02-101113City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Pb: 253.661.4000 Fax: 253.661.4129
A
r
Electrical Permit #:02 - 101113 - 00 - EL
Project Name: ATTERBURY
Project Address: 33616 27TH SW
Project Description: ELE - Altering up to 4 circuit for new addition
Inspection request line: 253.835.3050
Parcel Num :255700 0080
Owner
Applicant
Contra
Rocky L & Paula K Atterbury
STONEHENGE HOMES INC
oc y L &Paula K At ry
33616 27TH PL SW
5110 NE GALLEON DR
33616 27T
FEDERAL WAY WA 98023-7711
TACOMA WA 98422
11*
A 980 711
FEDEr595
(253
• 1 hereby
the occu
the City
that the above infl
.nd the use wilLbe
Owner or a91%
0
IFMFWORK IS STARTED.
13, 2002
ie cabtruction on the above described property and
rules and regulations of the State of Washington and
i
u. r Al P� U
y
Cff.OfRE G CF -N ED CONSTRUCTION PERMIT APPLICATION
- _ -
PPLICATION NUMBER:
R 1,3 1001 PLICATION NUMBER:
FEUERAL W A'� PPLICATION NUMBER: -
**The follo(pii�� �l cj� �tnatioti — Please print (ih ink) or type**
Please note: Electrical; Fire Prevention )�ystems and Engineering permits may require a separate application..
SITE ADDRESS: -�el & -2-7 P6 SW ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): lAL&L'y2E , )e ry L4 cri-c( —4.1
=ar) rj%
CONTRACTOR:
APPLICANT:
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE: I
CITY Of FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
NAmt: /DAYTIME PHONE:
l
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): ( -
E-MAIL ADDRESS: ,
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE:
PROPOSED USE:
DETAILED BUILDING INFORMATION -
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
PROPOSED VALUATION FOR IMPROVEMENTS:
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN 11 HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
'-" FLOOR
EXISTINGSQ.FT.
PROPOSED SQ. FT.
TOTAL
iBASEMENT' .. " *.;+irx
. fY .j ygy;: r •.v.r� . ,> -
:.:� .. — i , r „rr-
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
e'
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNiT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCr(S) GAS.PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
SATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLETS) SINKS) WATER CLOSET(S) misc.( )
INTERCEPTORS) Sucv(S)
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,%ftre such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information sAppligh to the city as a part of this application.
PROPERTY OWNER ❑ APPLICANT El CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOK 9718 - FEDERAL WAY, WA 98063-9718 - 253661-4000 - FAX: 253661-4129
www. citwffederalway.CO-
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!*******�-,—,--�--
Butidng, mechanical, and fire prevention system fees are based on the following schedule.
TABLE A. ' a
PLUS:
TM&VAWATION
FEE FACrM
(1) $1.00 to $sf• .
(1) 526.00 .
(2) $501.00 to $2,000.00
(2) $26.00 for the first $500.00 plus $3.50 foreach additional $100.A0or fraction thereof, to and including
$2,000.00
(3) $2,001.00 to $25,000.00
(3) $78.50 for the first $2,000.00'plus $15.50 for each additional
$1,000. or fraction thereof, to and
including $25,000.00
(4) $25,001.00 to $50,000.00
(4) $435.00 for the first $25,000.00 plus 511.00 foreadr additionalS1.000.00or
fraction thereof, to and
including $50,000.00.
(5) $50,001.00 to $100,000.00
(5) $710.00 for the first $50,000.00 plus $8.00 for each additional
S1.000.00 or fraction thereof, to and
including $100,000.00.
(6) $100,001.00 to $500,000.00
(6) $1,110.00 for the first $100,000.00 plus 56.010 for each
additional51.000.00or fraction theropf, to and
including $500,000.00
(7) $500,001.00 to $1,000,000.00
(7) $3,510.00 for the fist $500,000.00 plus $5.50 for each addtnat
51.000.00 or fraction thereof, to and
Including $1,000,000.00.
r
(8) $1,000,001.00 and up
(8) $6,260.00 for the first $1,000,000.00 plus $4.010 for each
additional S1.000, or fraction thereof.
Bold number is the base fee for the specified increment
rtaCdred, underfined number Is the fee Peradd1bonal soedfred
Increment
Add 65 percent of the base building permit fee for plan review W.
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add 15 percent of the base building permit fee for Fire District #39 surcharge, commercial only.
Add $4.50 for WA State Building Code Council, plus $2.00 per unit for duplex & above.
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (1
Estimated Plan Review Fee: (2)
** Electrical, plumbing, and mechanical fees are calculated separately **
(a) Base Fee:
(b) Additional Increment Fee:
Estimated FW Fre Department Surcharge: (3)
(OOMMERCLAL ONLY)
0 MECHANICAL
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number. (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5)
■ FIRE PREVENTION SYSTEM
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (6)
Estimated Man Review Fee:
(a) Base Fee:
(b) Additional Increment Fee:
N PLUMBING
Base Fee Number of Focdee5
$22.50+( X $8.00/fixture) _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
Sub Total (Pageone): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)
TABLE B
NEW RE41DENTIAL SERVICES'
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
Single Family
Service or feeder only .........................
