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02-100224
City Federal Way Community Development ServicesElectrical Permit #:02 - 100224 - 00 - EL 33530 1st Way S Federal Way,WA 98003-6210 2 * Ph 253.661 4000 Fax 253.661 4129 Inspection request line: 253.835.3050 Project Name: TEAM HEALTH Project Address: 3455 S 344TH Suite210 Parcel Number: 222104 9006 Project Description: ELE-Wiring for furniture Owner Applicant Contractor BEDFORD PROPERTY INVESTOR LAZER ELECTRIC LAZER ELECTRIC 9523 19TH AVE E 9523 19TH AVE E TACOMA WA 98445 TACOMA WA 98445 (253)535-1900 Electrical Fixtures Description Quantity Description IQuantity Description IQuantity Circuits- Commercial 9 PERMIT EXPIRES July 15,2002,IF NO WORK IS STARTED. Permit issued on January 16,2002 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 accorince w' i e laws,rules and regulations of the State of Washington and the City of Federal Way. Owner or a t,llW Date: MIV �l l 7(© `2— rwL Y? — a G CONSTRUC I ION PERMIT APPLICATION uV FZY APPLICATION NUMBER: a 2.- _Lao Z�r� - � APPLICATION NUMBER: -_JAN 1 5 201i>: APPLICATION NUMBER: - • - - - **The fdllo*luing:icpg_gvjyail information-Please print(in ink)or type** BUILDING DEPT. Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. _ //` ■ `PROPERTY •INFORMATION : ' ' -•. - - _ SITE ADDRESS: 3%� 34'CCh Su,'-(e. t(a ASSESSOR'S TAX/PARCEL#: - LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ::..;-:1,‘:';:;--' : -.::".".--:-:;-=:';-4.' .-. . _. _ --;!2-',:2-': = _ . ■,PROTECT INFORMATION - _ - .. ' .- TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): —1 / l PROJEIT NAME: l eq '7 e 5 44 - _ .- -- .= - ■ PEOPLE INFORMATION .',_- - ..,.._ :-- -. - PROPERTY OWNER: NAME: n _ n DAYTIME PHONE: (JcUf�d �Coae - 7 0 (0r $fro \ ( ) _ MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): CONTRACTOR: NAME: DAYTIME PHONE: �- Ct Ze:- E( 4ri't_ n C (?S))3'35-ifoo MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP); EVENING PHONE: 95-;_3 ) AOE c- Neo•ii1 U-49 9549c ( ) - CI TY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: ( ) h. CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy of card milked) / / APPLICANT: NAME: DAYTIME PHONE: L, arr y .S 4e:-)e_(7 ( ) - MAILING ADDRESS(MEET ADDRESS;CITY,STATE,ZIP: EVENING PHONE: ( ) - .l RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT A CONTRACTOR __ --- ' - .1 .DETAILED BUILDING INFORMATION 7 = ' ' - ---- - EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES 0 NO WATER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC) ifv*NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ _x IN 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: - - Vv '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.( .0 ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS • PLUMBING BATHTUB(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 II GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) --■ DISCLAIMER/SIGNATURE BLOCK -- _ V ___ " - - V 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 ari - out of the reliance of the city,induding its officers and employees,upon the accuracy of the information supplied te ■ e d . a .rt of this plication. l / NAME/TITLE: �'/L� Gl C f1 DATE: ❑ PROPERTY OWNER APPLICANT 9 CONTRACTOR `FOR OFFICE USE ONLY::-I '❑ NE1fV := :_-= ❑ADDITION '❑ALTERATION '=0 itEPAkiC -❑TENANT IMPROVEMENT - CENSUS CODE: -. LOTSIZE: GZONINGDESIGNATION:_ _ BUILDING SHELL ONLY? x❑ YES 0 NO =COhtPPLAN'DESIGNATION BASIC PLAN? :„❑YES ❑ NO' - :SECTION;_<;r'_ -TOWNSHIP . RANGE - NEW ADDRESS REQUIRED? -❑ YES 0:NO :PLATTED LOT? _ 0 YES ❑ NO CHANGE OF USE?