09-1015322,
C" of
Fediemi C E I V E D*P E R M_ I T SF MF CO ME EL PL DE EN4Z?)
"' I ' '
33325 8a ZE'NNE
2 ""' APPLICATION
253-835-2607- FAX 2.53-835-2609 of
LA I "F FEDERAL WAY
The following is requippdrift%rmation -an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS. 32_1Z3. We,4-Pn+a-evse_r
APPLICANT NAME
OFFICE PHONE
Wo,)t S.
(sUITE UNIT
ASSESSOR'S TAX/PARCEL ; I'
5_1
& �
a C
LOT SIZE (sfi
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING %,FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of tuork mctuded on this Ran_ng ojjW
AT WM rAr, i R X 0
PROJECT NAME (Name of Business or Ouner Last Nam
I
0 PEOPLE INFORMATION
PROPERTY
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
ME PRIMARY PHONE
=7 E-MAIL ADDRESS
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
C 1()!n
k_S5�cp )b i re�c n
(112S) q&l
NO ADDRESSZ
STATE,ZIP
CELL PHONE
IA�:3
ISIt`�,
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATIONDATE
PAX WMBER
kqOtS ICSDto\ w S L
i 1 - aq
( ) 1481 -gtbgS
CONTRACTOR'll 1=18TRATION NUMBER.
Z"MAVON DATE
E-MAIL ADDRESS
Uomxpam" UL-
C4_8_ I I .
je,5&Gae�C �EW
COMPANY NAME
COMPANY
APPLICANT NAME
OFFICE PHONE
MAILINOADDRFSS
CITY. STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
1:3 Architect o Tenant o Agent 13 Other
FAX NUMBER
( -
- WNW21490 RMANTAM IMP Mdwom
NAME
Per RCW19.27.095.
Lender information is required If project value exceeds $5,000
MAIUNO ADDRESS
CITY, STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK ka
SPRINKLERED BUILDING? YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? E3 YES El NO
WATER SERVICE PROVIDER o LAKERAVEN o HIGHLINE 0 TACOMA 0 PRIVATE (WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN 0 MGHLINE o PRIVATE ISEPTIC)
.can)
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
S . FT.
TOTAL
SO. FT.
BASEMENT
o YES o NO
BASIC PLAN?
a. YES
FIRST
ZONING DESIGNATION
CHANGE OF USE?
SECOND
o NO
NEW ADDRESS REQUIRED?
o YES a NO
THIRD
o YES
o NO
PLATTED LOT?
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED?
o YES
o NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
ZM87'af6
rsorossa
Toru.
TolALia87TNa el
TOTAL FROPOMID er
TOTAL BF
—NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate. number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value 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 )eommerei.q
COMPRESSORS FURNACES RANGES
DUCTS. GAS LOG SETS REFRIG. SYSTEMS
BATHTUBS Io TablsbeWer combo) LAVS peh.em sbd* URINALS MISC (Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS tr n q
ELECTRIC WATER HEATERS SINKS WASHING MACHINES .
HOSE BIBBS SUMPS
I certjfy under penalty of peyury that I am the property owner or authorised agent of the property owner. I certVy that to the best of my
knowiedgs, the Information submitted in support of this permit application is true and correct. I eerto that I will comply with all applicable
city qf Federal Way regulations pertaining to the work authorised 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 attornegs' fees incurred in the
investigation and defense of such clainQ, which may be made by any person, including the undersigned, and filed against the city, but only
when 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 o ppiication. _ A
SIGNATURE:
Owner
a NEW a ADDITION
o ALTERATION
o REPAIR a. TENANT IMPROVEMENT
BUILDING SHELL ONLY?
o YES o NO
BASIC PLAN?
a. YES
o NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
o NO
NEW ADDRESS REQUIRED?
o YES a NO
UP/SEPA/SU?
o YES
o NO
PLATTED LOT?
