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Federal Way PERMIT
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tF.IlERAI. WAY, WA 9BOGi-9718
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Thefollowing is required - an incomplete application will not be accepted. Please print legibly (in ink) or type.
INTOR-MATION
sITE ADDRESS 32129 Weyerhaeuser Way South SUI IUMT # 100
ASSESSOR'S TAX/PARCEL # _ _ 2� 5465'5 _ _ - 0070 � LOT SIZE (sfi
LEGAL DESCRIPTION (e.g. Aaw Estates, Lot 1)
(Aft-* -p—fe ~f- k.O i IWW d.%* tbN
E PROJECT •-
TYPE OF PERMIT ❑ BUUMING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this nermtt onlul
Install additions to fire alarm system for tenant improvement.
PROJECT NAME (Name of Business or Oumer Last Namel Farmer's Insurance
•
PROPERTY
OWNER
CONTRACTOR
el
.Ia q-th•r+.•-lb••
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
PANATTONI DEVELOPMENT
APPLICANT NAME
;RIMAFtYPHONE
-
MAILING ADDRESS
CnY, STATE, ZLP
E-MAIL ADDRESS
FAX NUMBER
COMPANY NAME
Paladin Protection, Inc.
APPLICANT NAME
Kris Conner
OFFICE PHONE
( 253) 875
- 3016
MAILING ADDRESS
17404 Meridian East, #F303
CITY, STATE, ZIP
PUyallup, WA 98735
CELL PHONE
( 235) 223
- 9464
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
20-08-104613-MBL
EXPIRATION DATE
FAX NUMBER
( 253) 875
- 3025
CONTRACTORS REGISTRATION NUMBER
PALADPI926ND
EXPIRATION DATE
08/04/2010
E-MAQ. ADDRESS
kris@paladinprotection.com
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant o Agent ❑ Other
FAX NUMBER
NAME IPRIMARY PHONE E-MAIL ADDRESS
Kris Conner 1 ( 253 ) 223 -9464 1 kris@paladinprotection.com
NAME
Per RCW 19.27.095:
Lender irtfbrmation is required If project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $. VALUE OF PROPOSED WORK $ 5,895.00
SPRIIHffi.SRED BUILDING? 10 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/RE9UIBED9 ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGffiDNE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ I.AXEHAVEN ❑ HIGHLLNE ❑ PRIVATE (SEPTIC)
PROJECT •
AREA DESCRIPTION
FMSTING
SQ.M
PROPOSED
SO, FT.
TOTAL
89, FT.
BASEMENT
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
FIRST
COMPRESSORS
FURNACES
RANGES
SECOND
_ _ GAS LOG SETS
REFRIG. SYSTEMS
THIRD
❑ YES
o NO
NEW ADDRESS REQUHWD?
ADDITIONAL FLOORS (DESCRIBE)
UP/SEPA/SU?
❑ YES
❑ NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
❑ YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
ZM ,
raorosm
1111TAL
Tarweas SP
rorwrnorasmsr
IMasr
••NEW HOMES ONLY"" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of jixture to be installed or relocated as part of this project Do not include exisliny fixtures to remain.
Value of Mechanical Work $ (A COPY OF BID OR ES71HATE MUST BE INCLUDED V= APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (commerctat)
COMPRESSORS
FURNACES
RANGES
DUCTS
_ _ GAS LOG SETS
REFRIG. SYSTEMS
BATHTUBS (or Tub/Shower Combo)
IAVS (Bathroom Sinks)
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (Tonet)
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
ZONING DESIGNATION
I cercfy under penalty ofpedmy that the bdkematfon furnished by me as eros and correct to the brat gf mll k noudedge, and.f� that I
am onthorlsed bg the owner gf the above premises to perform the .Dori[ for which the permit application is made I farther agree to holo
hornless the City of Federal wry as to any claim (including costs, expenses, and attorneys'fees, incurred in the investigation and dna gf
such claim); which may be made bg waning the �ersiyned. �jUed a�aao rhe City of Peden d wag, but only urbane such claim
arises oat of the reliance of the dty, qffi— and employees. upon the aocu vwg of the hdbrmation supplied to the eft — a part of
this opplication_ , /J
1/12/2009
(S%_tU e) Mile)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent Ia Contractor ❑ Architect ❑
FOR OFF= USE ONLY
11 NEW ❑ ADDITION
❑ ALTERATION
❑ REPAIR ❑ TENANT D0%OVEXFNT
BUILDING SHELL ONLY?
o YES ❑ NO
BASIC PLAN?
o YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
o NO
NEW ADDRESS REQUHWD?
❑ YES ❑ NO
UP/SEPA/SU?
❑ YES
❑ NO
PLATTED LOT?
❑ YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
n NO
Bulletin #100 —January 1, 2007 Page 2 of 4 MandoutMenmit Application
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIAL/ENDUSTRIAL 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-FAlIdII.Y (three units or more)
❑ Over 1000 amp 563.00 300.00
Service Feeder
❑ Up to 200 amp $120.50 $ 35.50
❑ 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
❑ 601 - 800 amp 262.00 140.50
ALTERED COMMERCIAL/INDIISTRIAL
❑ Over 800 amp 375.50 280.50
Service or Feeders
❑ 0 to 200 amp $120.50
ALTERED SINGLE/MULTI FAMMY
❑ 201 - 600 amp 280.50
Ll 601 - 1000 amp 423.00
Service or Feeder
Ll 0 to 200 amp $ 92.50
❑over 1000 amp 471.00
❑ 201 - 600 amp 149.50
❑ # of circuits to be added/altered
❑ over 600 amp 225.50
(1-5 circuits - $94.50; Add'n circuits, $7.00/ea)
❑ # of circuits to be added/altered
CON04ERCIALANDUSTRIAL 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
❑ Medical/Educational/Institutional Facility
MANUFACTURED HOMES
❑ Service or feeder only $74.00
❑ Service and feeder $120.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK
Residentua lmuiti Family $65.00
❑ # of service or feeders
(Hirst service/feeder-$74.00; each add n -$48.00)
CommercialAndustrial Service or Feder 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
LlSwimming pool/hot tub ................ $111.00
Square Feet to be served by system(s) 1800
(Includes additional circuit, if required)
0 Fire Alarm System
❑ Yard Pole meter loops ..................... $74.00
❑ security Alarm System
❑ Additional Plan Review $111.00/hour
❑ voice Cabling
(for modified submittals)
❑ Data Cabling
❑ Automation Fee on all Permits $5.00
11
..
I� 2500 ft2-$65.00;
Each add'n 2500 ft2-17.00) *Per WAC 296-46-91 o(5)(b)(i & tV
Bulletin #100 - January 1, 2007 Page 3 of 4 k\Handouts\Permit Application