00-105546;.0/17/00 TUE 08:41 FAX 2536614129 CITY OF FEDER:kL WAY
wjuei
CONSTRUCTION PERMIT APPLICATION
PPLICAn
PPLICA-RON NUMBER:
F3Y
r %+ PPLICA-UON NUMBER: -
V **The following is required Information — Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems +and Engineering permits may require a separate application.
a
ASSESSOR'S TAX/ PARCEL #:
SITE ADDRESS: / 9�� Arc I�w ✓ S _ — — —
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application):
C1 BUILDING ❑ PLUMBING [3 MECHANICAL ❑ DEMOLITION
'ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
' w c
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
NAME: ZS 3 ILL
3 S
CONTRACTOR: /
EVENING PHONE:
MAIUNG ADDRESS (STREET ADDRESS; Cf1Y, SIAM, 4LP):
0 8 So Al iia c 0**11a
FAX NUMBER:
CITY OF FEDERAL WAY BUSINESS UCEN5E NUMBER: -
EXPIRATION DATE:
CONTRACTORS REGISTRATION NUMBER: � - � � � u / /
DAYt"IME PHONE:
APPLICANT: NAME: ( 2 5'3) 7 7 ' 07
h SO GV N EVENING PHONE:
MAILING ADORE55 (STREET TY, SPATE, ZIP):
0 S
Z-4 S 7— FAX NUMBER:
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT OTHER {DE�AP
BE): (MaL ADOREss:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ ANTCONTRACfOR
EXISTING USE: S_.TGI[ ��.f►� ,4'_ T its` EXISTING BiJII_DING ASSESSED/APPRAISED VALUATION j
PROPOSED USE- � '� o /L 1��1w►� 1 � /?es• PROPOSED VALUATION FOR IMPROVEMENTS: � '
SPRINKL£REO BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSEb/REQUIRED: [I YESS NO
TER SERVICE PROVIDER: C1 LAKEHAVEN C3HIG:HLINE ❑ TACOMA C3 PRIVATE (WEU,) h
WA
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE (SEPTIC)
10/17/00 TUE 08:41 FAX 2536614129
OF 1'hUL'1 •n•
ssNEW RESIDENTIAL CONSTRUCTION ONLY**
__ _ ESTIMATED SELLING PRICE:
AIR HANDLING UNITS)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
"�— DUCT(S)
Indicate numtN:r of each type of fixture
MECHANICAL
GAS LOGS) REFRIG. SYSTEMS)
E{(ApORATIV� COOLERS) — HOOD(S) WOODSTOVE(S)
FAN(S) RANGE(S) MISC. (�
�— FIREPLACE INSERT(S) ,_--
FURNACE(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
GAS PIPE OUTLET(S)
BATHTUB(S).
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
PLUMBING
URINAL(S) WATER HEATER(S)
LAVATORY(S)t - VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
RAIN WATER .SYS.
SHOWERS) ; WASH MACHINE OUTLET MISC.
SINK(S) WATER CLOSETS)
me is Permit apPlicatlon is made. I
I certify under penalty of perjury that � above pre�lon nlses t furnished perform the work for whiff ee and corred operm the � of my knowledge, and
furaherr, that I am authorized by the owner of the ex enses, and attorneys' fees Incurred in the
w�eC agree to hold harmless
the City of Federal Way as td any daim (including costs, p
City Of
Investigation and defense of such claim),
which may be made by any person.lnduding its officers and employees, upon thincluding the undersigned, and filed against the
acatracy
Federal Way, but only where
such daim arises out of the re�ance of the city,
of the information my wed the city as a part of this appU{�atlon.
