02-102614 City or Federal Way Electrical Permit #:02 - 102614 - 00 - EL
Corinriumty Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: GIPSON
Project Address: 2105 SW 339TH Parcel Number: 330620 0300
Project Description: ELE-Install low voltage security alarm
Owner Applicant Contractor
Juan&Renee J Gipson Juan&Renee J Gipson Juan&Renee J Gipson
2105 SW 339TH ST 2105 SW 339TH ST 2105 SW 339TH ST
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-7729 98023-7729
Electrical Fixtures
Description 'Quantity Description 1Quantjty Description Quantity
Low Voltage Burgler Alarm-Residen 1
PERMIT EXPIRES December 18,2002,IF NO WORK IS STARTED.
Permit issued on June 21,2002
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: < t i I elk - I Date: (00 I ^ ^
C 149 s E, a 11,7--- 7--- Ll.-D 2- ��
CT
G_ RECEIVED CONSTRUCTION PERMIT APPLICATION
uV �i EI L APPLICATION NUMBER: oz.- Q�4 -
N 4 T APPLICATION NUMBER: -
CITY OF FEDERAL WAY
**The
NUMBER: -foll kiliP iQcriak ainformation—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTYINFORMATION
�� ` +
SITE ADDRESS: GRJ(nn 5 .� "t)S
SSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY ATTACH SEPARATE DESCRIPTION IF LENGTHY):
$ i v-19 I /-e•.e ( l 360 F ►-Nn. _
' ■ PROTECT INFORMATION
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION
ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 1,0 GO VO(4-09re_ 5 LAy,' -y Q 1 a v
PROJECT NAME:
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
J bk (J Glpsov) (953) 838' - b gae1
MAILING ADDRESS
L� `%�ADDRESS;� Poy rtoct@Lat try ct.)19 cig -r3
CONTRACTOR: NAME:
DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION/DATE:
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT 0 OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROSECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT _ .
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
-- ._ ,.,_ r .. . . ,....+.. :•�. . per•,t FIXTURES �. . ..t:-. ._..... . .. ... _ <,_x. ><_. ,,. . ..t
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) WOODST.OVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC L] GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
- ■ DISCLAIMER/SIGNATURE BLOCK
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 daim(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the city as a art of this application. — C
NAME/TITLE: DATE: ICJ— , J
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
V r
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•
". ,:_ •CHANGE�OF USE?-�_- .x�7�YES�:'=�?NO;;�1, :� ,..
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtvoffederalway.com
■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $50.00 #of Thermostats(First-$37.50;add'n-$I I.50ea)
(First 1300 ft2-575.00;Each add'n 500 ft2-$24.00) _Service and feeder $81.00 IN of Low voltage fire or burglar alarms
Square Feet: First 2500 ft2-$43.50;Each add'n 2500 ft2-S 11.50
_Each outbuilding or garage $31.00 MOBILE HOME/RV PARK Square Feet: 14.0, -
(Inspected with service) _#of service or feeders `Per WAC 296-46-910(5)(b)(i&ii)
_Each outbuilding or garage $50.00 (First service/feeder-550.00;Add'n service/ _#of Signs(First sign-S37.50;add'n sign I
(Inspected separately) feeder-$32 each) $17.50 each)
_Swimming pool,hot tub,spa $75.00
_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 $ 81.00
Up to 200 amp $ 81.00 $ 24.00 Feeder _201-600 189.00
_201-400 amp 101.00 50.00 _0 to 100 $ 81.00 S 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 _#of circuits
_Over 800 amp 252.50 189.00 _401-600 220.50 88.50 (1-S 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/Commercial/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 AO
#of circuits _over 600 109.00
(1-4 circuits-$50.00;Add'n circuits S5 ea)
If a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps,a plan review is required.Tee is 35%of
permit fee+S63.50.Add'l plan review for other submissions is$75.00/hr.
d
FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) .NUMBER OF UNITS(C) TOTAL(0) +
TOTAL COLUMN(D):
Total Column(0)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50+( X.35)=(13)
• DEMOLITION
Estimated Permit Fee: (14)
i� Bond Amount:(15)
IN ENGINEERING
Estimated Permit Fee:(16)
Bond Amount: (17)
■ OTHER FEES
e
E Mitigation Fee:(18) (20) (22)
F. SBCC Surcharge:(19) (21) (23)
Total(Pages one&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)= (24)
I. Bulletin#100-February 19,2002
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.
TABLE A
TOTAL VALUATION FEE FACTOR
(1)$1.00 to$500.00 (1)$26.00
(2)$501.00 to$2,000.00 (2)$26.00 for the first$500.00 plus$3.50 for each additional S100.010 or 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$15.50 for each additional$L000.00ot fraction thereof,to and
induding$25,000.00
(4)$25,001.00 to$50,000.00
(4)$435.00 for the first$25,000.00 plus 111.00 for each additional$1.000.00 or 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$8.00 for each additional$L000.00 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$6.00 for each additional$1,000.00 or fraction thereof,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 additional$1,000.00 or fraction thereof,to and
Including$1,000,000.00.
(8)$1,000,001.00 and up
(8)$6,260.00 for the first$1,000,000.00 plus$4.00 for each additional$L000.00or fraction thereof.
Bold number Is the base fee for the specified increment
Italicized,underlined number Is the fee ver additional svedfed Increment
PLUS: Add 65 percent of the base building permit fee for plan review fee.
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add 15 percent of the base building permit fee for Are District*39 surcharge,commercial only.
Add$4.50 for WA State Building Code Council,plus$2.00 per unit for duplex&above.
**Electrical,plumbing,and mechanical fees are calculated separately**
- - - ■ BUILDING
(w PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (1)
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERCIAL ONLY)
■ 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: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
•• PLUMBING
Base Fee Number of Fixtures
$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(Page one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)= (11)