RESIDENTIAL
AREA DESCRIPTION(in 3hquare feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
•
GARAGE 0 CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COM ERCIAL EW/ADDITION
AREA DESCRIPTION Area Construction #of
• cupan•• Group(s) Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occ .anc: Group(s) Construction #of Additional Information
in Square FeetType Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-January I,2010 Page 2 of 4 k:AHandouts\Permit Application
,.
• 4
ELECTRICAL
RESIDENTIAL COMMERCIAL
NEW SINGLE FAMILY RESIDENCE \ NEW COMMERCIAL
To al Square Feet
(includ g attached garage): 1st Service/Feeder Additional Feeders
0- '00 amp x$132.50 x$ 80.50
FEES: Fi t 1300 ft2-$122.00; 101- 20 a amp x$164.00 x$103.50
Eac additional 500 ft2-$39.00 201- 400 . p x$307.00 x$121.00
NE" MULTIFAMILY (3 units or more 401 600 . • x$358.00 x$143.50
st Service/Feeder Additional F'eders 601- 800 amp x$463.00 x$196.00
0- 200 amp x $132.50 x 39.00 801 -1000 amp x$565.00 x$236.50
201 -400 amp x $164.00 x $ 80.50 Over 1000 amp x$616.00 $328.50
401 -600 amp $224.00 ' $111.50
601 -800 amp x 87.00 x $153.50 Over 600 volts surcharge x$103.50
Over 800 amp x $4 0.50 x $307.00
ALTERED SINGLE o TI FAMILY ALTERED OM RCIAL
1st Service/Feeder :dditional Feeders 1 s Service/ • der Additional Feeders
0- 200 amp x $101.01 x $ 39.00 0- 200 amp x$13 x$103.50
201 -600 amp x $164.6 0 x $ 80.50 201 600 amp x '. 07.00 x$121.00
Over 600 amp x $24..50 x $111.50 601 -1000 amp $463.00 x$196.00
Over 1000 amp x$515.50 x$328.50
Added or Altered Circuits
1-4 circuits$80.50;each .dditional$8.00 Added or Altered Cir uits
1-5 circuits$103. 1;each additional$8.00
Mast or meter repair $60.50
Mast or meter epair $111.50
' FACTURED HOMES PLAN REVIEW FEES
Service or feed- only x $ 80.50 0
$ '1 3.50 plus 35%of Permit Fee;Plan Review required for:
Service and f:-der x $132.50
❑ New,or alteration to,service of 1,000 amps or greater
❑ Medical/Educational/Institutional Facility
Plan review for modified submittals $105.50/hour
MISCELLANEOUS SERVICE/EQUIPMENT
LOW VOLTAGE TEMPORARY SERVICE
❑ Fire Alarm System is Service/Feeder Additional Feeders
❑ Security Alarm System
Voice/Data Cabling ?, ,� 0 60 amp x se
71.00 x $ 32.00
0 Other 61 - 100 amp x $ 80.50 x $ 39.00
Area to be served by system:
101-200 amp x $103.50 x $ 51.00
1st 2,500 ft2-$71.00;each additional ,500 ft2-$18.50
201-400 amp x $121.00 x $ 60.50
#of Thermostats 401 -600 amp x $164.00 x $ 80.50
First$60.50; each additional$18.50
Over 600 ampx $184.50 x $ 92.00
#of Signs **NOTE: an automation fee of$6.00 will be charged
First$60.50; each additional$28.50
on all permits**
Yard Pole/meter loops/pedestal x$ 80.50
Portable Generator(transfer equipment) x$101.00 For fixtures or fees not listed contact the Permit Center at
Ditch cover/inspection only x$121.00 253-835-2607
Bulletin#100-January 1,2010 Page 3 of 4 k:\Handouts\Permit Application
. , I
Electrical
City ity of Development
tWayS Permit #: 10-101463-00-E L
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
is
Project Name: US DEPT OF AG II li'4
Project Address: 33400 9TH AVE S SUITE 200 Parcel Number: 926501 0060
Project Description: Low voltage phone and data.
Owner Applicant Contractor ,
GOLDEN STONE LLC KIRBY ELECTRIC INC KIRBY ELECTRIC INC
33400 9TH AVE S SUITE 204 4826"B"ST NW SUITE 101 KIRBYEI077BN(1/13/11)
FEDERAL WAY,WA 98003-2607 AUBURN WA 98001 4826"B"ST NW SUITE 101
AUBURN WA 98001
Is Use Educational or Institutional? No Service greater than 1000 Amps? No
Low Voltage-. x
Other(Commercial
1
PERMIT EXPIRES Wednesday, April 13, 2011
Permit Issued on Tuesday, April 13, 2010
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
,/ and the City of Federal Way.
/
Owner or agent: C is- / --e Date: 41/3//0
Mk
• F r
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 10-101463-00-EL Address: 33400 9TH AVE S SUITE 200
Owner: GOLDEN STONE LLC FEDERAL WAY, WA
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are loggedon the back of this card.
0 UFER Ground (4295) El Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
CI Pool Bonding(4195) ❑ Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) •El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date 13
(S Date ( &--it)
o Final-Electrical(4055)
Approved
By Date
Rough Electrical Final Electrical ❑ Right of Way
❑ Approved ❑ Approved Approved
By Date By Date By Date