07-100372 r •
4 y
REG,ED
Cir., Way PERMIT U 2 - o 3
COMMUNITY DEVELOPMENT SERVICES JAN 2 4 2O(' SF MF CO ME EL PL DE EN e
33325 87t'AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718
�253-835-2607•FAX 253-835-2609 CITY OF FE7A ATION
wmw.ciiuoffederalwaa.com BUILDING DEPT,
The following is re•uired information-an incom•lete a••lication will not be acce•ted. Please •rint legibly(in ink)or ty•e.
1 C�f� , • PROPERTY INFORMATION
SITE ADDRESS , 0 / /i4 / /4) S SUITE/,(NIT# 6-')
ASSESSOR'S TAX/PARCEL# 9 7 C C' e - Ci l 2. e LOT SIZE(sfi
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) LC}/ Z r G/Av} + ?0,k ipd L•1 i :D--
(Attach separate page for lengthy legal description/
MI PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING 0 PLUMBING ❑ MECHANICAL
❑ DEMOLITION , ❑ ENGINEERING XFIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
'Ab�)10C i I )1 Ti r il\)e: At.'") 1,.1b i C._A I t\C-. Di Ott.„S Pic tS r,r C-. F 2 F /{L.14141,1
e".<'-'A57i2c, l' ' A 11 _ I G-2_ Il L- 2L)2?moi_ C r=- —rew t fu I r r'vi ive.'E11i. v`�•
PROJECT NAME(Name of Business or Owner Last Name) ?,, VA� A, 4,,,,te3)4 $1e tZ
• PEOPLE INFORMATION
PROPERTY NAME�J• PRIMARY PHONE
OWNER /(/Rki& 7-11itr) / $1) r/4. ' ( .. ( ) -
MAILING ADDRESS / _L
CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Silh i fl.) Fl) !`L,5 1 /)!fh._5 PilpkiV PileSillilk11 Pe e (=72CI ALN4
- C" (2'D )Z 1 -ZC o['/
MAILING ADDRESS CITY,STATE.ZIP CELL PHONE
IG'(- 2I1-I t rat,'e_ 11 T- oke.c,n, - i.-,e4 `7' 412`I ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
i 2 -a T -C C` C C - s L '? ' .Si /Qct (Z_. J) 9z 017z
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
s U3 L t i E ?'i ' 1- a /Z ' 2Z "es
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
51-11 t+- Fs PA .5y. iir11 dlik_.t-ii: l-cbr i O,PcLitc--. r (z53) 24iP - zocz,
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
1/e&. . 411.41 /40,e /L4-vs i. 7-14‘•6# G0G''- y Z Ct( ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant ❑Agent IXOther(Describe) j`t12 ALARtvl Ca1S t 11 ( 2 -3) 9Z6-' -0'f`6.
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
L_Jix‹,it \(71 IZvz (26-J) 71-1 2 C? Z_ L?).1121CS0 J`� Ca#IL L��
LENDER
►e) n t NAME
MAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
EXISTING USE _i On L y �pPROPOSED USE -0/i i j 1 - 0r-FIC
EXISTING ASSESSED/APPRAISED VALUE $p`((/f/7` `/� VALUE OF PROPOSED WORK $ -J i o C e <J
SPRINKLERED BUILDING? 0 YES i<NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
4,14 i.
• •
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT -7 z t 7
FIRST 3; tl' _3, L-Cz• 7, ,.)k
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
EXISTING PROPOSED TOTAL TOTAL,EXIBTltYa SF- TOTAL PROMISED..SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commeretai) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS for Tub/Shower Combo) SHOWERS WATER CLOSETS(Touet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bathroom sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
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. (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 officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
4 y_ -' t"' //" U" r'/..---'NAME/TITLELE DATE —
(Signature) / (Title)
RELATIONSHIP TO PROJECT ❑ wner ❑ Agent Contractor ❑ Architect XOther Fi 7 /41/ r tY?f \
, RO" FI* EI<IS#0**
o PTEW a ADD ZON o A[•TER TI(�1 € ' RO
$[TILLtIIYG SHELL '? t t7 NO �� I
ZONING',II�SIG31[44TIOI�I: � OF JE? o NQ
NEW DPRE REQ ti o y z t'i e11 `,' 1*P.A `,Stt? B a, B a®
'PLATTED L0 '? - . . :' .:0-TESca �3 .: ,, . 1'/E11 O RMt %IQUH ED i i7 NO
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application
II •
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
U Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$104.50;Each add'n 500 ft2-$33.50) U 0 to 100 amp $113.50 $69.50
U Detached outbuilding or garage U 101-200 amp 141.00 89.00
(Inspected with service) $44.00 U 201-400 amp 264.50 104.00
U Detached outbuilding or garage U 401-600 amp 308.00 123.50
(Inspected separately) $69.50
U 601-800 amp 398.50 168.50
U 801 - 1000 amp 486.50 203.50
NEW MULTI-FAMILY(three units or more) U Over 1000 amp 530.50 283.00
Service Feeder
U Up to 200 amp $113.50 $33.50 U Over 600 volts surcharge $89.00
❑ 201 -400 amp 141.00 69.50 U Mast or meter repair $96.00
U 401 -600 amp 193.00 96.00
U 601 -800 amp 247.00 132.00 ALTERED COMMERCIAL/INDUSTRIAL
U Over 800 amp 353.50 264.50 Service or Feeders
U 0to200amp $113.50
ALTERED SINGLE/MULTI FAMILY U 201 -600 amp 264.50
Service or Feeder U 601 - 1000 amp 398.50
U 0 to 200 amp $87.00 L7over 1000 amp 443.50
U 201 -600 amp 141.00
U #of circuits to be added/altered
U over 600 amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea)
U #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$69.50;Add'n circuits$7.00/ea) $89.00 plus 35%of Permit Fee
U Service- 1,000 amps or greater
U Mast or meter repair $52.00 U Medical/Educational/Institutional Facility
MOBILE HOMES
U Service or feeder only $69.50
U Service and feeder $113.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $61.00
U #of service or feeders
(First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $69.50
U 101 -200 amps 89.00
U 201 -400 amps 104.50
U 401 -600 amps 141.00
❑ over 600 amps 152.50
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats U #of Signs
First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'n sign$24.50/ea)
U Swimming pool/hot tub $87.00
(Includes additional circuit,if required)
U Yard Pole meter loops $104.50
❑ Secun ystem
U Additional Plan Review
❑ Voice Cabling $104.50/hour
❑ Data Cabling (for modified submittals)
■
U Automation Fee on all Permits .. $5.00
Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application