03-104855f
City of Federal Way
Community Development Services
33530 Ist Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #: 03 -104855 - 00 - ME
Inspection request line: 253.835.3050
Project Name: KC DRIVE-IN 0
Project Address: 28843 MILITARY /S Parcel Number: 042104 9030
Project Description: Install Class I commercial hood in conjunction with tenant improvements.
Owner
Applicant
Contractor
Rodney W Snyder
WESTERN COMMERCIAL REAL ESTATE
WESTERN COMMERCIAL REAL ESTATE
28815 PACIFIC HWY S #10A
28815 PACIFIC HWY S #10A
28815 PACIFIC HWY S #I OA
FEDERAL WAY WA
FEDERAL WAY, WA
FEDERAL WAY, WA
I4gdWr�*Yaluation..........................................8525
98003 Over the Counter Permit..(253)•94}.6600........
No
PERMIT EXPIRES April 27, 2004.
Permit issued on October 30, 2003
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 Date: b
//- / Z - D 3 c-.t�
lZ�zz��A�/
RECOVED CONSTRUCTION PERMIT APPLICATION
CITY OF P -V
Federal Way OCT 2 4 2003 PPUCATION NUMBER: - Q y R��_
PPUCATION NUMBER:
CITYOtFnFEDERALWAY PPUCATIONNUMBER: _
—The follow l��t5requiPEnformation - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY •. •
SITE ADDRESS: ���� /y1�L[t-s�e� SASSESSOR'S TAX/PARCEL 1 7
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
O ELECTRICAL O ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): —1 `s"J'f-rkt ` cmc>� I T Az 6 vkC,1-10-ra�
S
PROJECT NAME: K�ZsaS� 't•� ���-O C�Ti 1�( �..�f G
PEOPLE• •
PROPERTY OWNER: NAME: t
v OcJcq
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
,etI6 4
CONTRACTOR:
'HONE'
NAME:
I DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE. ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:
i EXPIRATION DATE:
(copy of card required)
1 / /
APPLICANT: NAME:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
Iters P.+4, S, / d A <r V,�, . �J4. �3 �� -:5
RELATIONSHIP TO PROJECT:
O ARCHITECT O TENANT O OTHER ( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: O PROPERTY OWNER p6 APPLICANT O CONTRACTOR
3ETATLED BUILDING INFARMATIC
3)g1-0 -U or,
EVENING PHONE:
(,c � 53 ) "SZ - 773 /
FAX NUMBER:
( 2S3 ) W/ - 671e,
E-MAIL ADDRESS:
wC—P—i2w11?AC, L.
EXISTING USE: T EXISTING BUILDING ASSESSED/APPRAISED VALUATION /cc--,- -dla--Cp , -C-
7— 8,525 co
PROPOSED USEPROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? ❑ YES W116-- FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: WfE//S O NO
�� ��
WATER SERVICE PROVIDER: e'LAKEHAVEN ❑ HIGHLINE O TACOMA O PRIVATE (WELL) �� R 3T 'mob D S
SEWER SERVICE PROVIDER: L!;,CAKEHAVEN O HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** '
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
SHOWER(S)
GAS PIPE OUTLET(S)
SINKS)
FIRST
SUMP(S)
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S)
BBQ(S) I FAN(S)
BOILERS) FIREPLACE INSERTS)
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S)
PLUMBING
BATHTUB(S)
LAVATORY(S)
DISHWASHER(S)
RAIN WATER SYS.
DRINKING FOUNTAIN(S)
SHOWER(S)
GAS PIPE OUTLET(S)
SINKS)
INTERCEPTORS)
SUMP(S)
Value of Mechanical Work: $
GAS LOG(S) REFRIG. SYSTEM(S)
HOOD(S) WOODSTOVE(S)
RANGE(S) MISC. ( )
HEAT SOURCE: 9-6LECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC.
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. 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 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.
NAME/TITLE: Win[ .�.-r/4� DATE: � '03
❑ PROPERTY OWNER .e APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 -; FAX: 253-661-4129
www citvoffederalwav com
Construction Permit Fee Calculation Sheet
*******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY&CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT.
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building, mechanical, and fire prevention system fees are based on the following schedule.