- - ❑YES 0 NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 • - - ■ ELECTRICAL • r TABLE B . NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES Single Family _Service or feeder only $48.00 _#of Thermostats(First-$36.00;add'n-$11.00ca) - (First 1300 ft2-$72.00;Each add'n 500 ft2-$23.00) _Service and feeder $78.00 _If of Low voltage fire or burglar alarms Square Feet: First 2500 ft2-$42.00;Each add'n 2500 ft2-$11.00 _Each outbuilding or garage $30.00 MOBILE HOME/RV PARK Square Feet: (Inspected with service) _if of service or feeders `Per WAC 296-46-910(5)(b)(i&ii) _Each outbuilding or garage $48.00 (First service/feeder-$48.00;Add'n service/ _#of Signs(First sign-$36.00;add'n sign (Inspected separately) . feeder-$3I each) S17.00each) _Swimming pool,hot tub,spa 72.00 -Yard Pole meter loops 48.00 1 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 $ 78.00 -Up to 200 amp $ 78.00 $ 23.00 Feeder _201-600 182.00 201-400 amp 97.00 48.00 _ _ 0 to 100 $ 78.00 $ 48.00 _601-1000 274.00 ' 401-600 amp 133.00 66.00 _101-200 97.00 61.00 over 1000 305.00 _601-800 amp 170.00 91.00 _201-400 182.00 72.00 q#of circuits _Over 800 amp 243.00 182.00 _401-600 212.00 85.00 (1-5 circuits-$61.00;Add'n circuits,$5 ea) ", ALTERED SINGLE/MULTI FAMILY _601-800 274.00 116.00 (When inspected separately from the services.) _801-1000 335.00 140.00 TEMPORARY SERVICE Service or Feeder _Over 1000 365.00 195.00 Residential/Multi-Family/Commercial/Industiral 0 to 200 amp $66.00 _Over 600 volts surcharge 61.00 _0-100 48.00 _201-600 amp 97.00 _Mast or meter repair 66.00 _101-200 61.00 _over 600 amp 146.00 _201-400 72.00 _Mast or meter repair 36.00 _401-600. 97.00 _P of circuits _over 600 105.00 ' (1-4 circuits-$48.00;Add'n circuits$5 ea) If service is greater than 200 amp,a plan review is rcq'd.Fee is 35%of permit fee+$61.00.Add'I plan review for other submissions is$72.00/hr. 110 F.DQUREDESCRIPTIONWM IFIXTURE;ifEE_FROM TABLE".B'(B):✓ ;i tUMBER`OF:UNITS LC)#*#*A. i"•'`; _ OTAL(D)41/S*4 " • 3S1=:';.,i-,:-.TOTAL COLUMN(D):- Total D)`Taal Column(0) Estimated Permit Fee: (12) Estimated Permit Fee from fine 12 Estimated Plan Review Fee: $56.25+ X.35=(13) ■ DEMOLITION - i 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-August 20,2001 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 (I)$1.00 to$500.00 (1)$24.25 (2)$501.00 to$2,000.00 (2)$24.25 for the first$500.00 plus 53.27 fur each additional$100.00 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 515.00 for each additional$1,000.00 or fraction thereof,to and •.uding $25,000.00 (4)$25,001.00 to$50,000.00 (4)$403.61 for the first$25,000.00 plus 510.82 for each additional$1.000.00 or fraction. -.,to and including $50,000.00. (5)$50,001.00 to$100,000.00 (5)$664.35 for the first$50,000.00 plus 57.50 for each additional$1.000.00 or fraction -.f,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 56.00 kr each additional$1.000.00fraction thereof,to-end including $500,000.00 (7)$500,001.00 to$1,000,000.00 (7)$3,337.23 for the fist$500,000.00 plus 55.09 fir each additional$1.10 to 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 53.91 for each ate.'. .1$1.000.00 or fraction thereof. Bold number is the base fee for the specified increment jtarcizeA undedined number Is the fee per additional . ed lncrrment • 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, '.mmerdal only. Add$4.50 for WA State Building Code Council,plus$2.00 per unit for duplex . above. **Electrical,plumbing,and mechanical -. are calculated separately** •— ■ BUILDING PROPOSED VALUATION: FEE FACTOR FROM TABLE A: Number: (a)Base •r (b)Additi. al Increment Fee: Estimated Permit Fee: (1) Estimated Plan Review Fee: (2) Estimated FW Fire Department Surcharge: (3) (COMMERCIAL ONLY) - ■ MECHANICAL- -- s - ..- PROPOSED VALUATION: FEE FACTOR FROM TABLE A:Number: (a)Base Fee: (b)Additional Increment Fee: Estimated Permit Fee: (4) Estimated Plan Review Fee: )___ -- -' • - ' -- • - - ■ FIRE PREVENTION SYSTEM • PROPOSED VALUATION- 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 $21.00+{ X$7.00/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)