02-100326 _.
--
City of Federal Way Electrical Permit #:02 - 100326 - 00 - EL
Community Development Services
ill33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 In ion re mne: 253.835.3050
Project Name: JOHNSON Ilii-
Project Address: 33270 26TH SW Par umber: 8944 0560
Project Description: ELE-Panel changeout for exist' ' en•
Owner Applicant ontractor
Kathleen A Johnson ACTION ECTRI • , ' •N PLUS E C INC
33270 26TH PL SW P.O.BOX 1423 .O.BOX
FEDERAL WAY WA LE VALLEY WA 980 MAPLE VALLEY WA 98038
98023-2772 (206)650-7754
t
sil S
El' ical Fixtur
r Description IIMERIPIA ®` Or jr• Quantity Description Quantity
-rvice: -Residential 11111.-i , i
_Al
IF
IT EXPIRES July 23,2002,IF NO WORK IS STARTED.
Permit issued on January 24,2002
•I hereby certify that t b mfo tion is t. ect and that the construction on the above described property and
the occupancy and the will be in acco •• •- with the laws,rules and regulations of the State of Washington and
the City of Federal Way. 1
ArkOwner or agent: Date: Z o 2.------
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2 s-- o z, coy-1--el,-/--,'0L,. s . ,... •
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RECEI ED
eff•O G CONSTRUCTION PERMIT APPLICATION
F APPLICATION NUMBER: ...or - .
uv FAL JAN 2 4 � '
APPLICATION NUMBER: OZ- lQ 0,10- -a v-4Z
CITY OF FEDERAL WHY APPLICATION NUMBER: - -
BUILDING DEPT.
**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.
'-2 - . - - •• - - -Ki PROPERTY INFORMATION -
SITE ADDRESS: 33Z 7L/ 2& / 5/ ASSESSOR'S TAX/PARCEL #: v f.y .3 0 - O v_
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
--- ; - -'-'.-:- - ►A. PROJECT INFORMATION _ - .
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
(ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
fiC (heI_- 17 5'
•
PROJECT NAME: L fil -(0/.)
0 PEOPLE INFORMATION •
PROPERTY OWNER: NAME: icfrorilte,_miDAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: /� DAYTIME PHONE:
—MA/ / &J ? - tile-2 2 (&&16 ) 6Sv ).s.—
MAILING A RESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: i
A8/ Z3 ( -
CITY OF FEDERAL SINESS LICENSE NUMBER: FAX NUMBER:
0/ - / 0 Z / 9- x_ )O (4/)fl f/3 -2F/es,
CON&lie...,
REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / 47-/o_fii-0 ff P _ _ / /
APPLICANT: NAME: ��� GW DAYTIME PHONE:
p/n/ (2t6) e Sb -71S--t-r
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: I
( ) I
RELATIONSHIP TO PROJECT: FAX NUMBER: 1
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS'
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
' - ' 1 DETAILED BUILDING INFORMATION - . .
EXISTING USE: 'LA EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ t
PROPOSED USE: ka 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: $
•
• ■ PROTECT 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: 0 ELECTRIC 0 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) MP(S)
72 DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury th t 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,including the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the information sup lied to the city a a art of this application.
NAME/TITLE: < / DATE: D
0 PROPERTY OWNER ❑ APPLICANT (CONTRACTOR
:FOR OFFICE USE ONLY: I
£❑:NEW.- "❑-ADDITION ❑ ALTERATION ❑,REPAIR - C TENANT IMPROVEMENT
`CENSUS CODE:___ - LOT SIZE: • -
:ZONING DESIGNATION: BUILDING SF#ELL ONLY? ❑YES ❑ NO
f =COMP-PLAN DESIGNATION - BASIC PLAN?= ❑YES ❑NO - -
SECTION,. _- _ TOWNSHIP RANGE NEW ADDRESS REQUIRED? 0 YES ❑ NO
-PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.cityofederalway.com
f
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-$11.50ca)
(First 1300 ft2-S75.00;Each add'n 500 ft'-$24.00) _Service and feeder $81.00 #of Low voltage fire or burglar alarms
Square Feet: First 2500 ft'-$43.50;Each add'n 2500 ft'-S11.50
_Each outbuildingor garage. ..... .$31 00 MOBILE HOME/RV PARK Square Feet-
(Inspected with service) _#of service or feeders * Per%VAC 296-46-910(5)(b)(i&ii)
_Each outbuildingor garage.. ... .. . $50 00 (First service/fecdcr-550.00,Add.n service/ _4 of Signs(First sign-$37.50,add'n sign
(Inspected separately) fecdcr-$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.... $ 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 (1-5 circuits-563.50;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.......................................101.00
_#of circuits over 600 . . ... ...........109.00
(1-4 circuits-$50.00,Add'n circuits$5 ea)
If service is greater than 200 amp.a plan review is req'd.Fee is 35%of permit fee+$63.50.Add'I plan review for other submissions is$75.00/hr
FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D)
TOTAL COLUMN(D):
�C6 ToColumn(0)
Estimated Permit Fee: (12) 1
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50+( 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)
SHCC 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 18,2002
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$350 for each additional$100.00 or fraction thereof,to and including
$2,000.00
(3)$2,001.00 to$25,000.00
(3)$78.50 for the first$2,000.00 plus 515.50 for each additional$L000.00or 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$11.00 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 t1.000.00 or fraction, - eof,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 16.00 for each additional$1,000.00• fraction therepf,to and
including$500,000.00 r
(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$1,1-.r.i r or fraction thereof,to and
including$1,000,000.00. 4
(8)$1,000,001.00 and up
(8)$6,260.00 for the first$1,000,000.00 plus$4.00 for each,0J; 'flat$1,000.00 or fraction thereof.
Bold number is the base fee for the specified increment
Italicized,undefined number Is the fee per additional„ .fed 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 , y.
Add$4.50 for WA State Building Code Counal,plus$2.00 per unit for duplex&above.
**Electrical,plumbing,and mechanical - are calculated separately**
• BUILDIPiIG
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A:Number: (a)Base .•-:
(b)Ad.'ronal Increment Fee:
Estimated Permit Fee: (1)
Estimated Plan Review Fee: (2)
Estimated FIN Are Department Surcharge: )
(COMMERCIAL ONLY)
■ MECHANICAL
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Num... (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Plan Review :•: (5)
• FIRE PREVENTION SYSTEM
PROPOSED VALUATIO :
FEE FACTOR FROM ABLE 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 (Paye one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)