PLUS:
TARI F A
TOTAL VALUATION
FEE FACTOR
(1) $1.00 to $500.00
(1) $30.00
(2) $501.00 to $2,000.00
(2) $30.00 for the first $500.00 plus Sq 00 for each addition/ S100
OO or fraction thereof, to and including
$2,000.00
(3) $2,001.00 to $25,000.00
(3) $90.00 for the first $2,000.00 plus 518.00 for each additions/ Sl
000 OO or fraction thereof, to and
including $25,000.00
(4) $25,001.00 to 550,000.00
(4) $504.00 for the first $25,000.00 plus 1L3.00 for each additionl.V
Ate/ A2 or fraction thereof, to and
Including $50,000.00
(5) $50,001.00 to $100,000.00
(5) $829.00 for the first $50,000.00 plus S2Oi9 foreadr addition/SLOW.
OO or fraction thereof, to and
Including $100,000.00
(6) $100,001.00 to $500,000.00
(6) $1.279.00 for the first $100,000.00 plus S_7.L2foreach add nalsl
000. Dor fraction thereof, to and
including $500,000.00
(7) $500,001.00 to $1,000,000.00
(7) $4,079.00 for the fist $500,000.00 plus 56.019 for eadr add' ' nab
S7 o Gd or fraction thereof, to and
Including $1,000,000.00
(8) $1,000,001.00 and up
(8) $7,079.00 for the first $1,000,000.00 plus S4 S2 for each addt0
at 51000 A9 or fraction thereof.
Bold number is the base fee for the specified Increment
Ira11dred underAned number Is the lee per addA & i ed
/n meet
Ann ---f .,r.i,a k,re {.. .HA;
5 6
-.__ __ r_. �... ......� .,.........y P-11" c .v, yw.. wv ew ico.
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add 15 percent of the base building permit fee for Fre District #39 surcharge, commercial only.
Add $4.50 for WA State Building Code Council, plus $2.00 per unit for duplex & above.
•s Electrical, plumbing, and mechanical fees are calculated separately s*
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee:
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERCIAL ONLY)
■ BUILDING
(a) Base Fee:
(b) Additional Increment Fee:
0 MECHANICAL
PROPOSED VALUATION: 1:71 C5 S . CDC>
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (4)
Estimated Pian Review Fee: (5)
(a) Base Fee:
(b) Additional Increment Fee:
PREVENTIONFIRE
PROPOSED VALUATION: �. v �r�. T� �ooD�T S�►m
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee:
Estimated Plan Review Fee: (7)
(a) Base Fee:
(b) Additional Increment Fee:
Base Fee Number of Rxtures
$26.00+( X $9.00/fixture) _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65=
Miscellaneous Fixture Charge: (10)
Sub Total (Page one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)
(9) Estimated Plan Review Fee
DESCRIPTION
ORDER NO. 838049-C2
TION. OF GOVERNMENT LOT 2, SECTION 4, TOWNSHIP 21 NORTH, RANGE 4 EAST,
. IDt-KING COUNTY, WASHINGTON, LYING WEST OF THE COUNTY ROAD COMMONLY
4 KNOWN ;AS THE MILITARY ROAD;
EXCEPT THE SOUTH 242.00 FEET THEREOF;
t_y
ALSO. EXCEPT ANY PORTION THEREOF LYING WITHIN THAT CERTAIN TRACT OF L
- — = CONVEYED TO THE STEEL LAKE GRANGE NO. 805 BY DEED RECORDED UNDER RECORDING
NO. 1957584;
AND ALSO EXCEPT THE NORTH 42.00 FEET OF SAID GOVERNMENT LOT 2 FOR ROADS;
(ALSO BEING KNOWN AS LOT 1 OF CITY OF FEDERAL WAY BOUNDARY LINE ADJUSTMENT
NO. 9703189004.)
Page 2
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33530 First Way South
PO Box 9718
Federal Way WA 98063-9718
253-661-4000; Fax 253-661-4129
www nitVaffederalway cam
Affidavit in Lieu of General Contractor Registration
State of Washington
County of King
state as follows:
(Print name as signed)
1. I have made application for a building permit from the City of Federal Way, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the
Revised Code of Washington (RCW), a copy of which is printed on the reverse side of this affidavit.
3. I understand that prior to issuance of a building permit for work that is to be done by any contractor,
the City of Federal Way must verify either that the contractor is registered by the State of
Washington, or that one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Federal Way of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I
consider the work authorized under this building permit to be exempt under No. 3 , and will
therefore, not be performed by a registered contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any
decision to engage an unregistered contractor to perform construction work.
