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10-102439 ET\/ 10_ - ' 0 24-3 . ' ERMIT SF MF CO ME EL PL DE EN ...._Fe Federal Way JUN r0APPLICATION �ulit COMMUNITY DEVELOPMENT SERVICES 253-835 2607•FAX 253-8.35-2609 zz t Imo cirmf, i 01I / `' v 44i3t ins, ,,.., '..,,..., k P �2L PET TY b SITE ADDRESS 1-2 je t to (ttelth�t etta ; / SUITE/UNIT# ZONINGASSESSOR'S TAX/PARCEL# ?rpt Yr 2L °ie-- a� L_/ $its PROJECT NAME OF PROJECT , (Tenant or Homeowner Name) 44//1..7Gi/ rU ,/ /1 ❑ BUILDING ❑ PL BING ❑ MECHANICAL TYPE OF PERMIT '� ❑ DEMOLITION.. ELECTRICAL ❑ ENGINEERING FIRE PREVENTION % e/ O GC/4 y 2 Si'!-i c-31-e' (-6. 71,-C/ J'f Qe 76 C..c 4`,- c PROJECT DESCRIPTION 3 5-MO 1.`� e.„ y(��,fQ 15.../ '&(/c� 7 6p / ii ce?!,/c, Detailed description of work to i ' be included on this permit only d e U�' e r 2-i �''/,s 7`'/,,t g �� `j C�21, / s NAME 1 /' PRIMARY PHONE PROPERTY OWNER ?' f( / - 7J- /4/Q/ c z(� ( ) - MAILING ADDRESS,CIITTY,STATE,E,ZIP ( E-MAIL PO; 861k/ OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT NAME — - PRIMARY PHONE ;`i e Sys7/ �s Loef� (25 )JY) - /2e CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP FAX 26)6 ©,7 -(?2- , C '//,/, $7'e (1 V' 7 (2,5-1) 7 se's' /7 3 WA STATE CONTRACTOR' ENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# (C.r6 5('‘,/,:i C-5- Z i''j i / ( / /C. i <ft9/(Z,Y'/% ( t 1 NAME/�iZ----,(..1_1717'1, PRIMAARYPHHONE APPLICANT ---4.7 t-{7 5 7171'7, ( ) (- 1,-,Ii/Le MAILING ADDRESS,CITY,STATE,ZIP Co"/1.7L14 c /'0-1 ( ) - PROJECT CONTACT NAME PRIMARY PHONE (The individual to receive and ( ) respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP ^_(, FAX 5/aconcerning this application) � ( ) - ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL ( ) PROJECT FINANCING NAME ❑ OWNER-FINANCED Required for projects with value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE (RCW 19.27.095) ( ) - I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as apart of this a..lication. SIGNATURE: .1/ DATE (�1 (C/ 'tO PRINT NAME: C7j( ( C ( 14 5-7,7 Bulletin#100-January 1,2010 Page 1 of 4 k:AHandouts\Permit Application • v 7 • MECHANICAL FIXTURES Value of Mechanical Work$ (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 OUTLLlb 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(orTUb/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 $ SFo $_ EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes ❑ No ❑Yes ❑ No RESIDENTIAL AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER(describe) EXISTING PROPOSED TOTAL Area Totals **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL - NEW/ADDITION AREA DESCRIPTION Area Construction #of in Square Feet Occupancy Group(s) Type Stories Additional Information NEW BUILDING ADDITION COMMERCIAL - REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Construction #of in Square Feet Occupancy Group(s) Type Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100-January 1,2010 Page 2 of 4 k:\Handouts\Permit Application • • ELECTRICAL • RESIDENTIAL COMMERCIAL NEW SINGLE FAMILY RESIDENCE NEW COMMERCIAL Total Square Feet 1.,Service/Feeder Additional Feeders (including attached garage): 0- 100 amp x$132.50 x$ 80.50 FEES: First 1300 ft2-$122.00; 101 - 200 amp x$164.00 x$103.50 Each additional 500 ft2-$39.00 201 - 400 amp x$307.00 x$121.00 NEW MULTIFAMILY (3 units or more) 401 600 amp x$358.00 x$143.50 1,,Service/Feeder Additional Feeders 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 x$328.50 401 -600 amp x $224.00 x $111.50 601 -800 amp x $287.00 x $153.50 Over 600 volts surcharge x$103.50 Over 800 amp x $410.50 x $307.00 ALTERED SINGLE or MULTI FAMILY ALTERED COMMERCIAL I.,Service/Feeder Additional Feeders I s Service/Feeder Additional Feeders 0- 200 amp x $101.00 x $ 39.00 0 200 amp x$132.50 x$103.50 201 - 600 amp x $164.00 x $ 80.50 201 600 amp x$307.00 x$121.00 Over 600 amp x $246.50 x $111.50 601 1000 amp x$463.00 x$196.00 Over 1000 amp x$515.50 x$328.50 Added or Altered Circuits 1-4 circuits$80.50;each additional$8.00 Added or Altered Circuits 1-5 circuits$103.50; each additional$8.00 Mast or meter repair $60.50 Mast or meter repair $111.50 MANUFACTURED HOMES PLAN REVIEW FEES Service or feeder only x $ 80.50 $103.50 plus 35%of Permit Fee;Plan Review required for: Service and feeder x $132.50 ❑ - , or alteration to,service of 1,000 amps or greater ❑ Me.'cal/Educational/Institutional Facility Plan reviehv for modified submittals $105.50/hour MISCEL US SERVE/EQUIPMENT LOW V• TAGE \()LYj1,, / TEMPORARY SERVICE X.Fire Alarm System Service/Feeder Additional Feeders ❑ Security Alarm Syst- ❑ Voice/Data Cablin_ 0- 60 amp x $ 71.00 x $ 32.00 O Other �� 61- 100 amp x $ 80.50 x $ 39.00 Area to be served b, system: 1 -200 amp x $103.50 x $ 51.00 Pt 2,500 ft2-$71.00;etch additional 2,500 ft2-$18.56 201 -400 amp x $121.00 x $ 60.50 #of Thermos ats 401-600 amp x $164.00 x $ 80.50 First$60.50;each a ditional$18.50 Over 600 amp x $184.50 x $ 92.00 #of Signs **NOTE: an automation fee of$6.00 will be charged First$60.50; each addition. '• . • on all permits** Yard Pole/meter loops/pedestal x$ 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