01-102660 RiirEiverp
UTI Of = CONSTRUCOON PERMIT APPLICATION
FA L ` APPLICATION NUMBER: d L - L 0 Z �Q -DO_ F)
vVr�v �ULO � ��;�� ! APPLICATION NUMBER: -
t;I IY OF FEDERAL WAY
BUILDING DEPT. APPLICATION NUMBER: -
**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.
/ di i.,9;A:.PERTY INFORMATION
SITE ADDRESS:0,41 ?�✓6�'�Ai��- 35614se� / ASSESSOR'S TAX/PARCEL#:. 1S 2/e�- - 9:W/
LEGAL DESCRIPTION OF SUBJECTBECPR ERTY(ATTACH ARAE DESCRIPTION IF LENGTHY):
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TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING IJ FIRE P' VENTION SYSTEM
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PROJECT DESCRIPTION(Provide detailed description): ',Lig_/ l✓ i/i•L rd' _Al __..k.,_...
PROJECT NAME 'f tJ/1J € ���� rte,"
IS Fi"f.r I,I, Z.:A' .'kMATION
PROPERTY OWNER: NAME: / ' / ` DAYTIME PHONE:
MAIL NG ADDR SS •EET ADDRESS,CITY,STATE, IP):
.as-5,w 3 Sfs-, St kaltf IJai . 9 VT--
CONTRACTOR: NA fi-fri -
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DAYTIME PHONE:/ k/6 Wel« .//tic , /(6/711 /145'144 (2- )gC1 -S•zZ z
MAILING
ADDRESS CITY,STATEelefrnierV ed,ZIP tco) /G' f rJ — 1.1e-1551?(277 PHONE:
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: (/7 FAX NUMBER:
- - (ZS3) 8S7 23IZ—
CONTRACTOR'S REGISTRATION NUMBER: n f� EXPIRATIONPIDATE:
(copy of card req�xred) /_/c 4 'V. i f//7 9/� 2
( / - / 0// l O/
APPLICANT: NAME: � "� me($7it p DAYTIME PHONE:
'�W c v' ry //J / / ( )
MAILING ADDRESS(sTkEET ADDRESS;C ,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: /1 FAX NUMBER.
CI ARCHITECT CI TENANT OTHER(DESCRIBE): C-er>i' y"� ( ) - ,
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT XCONTRACTOR
• ■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
• •
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
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) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
: . ' ;?GNAT i;.c .•OC.r, •
•
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 uch claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only whe • such claim arises out of the reliance of the city,including its officers and employees, upon the accuracy
of the information s ppli-• to t • .- a ••rt of .• .••lication.
NAME/TITLE: — trig DATE: j •C.0 I
❑ PROPERTY OWNER ❑ A••LICANT Q CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
( M I INTTV nFVFI OPMFNT SERVICES•33530 FIRST WAY SOUTH•P 0 BOX 9718•FEDERAL WAY.WA 98063-9718•253-661-4000•FAX 753-661-4179
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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)$24.25
(2)$501.00 to$2,000 00 (2)$24.25 for the first$500.00 plus$3 27 for each additional 3100 00 or fraction thereof,to and including$2,000 00
(3)$2,001 00 to$25,000.00 (3)$71.46 for the first$2,000.00 plus$1500 for each additional$1,000000r fraction thereof,to and including
$25,000 00
(4)$25,001.00 to$50,000 00 (4)$403.61 for the first$25,000.00 plus$10 82 for each additional$1,000 00 or fraction thereof,to and including
$50,000 00.
(5)$50,001 00 to$100,000.00 (5)$664.35 for the first$50,000.00 plus$7.50 for each additional$1,000.00 or fraction thereof,to and including
$100,000.00.
(6)$100,001.00 to$500,000 00 (6)$1,025.55 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)$3,337.23 for the fist$500,000.00 plus$509 for each additional 31,000 00 or fraction thereof,to and including
$1,000,000 00.
(8)$1,000,001.00 and up (8)$5,788.23 for the first$1,000,000.00 plus 33 91 for each addihonal$1,000 00 or fraction thereof.
Bold number is the base fee for the specified increment
Italicized,underlined number is the lee per additional specified 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 Fire 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
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
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
$21.00 +{ X$7.00/fixture) = (8)Estimated Permit Fee
Estimated Permit Fee
X .65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge:(10)
Sill)TOtal rna.,Pnr„•n' I ine(c)(11+(71+(i1+(41+(cl+(61+(71+(81+(91+(l01 = (111
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TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_
Single Family _Service or feeder only $44.25 _#of Thermostats(First-$33.50,add'n-$10 50ea)
(First 1300 ft2-$67.00;Each add'n 500 ft2-$21.50) _Service and feeder.............. .. .. $72 25 _#of Low voltage fire or burglar alarms
Square Feet: First 2500 112-$38-75,Each add'n 2500 ft'-$I0 50
_Each outbuilding or garage ... . . $28 00 MOBILE HOME/RV PARK Square Feet.
(Inspected with service) _II of service or feeders *Per WAC 296-46-910(5)(b)(i&ii)
_Each outbuilding or garage $44.25 (First service/feeder-$44.25,Add'n service/ _#of Signs(First sign-$33 50,add'n sign
(Inspected separately) feeder-$28 each) $16 00 each)
_Progress inspection per 1/2 hr. .. $33.50
_Swimming pool,hot tub,spa 67 00
Yard Pole meter loops 44.25
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 $72.25
_Up to 200 amp $72.25 $21.50 Feeder _201-600 169.00
_201-400 amp 89.75 44.25 _0 to 100 $72.25 $44.25 _601-1000 254.50
_401-600 amp 123.25 61.50 _l01-200 89.75 56.25 _over 1000. 282.75
_ (1
601-800 amp 158.00 84.25 201-400 169.00 67 00 _#of circuits
_Over 800 amp 225.25 169.00 _401-600 197.00 78 75 -5 circuits-$56 25;Add'n circuits.$5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800 254.50....... 107.25
(When inspected separately from the services.) _801-1000 310.75 129.75 Temporary Service
Service or Feeder _Over 1000 339.00 181.00 _0 to 60 ..........$38.75
_0 to 200 amp $61.50 _Over 600 volts surcharge 56.25 _61- 100 44.25
_201-600 amp 89.75 _Mast or meter repair 61.50 _101-200........................................56.25
_over 600 amp 135.25 _201-400.. 67.00
_Mast or meter repair ...........33.50 _401-600. ......................................89.75
_#of circuits _over 600 .... 97.75
(1-4 circuits-$44.25;Add'n circuits$5 ea)
- If service is greater than 200 amp,a plan review is req'd.Fee is 35%of pemit fee+$56.25.Add'I plan review for other submissions is$67.00/hr.
FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D)
i
TOTAL COLUMN(D):
II
Total Column(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $56.25+ X.35=(13)
■ DEMOLITION
Estimated Permit Fee: (14)
Bond Amount:(15)
■ ENGINEERING
Estimated Permit Fee:(16)
Bond Amount: (17)
■ OTHER FEES
Mitigation Fee: (18) (20) (22)
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)
Bulletin #100-January 3,2001