S50.00
q of Thtmtpstats (First -$37.50; add'n-S I l
_
(First I300.ft' 575.00; Each add'n 500 ft'
-524.00)
_
........_.....................
_ Sand fdcdcr
S81.00
_ .50ca)
_ q of Low voltage fire or burglar alarm
Square Feet. "' _ ..._
_crylce_
first 2500 W-543.50; Each add'n 2500 R' -S 11.50
_ Each outbuilding or garage ..... :.....................
S31.00
MOBILE HOME/RV PARK
Square Fect:
(Inspected with service)
9 of service or feeders
• Per WAC 296-46-9 1 0(5)(b)(i & ii)•
_ Eachoutbuildingor garage ...........................
$50.00
(First service/feeder-$50.00; Add'n service/
_ 9 of Signs (First sign -$37.50; add'n sign
(Inspected separately)
feeder -S32 each)
$17.50 each)
_ Swimming pool, hot tub, spa ...............$75.01)
Yard Pole meter loops .........................$50.00
NEW MULTI -FAMILY
COMMERCIAL/INDUSTRIAL
COMMERCIAL/INDUSTRIAL
(Includes three units or more)
Altered Service or Feeders
Service
Feeder
Amps Service or
Add'n
_ 0 to 200 ..............................................S 81.00
Up to 200 antp.............. $ 81.00 ................
$ 24.00
Feeder
_ 201 -600 .............................................. 189.00
201 - 400 am 101.00 ....................
50.00
_ 0 to 100.........................$ 81.00.......
$ 50.00
_ 601 - 1000............................................284.50
_ 401 - 600 amp ................ 138.00 ....................
68.50
_ 101-200 ........................ 101.00 ...........
63.50
-over 1000 ............................................. 317.00
_ 601 - 800 amp ................ 176.50 ....................
94.50
_ 201 -400 ........................ 189.00...........
75.00
_ i9 of circuits
_Over 800 amp ................. 252.50..................
189.00
_ 401-600 ........................ 220.50 ...........
88.50
(1-5 circuits -$63.50; Add'n circuits, $5 ea)
ALTERED SINGLE/MULTI FAMILY
_ 601-800 ........................ 284.50.........
120.50
(When inspected separately from the services.)
_ 801-1000 ...................... 348.00.........
145.50
TEMPORARY SERVICE
Service or Feeder
-Over 1000 ...................... 379.00.........
202.50
Residential/Multi-Family/Cominercial/Industrial
_ 0 to 200 amp ...............................................
$ 68.50
_ Over 600 volts surcharge ......................
63.50
_ 0-100 ................................................ S 50-00
_ 201 - 600 amp ..............................................
101.00
_ Mast or meter repair..............................
68.50
_ 101-200 ......... ...................................... 63-50
_ over 600 amp ................................................
151.50
_ 201-400 .. ........:..................................75.00
_ Mast or meter repair .......................................
37.50
_ 401-600 .............................................. 101.00
IfNofcircuits
_over 600 ............................................... 109.00
(1 A circuits -$50.00; Add'n circuits $5 ca)
It wtvi :c r3 gucatcu 111311 LVV amp, a plan review Is req a. i-ce Is S�,% Ol permit tee +16J.3U. Ad0'1 plan review for otner suninisslons Is 1 0MUthf.
Estimated Permit Fee: (
Total Column (D)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50 + ( X .35) _ (13)
Estimated Permit Fee: (14)
Bond Amount: (15)
0 ENGINEERING
Estimated Permit Fee: (16)
Bond Amount: (17)
8 OTHER FEES;
Mitigation Fee: (18) _
SBCC Surcharge: (19)
(20) (22)
(21) (23)
Total (PagesOne&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24
Bulletin tt 100 - January 18, 2002
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33530 First Way South
PO Box 9718
SEC E�Ep )~ederal Way WA 98063-9718
v 253-661-4000; Fax 253-661-4129
2002 www.ci.federal-way.wa.us
MAR 1 3
of
�EpEDEPwpY
C1TY
Affidavit in Lieu of Geneffit Contractor Registration
State of Washington
County of King
I, state as follows:
(Pri t 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. J�, 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
Bulletin # 116 — April 26, 2001
Signed and swo to,before me this
Day of AQ1' %,200A
; aYl L • 6�0n,-Dr
Notary's Name (Print)
Notary s Signature
NOTARY PUBLIC in and for the
Sta ,of Washington, residing at
rid County.
My Commission expires: 07. 112-31
Page 1 of 2 k:\Handouts — Revised\Contractor's Affidavit
V
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 66 or more contracts, the aggregate contract
pricy 'of which for labor and materials, and all other
Ytttatis, 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 incidenta) 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 who engages in the activities herein
regulated as an employee of a registered contractor
with wages as his sole compensation;
16) Contractors on highway projects who have been
prequalified as required by chapter 13 of the Laws
of 1961, RCW 47.28.070 with the department of
transportation to perform highway construction,
reconstruction, or maintenance work.
Bulletin # 116 — April 26, 2001 Page 2 of 2 k:\Handouts — Revised\Contractor's Affidavit