02-100185 City of Federal Way
Community Development Services Electrical Permit #:02 - 100185 - 00 - EL
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: ALBERTSON'S
Project Address: 31009 PACIFIC S Parcel Number: 082104 9062
Project Description: ELE-Installation of coax for satellite system
Owner Applicant Contractor
AMERICAN STORES PROPERTIE FIELD SERVICE NETWORK FIELD SERVICE NETWORK
FIELD SERVICE NETWORK FIELD SERVICE NETWORK
13501 100TH AVE NE SUITE 520 13501 100TH AVE NE SUITE 520
KIRKLAND WA 98034 (425)821-4646
Electrical Fixtures
Description Quantity - Description iQuantity Description ,Quantity
Low Voltage-Other Commercial 1
PERMIT EXPIRES July 14,2002,IF NO WORK IS STARTED.
Permit issued on January 15,2002
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 ago / )0•;7--Date: I //c
F IN tot` z '
&E.
�_ CONSTRUCT I ION PERMIT APPLICATION
uv EKY ElKFIL
APPLICATION NUMBER: 07-- J D D L
APPLICATION NUMBER: -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.
' • PROPERTY INFORMATION _ Q - . • - .
SITE ADDRESS: 3)00 G1 ?f .T C /6Oc tk- ASSESSOR'S TAX/PARCEL#: D V L O - I C 2-
LEGALESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
,��N2c�So, (r-ocem(
:_ •.PROTECT INFORMATION -
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
117KELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): .... 154-111-k\ ,10 e)C' -O 64' (4
PROJECT NAME: Al\>ery p Y..5
" ; _ • = =. _ ■ PEOPLE INFORMATION • •": : . _ _ . ._
PROPERTY OWNER: NAM DAYTIME PHONE:
� r Ov4go ) `ASr - 1419g
( 0 s MAIUG 51 RE �, _ �CITY, ASI- cN' Q cJA-` /(, c11eb-3
CONTRACTOR: NAME:. DAYTIME PHONE:
�i € fel
/ €eZe � (tin) ( --
1-1(44
(STREETMAILING ADDRESS � S, STA
te,Z EVENING PHONE:
c&` YUoJ a C S20
CITY OF FEDERAL WAY SINESS
/ UCEyNSSEE NUMBER: FAX NUMBER:
CONTRACTOR'Skia4(C &)IfATION �/NUMBER:a 34 - - IXPIRA ON OATS
(copy of card uiF I t L. D 019 OSS / / 03
APPLICANT: NAME: , (( _ DAYTIME PHONE:
aVItA —red G�r (4/.7 ") 971 -ZIGA44,
MAILING ADD (STREET ADDRE STATE,ZIP): EVENING PHONE:
r5C° \ 100 }-k.c -
RELATIONSHIP TO PROJECT: FAX FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CiiiCONTRACTOR
__ - --. --. • :.B 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 S .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 0 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
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) I MP(S)
---1i• DISCLAIMER/SIGNATURE BLOCK • - • - - _ .
I certify under penalty of perjury that ' e 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 part of this application.
NAME/TITLE: '��.�Q 1\1104-I1Q(/
DATE: / C I d 2
❑ PROPERTY OWNER ❑ APPLICANT 9*ONTRACTOR
•
FOR OFFICE USE ONLY: '
'-Q-NEW= _'1T ❑ADDITION -❑'ALTERATION =-❑;REPAIR • ❑TENANT IMPROVEMENT
CENSUS CODE: _.: ' = LOTSIZE _.
ZONING-15. : _ _ _ _ _ BUILDING SHELL ONLY? ;_❑-YES ❑ NO
•
COMP. 'I AN'DESIGNATIONBASIC PLAN? '"' ❑YES ' ❑NO'
;SECTIONS __'--==TOWNSHIP _ RANGE • NEW ADDRESS REQUIRED? - - ❑ YES -❑_NO
:PLATTED`LOT? _ ❑YES ❑ NO CHANGE OF USE?- 0 YES - ❑ NO
COMMUNITY DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000-FAX:253-661-4129
TABLE Q
NV/RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
1 _Single Family _Service or feeder only $48.00 #of Thermostats(First-$36.00;add'n-S 11.00ea)
(First 1300 ft2-$72.00;Each add'n 500 ft2-$23.00) _Service and feeder $78.00 6 #of Low voltage fire or burglar alarms
Square Feet: irst 2500 ft'-542.00 Each add'n 2500 ft2-$11.00
_
Each outbuilding orgarage $30.00 MOBILE HOME/RV PARK Square Feet: ' O'
(inspected with service) _#of service or feeders *Per WA 296-46-910(5)(b)(i&ii)
-Each outbuilding or garage $48.00 (First service/feeder-548.00;Add'n service/ _#of Signs(First sign-$36.00;add'n sign
(Inspected separately) feeder-53 1 each) $17.00 each)
_Swimming pool,hot tub,spa 72.00
Yard Pole meter loops 48.00
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 78.00
Up to 200 amp $ 78.00 S 23.00 Feeder _201-600 182.00
_201-400 amp 97.00 48.00 _0 to 100 $ 78.00 S 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 _#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/lndustiral
_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
_#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 req'd.Fee is 35%of permit fee+$61.00.Add'l plan review for other submissions is$72.00/hr.
31 'FDCTURE DESCRIPTION'(A) k TFIXTURE FEE:FROM TABLE B(B)1 ITALIOIVUMBER'OF:UNITS(C) r I ,.ZOTAL(D) Tx?t"
_
_
-. . -,•TOTAL COLUMN(D):4
Total Column(0)
Estimated Permit Fee: (12)
Estimated Permit Fee from fine 12
Estimated Plan Review Fee: $56.25+ X.35=(13)
- •■ DEMOLITION
Estimated Permit Fee: (14)
Bond Amount:(15)
- - - a 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
(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 addita'hal5100.00or 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$5000.00 or 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 51,000.00 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 57.50 for each additional$5000.00 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,brand including
$500,000.00
(7)$500,001.00 to$1,000,000.00 (7)$3,337.23 for the fist$500,000.00 plus;5.09 kr each additional$1,000.00 or fraction thereof,to and indudi g
$1,000,000.00.
(8)$1,000,001.00 and up (8)$5,788.23 for the first$1,000,000.00 plus;3.91 for each additional$1,000.00 or fraction thereof.
Bold number is the base fee for the specified increment
italicized,underlined number Is the fee per addit oval soedred 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 Coundl,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: (•
1 Estimated Plan Revie Fee: (5)
- - - - - _ ■ FIRE PREVENTION SYSTEM -
t PROPOSED VALU, ON:
FEE FACTOR F••M TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimat-' 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)