o YES a NO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 — January 1, 2008 Page 2 of 4 MandoutsTermit Application
RESIDENTIAL
COMMERCIAL
NEW RESIDENTIAL SERVICE
NEW COMMERCIALANDUSTRIAL 8ERVICE
Q Single Family Square Feet
Service or Feeder Each Addn
(First 1300 R2- $115.50; Each addn 500 W - $37.00)
L3 o to loo amp $125.50 $76.50
13 Detached outbuilding or garage
❑ 101 - 200 amp 155.50 98.00
(Inspected with service) $48.50
❑ 201 - 400 amp 291.00 115.00
C3 Detached outbuilding or garage
❑ 401- 600 amp 339.50 136.00
(Inspected separately) $76.50
❑ 601 - 800 amp 439.00 186.00
❑ 801 - 1000 amp 536.50 224.50
NEW (three units or more)
0 Over 1000 amp 584.50 311.50
Service Feeder
L3 Up to 200 amp $125.50 $37.00
Q Over 600 volts surcharge $98.00
Q 201 - 400 amp 155.50 76.50
13 Mast or meter repair $106.00
❑ 401 - 600 amp 212.50 106.00
ALTERED COMMERCK/INDUAMM
❑ 601 - 800 amp 272.00 145.50
❑ Over 800 amp 389.50 291.00
Service or Feeders
L] 0 to 200 amp $125.50
ALTERED SINGLE/MULTI
❑201 - 600 amp 291.00
❑ 601 - 1000 amp 439.00
Service or Feeder
Q over 1000 amp 489.00
❑ 0 to 200 amp $96.00
❑ 201 - 600 amp 155.50
of circuits to be added/altered
Q over'600 amp 234.00
(1-5 circuits - $98.00; Addh circuits, $7.50/ea)
L1 _# of circuits to be added/altered
COMMERCIAL INDUSTRUL PLAN R-L"a-W
$98.00 plus 35% of Permit Fee
(1-4 circuits-$76.50; Add% circuits $7.50/ea)
❑ Service - 1,000 amps or greater
L3 Mast or meter repair $57.50
❑ Medical/Educational/Institutional Facility
X&MMACTURED HOMES
Q Service or feeder only $76.50
U Service and feeder $125.50
TEMPORARY SERVICE
MOBILE HOME/RV PARR
Residential/Mult(-Family $67.50
C3 _# of service or feeders
(First service/feeder-$76.50, each addn -$50.00)
Coninterciat4ndustrial Service or Feeder Ampacity
Cl 0 -100 amps $76.50
❑ 101 - 200 amps 98.00
201 - 400 amps 115.00
❑ 401 - 600 amps 155.50
E3 over 600 amps 168.00
MISCELLANEOUS SERVICE/EQUIPMENT
L3 # of Thermostats
(3 _# of Signs
(First -$57.50; addn-$17.50/ea)
(First sign-$57.50; add fn sign $27.00/ca)
L3 Low Voltage
❑ Swimming pool/hot tub ................ $115.00
Square Feet to be served by system(s)
(Includes additional circuit, if required)
0 Fin Alarm System
❑ Yard Pole meter loops ..................... $76.50
13 Security Alum System
❑ Additional Plan Review $1 15.00/hour
13 Voice Cabling
(for modified submittals)
[3 Data Cabling
Q Automation Fee on all Permits $5.50
lot 2500 ft2-$67.50;
Each add 2500 W - $17.50) *Per WAC 296.4&910(SP)6 & ff)
Bulletin #100 -January 1, 2008 Page 3 of 4 MandoutsTernift Application
This is an overview of possible fees associated with the issuance of permits and is not intended to be inclusive.
BUILDING, MECHANICAL & FIRE PREVENTION PERMIT FEES
-� Building, mechanical, and fire prevention system fees are calculated based on the following schedule.
a Project valuation -for new construction or additions is based on a set cost per square foot as determined by the
Building Official.
-� Valuation for remodels, tenant improvements, alterations, etc. shall be provided by the applicant based on a
legitimate bid or cost estimate which reflects the fair market value of all elements of the project.
TOTAL PROJECT VALUATION INCREMENTAL FEE FACTOR
(1) $1.00 to $500.00 (1) $34.00
(2) $501.00 to $2,000.00 (2) $34.00 for the first $500.00 plus $4.50 for each additional $100.00 or fraction thereof to and
including $2,000.00
(3) $2,001.00 to $25,000.00 (3) $101.50 for the first $2,000.00 plus $20.50 for each additional $1.000.00 or fracdon thereof, to
and including $25,000.00
(4) $25,001.00 to $50,000.00 (4) $573.00 for the first $25,000.00 plus $14.50 for each additional $1.000.00 or fraction thereof to
and including $50,000.00
(5) $50,001.00 to $100,000.00 (5) $935.50 for the first $50,000.00 plus $10.00 for each additional $1.000.00 or fraction thereof, to
and including $100,000.00
(6) $100,001.00 to $500,000.00 (6) $1,435.50 for the first $100,000.00 plus $8.00 for each additional $1.000.00 or fractlon thereof,
to and including $500,000.00
(7) $500,001.00 to $1,000,000.00 (7) $4,635.50 for the fist $500,000.00 plus $7.00 for each additional $1.000.00 or fraction thereof, to
and including $1,000,000.00
(8) $1,000,001.00 and up 1 (8) $8,135.50 for the first $1,000,000.00 plus $5.50 for each additional $1.000.00 or fraction thereof.
PLAN REVIEW FEES
� Plan review fees are collected in addition to permit fees, based on a percentage of the associated permit fee
• Building Permit
• Mechanical Permit
• Plumbing Permit
• Fire Prevention Permit
• Fire review fees
• Additional Building Division Review
65% of Building Permit Fees
25% of Mechanical Permit Fees
65% of Plumbing Permit Fees
65% of Fire Permit Fees
15% of building permit fees
(Commercial building permits only)
$70.00/hour
PLUMBING PERMIT FEES
• $29.50 Permit Fee plus $10.00 per fixture
OTHER FEES (Vary according to project type and scope)
• WA State Building Code Council (SBCC) Surcharge ....................... $4.50/issued permit
• Public Works review fees............................................................... $130.00 for new single family
................ $782.00 for new commercial
• Zoning review fees.........................................................................$52.00 (residential only)
• School District impact fees (new residential only)...........................$4,077.00/single-family residence
................$1.820.50/multi-family unit
• Automation fee on all permits ........................................................$5.50
If you need assistance completing the permit application form, or have
questions concerning the application process, please contact:
Community Development Customer Service Counter at (253) 835-2607
Bulletin #100 - January 1, 2008 Page 4 of 4 k\Handouts\Permit Application