02-100957 J.of
CONSTRUCT I ION PERMIT APPLICATION
VV E3YFI Zf=I1__ APPLICATION NUMBER: !-d-- U° 7 ) - �
APPLICATION NUMBER: - _ - _ _
JAN 1 4 2002 APPLICATION NUMBER: ` _ _ - _
**The foll9W6ng LssrcOrgATformation-Please print(in ink)or type**
Please note: Electrical,Fire greveDonpEstTdms and Engineering g permits may require a separate application.
.. - - '' PROPERTY INFORMATION _
`'
SITE ADDRESS: 7/ ..:7 ('v J Os ST ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): -- -e i /2 n- /-71-‘44... c_
z.4:,-?% -. : .:_. .-.1.:-.1:3.,1.PROTECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL .❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): P/2. (//C e 2A
F f '
iigtOJECT NAME: `W
- •"PEOPLE INFORMAL MN
•OPERTY OWNER: NAME: DAYTIME PHONE:_
lift46 e �1 V �) X27- cz-9 37
MAILING DRESS(STREET ADDRESS;CITY,STA P): - .7S 10Y' S CIO /C �~L',4 6( 7
•NTRACTOR: NAME: �,
0DAYTIME PHONE:
!/+ ( ) -
MAILING ADO (STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of Card require / /
•PLICANT: NAME: DAYTIME PHONE:
: �� �, ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
I RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
ONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
U ,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 0 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)
BOILERS) 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)
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.( )
INTERCEPTORS) 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
er,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
er agree to hold harmless the City of Federal Way as to any daim(induding costs,expenses,and attorneys'fees incurred in the
estigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
•eral Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
the information suppii94 to the city as a part of this application.
E/TITLE: /' //i 11177C DATE: - -
– PROPERTY OWNER ElAPPLICANT ❑1CONTRACTOR
:-FOR OF,FICE=USE g4.
41:11WM40 AOUITION - - ❑ALTERATION _" ❑;REPAIR . °.==-_❑ TENANT IMPROVEMENT '
CENSUSCODE:_ =-==" _: - -- _ - 'LOTSIZE:+ :
ZONINGESIGNATION £_r__ r __ ._ BUILDING SHELL ONLY? ❑YES 0 NO - -
COMPJPL AN DESIGNATION_- _-=_ - = BASK PLAN? ❑YES"= ❑NO' "" —
SECTION`z > _ TOWNSHIP :.RANGE • NEW ADDRESS REQUIRED? _ ❑ 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
-- • ■ ELECTRICAL
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_. Single Family _Service or feeder only $48.00 _if of Thermostats(First-$36.00;add'n-$11.00ea)
(First 1300 ft2-$72.00;Each add'n 500 ft2-$23.00) _Service and feeder $78.00 M of Lowvoltage fire or burglar alarms
Square Feet: First 2500$2-$42.00;Each add'n 2500 ft2-$11.00 1
Each outbuilding or garage $30.00 MOBILE HOME/RV PARK Square Feet: ( )(b)(i&
•Per WAC 296-46-910 5
(Inspected with service) _#of service or feeders 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-$31 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 $ 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 $ 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 arnp 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
Oilr _Over 1000 365.00 195.00 Residentiai/Multi-Family/Commercial/Industiral
$66.00 _Over 600 volts surcharge 61.00 _0-100 48.00
_ 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
_
_X 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+561.00.Add'I plan review for other submissions is$72.00/hr.
li**F.DRURE:DESCRIPTION'(A)AO!tFIXTURE iFEE:FROM TABLE-1316)1'; :',4MUMBER'OF:UNITS(C)itekt Mt TOTALt(D)Ag$1,i % ''
r
s
. -TOTAL COLUMN(D):'
1
Total Column(D)
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)
- -- - ■ 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