�DATE: / � — a o
NAMEITITLE:
O PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
�� � JNCTY pEVELOPt4EN T SERVICES a 33530 FIRST WAY SOUTH 0, P.O. BOK 9718 • WAY, WA 98063.9716 q 253.661-9000 • FAX: 253.661-1129
AO/17/00 TUE 08:44 FAX 2536614129 CITY OF FEDERAL WAY
19 004
NEW RESIDENTIAL SERVICES
Single Family
_ ((First 1300 ftr467.00; Each add'n 500 R' -521.50)
Square Feet:
Each outbuilding or garage .........................•• $28.00
(Inspected with service)
Each outbuilding orgarA&C........................... $44.25
(Inspected separately)
NEW MULTI -FAMILY
(includes three units or moreService Feeder
_ Up to 200 amp ............... S72.25 ................. $ 21.50
201.400 amp .................. 89.75.................... 44.25
401 -600 Amp ................ 123.25.................... 61.50
601 - 800 amp................ 158.00 .................... 84.25
-"
over 800 amp ................. 225.25 .................. 169.00
_
ALTERED SINGLE/MULTI FAMILY
(When Inspected separately from the services.)
Service or Feeder $ 61.50
_ 0 to 200 amp .................................................. 89.75
_ 201- 600 amp ............................................
_ over 600 amp .............................................. 135.25
Mast or ureter repair ....................................... 33.50
N ofcircuits
(1-4 circuits -S44.25; Add'n circuits $5 ee)
If sery oe Is 8rcatcr than 200 amp, a plan review is req
TABLE- B
MOBILE HOMES 644.25
_ Service or feeder only ...............
Service and G:eder ............................... $72.25
MOBILE HOME:/RV PARK
_ q of service or feeders
(First servicefeeder-544.25; Add'n service!
feeder -$28 each)
COMMERCIAL./INDUSTRIAL
Amps
Service or
Add'n
Feeder
72.25
0 to too..........................$72.25
........
$ 44.25
_
101-200 ........................
89.75...........
56.25
_
201-400 ........................ 169.00 ...........
67.00
401-600 ........................
197.00 ...........
78.75
_
601- 800 ........................
254.50.........
107.25
_
801-1000 ......................
310.75.........
129.75
1000 ......................339.00.........
_
401 - 600 ................................................89.75
181.00
_Over
Over 600 volts surcharge ................••....
56.25
_
_ Mast or meter repair ..........................
50
plan
MISC EQUIPMENVIEMP SERVICES
_ 0 of Thermostats (First -$33.50; add'n-$ I0.50ca)
M of Low voltage fire or burglar alarms
First 2500 ft' -838.75; Fach add'n 2500 ft' -S 10.50
Square Feet:
• Per WAC 296-46-910(5)(b)(i & ii)
_ q of Signs (First sign -533.50; add'n sign
$16.00 each)
Progress inspection per 1/2 hr ...............$33.50
Swimming pool, hot tub, spa ............••..6700
Yard Pole meter loops ......I ................... .
25
COMMERCIAL/INDUSTRIAL
Altered Service or Feeders
0 to 200 ...............................................$
72.25
_
201-600 ..............................................169.00
_
601 - 1000 ............................................254.50
over1000 .............................................282.75
of circuits
—0
(1-5 circuits -556.25; Add'n circuits, SS
ea)
'temporary Service
0 to 60 ..................................................$38.75
_
61-100 ..................................................44.25
_
101-200 ................................................56.25
201-400 ................................................67.00
_
401 - 600 ................................................89.75
r over 600 .................................................97.75
U
0
Estimated Permit Fee: (12)
S Dotal CacunK+ (o)
Estimated Permit Pee from One 12 X.35 = (13)
Estimated Pian Review Fee: $56.25 +
Estimated Permit Fee: (14)
Bond Amount: (15) --
Estimated Permit Fee: (16)
Bond Amount (17)
Ktigation Fee: (18) (20)_ (22)
SBCC Surcharge: (19) (21)_ (23)
Total (P.vaonea.Y.w): Une(s)(11)+(12)+(13)+(14)+(15)+(16)+(:L7)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
Bulletin # 100 – August 29, 2000