APPLICANT'S SIGNATURE
C41
'PCE S��O�
,sSION
� 0
i
JB`..►
IIIIOj'WASM,p1O�-
Siq-n and s(n t9 before me this
2kZ ay of OC -11, 201-3
P G ria C e S�c r`c� ave
Not 's Narint)
Notary's Signature
NOTARY PUBLIC in and for, tl�e State of
Washington, residing a (p/tPt C County
My Commission expires: '440,
Bulletin # 116 — December 23, 2002 Page I of 2 k:\Handouts — Revised\Contractor's Affidavit
r f
Revised Code Of Washington
18.27.090 Exemptions. This chapter shall not apply to:
1) An authorized representative of the United States
government, the state of Washington, or any
incorporated city, town, county, township, irrigation
district, reclamation district, or other municipal or
political corporation or subdivision of this state;
2) Officers of a court when they are acting within the
scope of their office;
3) Public utilities operating under the regulations of the
utilities and transportation commission in
construction, maintenance, or development work
incidental to their own business;
4) Any construction, repair, or operation incidental to
the discovering or producing of petroleum or gas, or
the drilling, testing, abandoning, ro other operation
of any petroleum or gas well or any surface or
underground mine or mineral deposit when
performed by an owner or lessee;
5) The sale or installation of any finished products,
materials, or articles of merchandise which are not
actually fabricated into and do not become a
permanent fixed part of a structure;
6) Any construction, alteration, improvement, or repair
of personal property, except this chapter, shall apply
to all mobile/manufactured housing. A mobile/
manufactured home may be installed, set up, or
repaired by the registered or legal owner, by a
contractor licensed under this chapter, or by a
mobile/ manufactured home retail dealer or
manufactured licensed under chapter 45.70 RCW;
7) Any construction, alteration, improvement, or repair
carried on within the limits and boundaries of any
site or reservation under the legal jurisdiction of the
federal government;
8) Any person who only furnished materials, supplies,
or equipment without fabricating them into or
consuming them in the performance of, the work of
the contractor;
9) Any work or operation on one undertaking or project
by one or more contracts, the aggregate contract
price of which for labor and materials, and all other
items, is less than $500, such work or operations
being considered as a casual, minor, or
inconsequential nature. The exemption prescribed in
this subsection does not apply in any instance
wherein the work or construction is only a part of a
larger or major operation, whether undertaken by
the same or a different contractor, or in which a
division of the operation is made into contracts of
amounts less than $500 for the purpose of evasion
of this chapter or otherwise. The exemption
prescribed in this subsection does not apply to a
person who advertises or puts out any sign or card
or other device which might indicate to the public
that he is a contractor, or that he is qualified to
engage in the business or contractor;
10) Any construction or operation incidental to the
construction and repair of irrigation and drainage
ditches of regularly constituted irrigation districts or
reclamation districts; or to farming, dairying,
agriculture, viticulture, horticulture, or stock or
poultry raising; or to clearing or other work upon
land in rural districts for fire prevention purposes;
except when any of the above work is performed by
a registered contractor;
11) An owner who contracts for a project with a
registered contractor;
12) Any person working on his own property, whether
occupied by him or not, and any person working on
his residence, whether owned by him or not, but this
exemption shall not apply to any person otherwise
covered by this chapter who constructs an
improvement on his own property with the intention
and for the purpose of selling the improved
property;
13) Owners of commercial properties who use their own
employees to do maintenance, repair, and alteration
work in or upon their own properties;
14) A licensed architect or civil or professional engineer
acting solely in his professional capacity, an
electrician licensed under the laws of the state of
Washington, or a plumber licensed under the laws
of the state of Washington while operating within
the boundaries of such political subdivision. The
exemption provided in this subsection is applicable
only when the licensee is operating within the scope
of his license;
15) Any person wtlo engages'in`the activities herein
regulated ascan emp(6yee of a registered contractor
with wages; as his''§ote compensation;
16) Contractors on high*ay projects who have been
prequalified a& required by chapter 13 of the Laws
of 1961,-RCW 47.28;070 with the department of
transportationVperfdrm highway construction,
reconstruction, or maintenance work.
Bulletin # 116 — December 23, 2002 Page 2 of 2 k:\Handouts — Revised\Contractor's Affidavit