01-100115 k 12/27/00 WED 14:20 FAX 2536614129 CITY OF FEDERAL WAY (J002
{ • •
���` _t - _ c ETV F ) CONSTRUCTION PERMIT APPLICATION
V APPLICATION NUMBER: - c�c______211_5"- Ee
APPLICATION NUMBER:
'� � JANF��� APPLICATION NUMBER: _ _ - _ -
' **The following is required information-Please print(in ink)or types=
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.-
- — - ■ -PROPERTY INFORMATION
SITE ADDRESS: 3/41// <' C�/. -� vvtf�PEASSESSOR'S TAX/PARCEL it: .2'7 p'_O LaT�
52 g
_
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
I
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): , *BUILDING • i PLUMBING ,M • CAL DEMOLITION
- -ELECTRICAL 'ENGINEERING'4 N111ON SYSTEM
PROJECT DESCRIPTION(Provide detailed description): •- . t i ' _ •A
H s- ,
._ - ,►�_� -..tee / _ -t.r- •
—
PROJECT NAME: MN S t• In 6 /
■ PEO' :INFORMATION
PROPERTY OWNER: 4AME: DAYTIME woke:it1-60•1SD•tc (mac (t-a8) 3`15- 62bo
MAULING AODRffi(STREET AOOAESS;QTY ZIP):
_Y•°• %ItkX t, . - . Ib, 872 ,
CONTRACTOR: "NNAME DAYTIME RHONE:
.? ,�00 ( ) -
MAKING ADOR£LS(STREET • . ;CITY.STATE.ZAP: ING RHONE: -
/ \
.. chi.
• OF FEDERAL WAY (ICEIGE N A FAX NUMOER:
1 Ops TaN e)IIPP
H9:FIRATION DAVE;
I I
APPLIC \ NAME: DAYTIME PHONE:
' ' ' i 4 o AltaRTIE:rs We,. (425) S27 -2-10.73
ADDRESS 0 ADDRESS;QTY,STATE.ZI
EVENING PHONE:
AO t 3.0 Vi• S� W2 Vrwax�tt-,W� `16004 ( ) -
7IONSMI/TO PROJECT: FAX NUMBER:
'`ARCHITECT ❑TENANT 0 OTHER(DESCRIBE): (4j ) 82Z- C811
-
E-MAIL ADORESS: 1
ISl
4
C ACT PE' FOR THIS PROJECT: CI PROPERTY OWNER 0 APPLICANT 0 CONTRACTOR -S`i'AMOvAlC. OR\'►•C.V%
■ DETAILED BUILDING INFORMATION -
EXISTIN SES ALTSct,IS EXISTING BUILDING ASSESSED/APPRAISED VALUATION ; sem,
PRO•• O use F-141 --Au *ts PROPOSED VALUATION FOR IMPROVEMENTS: $ �• �U. d
5' • LEREO BUILDING? lirYES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED'lirYES ❑ NO
WATER SERVICE PROVIDER; 0 LAKEHAVEN CI HIGHLINE 0 TACOMA 0 PRIVATE(WELL1
SEWER SERVICE PROVIOER: LAKEHAVEN 0 HIGHtINE Cl PRIVATE(SEPTIC)
ti 12/27/00 WED 14:20 FAX 2536614129 CITY OF FEDERAL WAY 10003
•
**NEW RESIDENTIAL CONSTRUCTION ONLY* —
NUMBER OF BEDROOMS: ESTIMATED SWING PRICE: $
-PROJECT FLOOR AREAS — --
FLOOR EXISTING S e.FT. PROPOSED S..FT. TOTAL
BASEMENT
FIRST
52-t3 k.0 52310
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL: _ 52-13 l 0
1 FIXTURES --
Indicate number of each type of fixture
MECHANICAL
MR HANDLING UNIT(S) ^ EVAPORATIVE COOLER(S) GAS LOG(S) _ REFRIG.SYSTEM(S)
BBQ(S) `1 FAN(S) 4 HOODS) WOODSTOVE(s)
4 BOILERS) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
I DUCT(s) GAS PIPE OUTLET(S) HEAT SOURCE: 0.ELECTRIC 7GAS
PLUMBING
BATHTUB(S) _ 19 LAVATORY(S) I URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC O GAS
I , ORINIQNG FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLETS) I 0 SINK(S) (n . WATER CLOSET(S) _. MISC.(VR144N1___.)
INTERCEPTOR(S) SUMP(S) ,
A 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
'further,that I am autl u' ed by the owner of the above premises to perform the work for which the permit application is made. I
further gree to hold less the City of Federal Way as to any datm(Including costs,expenses,and
attorneys'fees maimed In the
Investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only Where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the infofmatidn supplied to the city as a pa offth`is�application.
\OA
NAME/TITLE: S
'51.11..,. - `�giltlle � DATE: 3 l• v /
2.001 —
❑ PROPERTY OWNER • APPLICANT ❑ CONTRACTOR
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coMHUNI Y DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH-P.C.SOX 971E•FEDERAL WAY,WA 90003-9716-253-641-4000.FAX:257-6G1-4I23
ti 12/27/00 1F'ED 14:21 FAX 2536614129 CITY OF FEDERAL WAY 1Q]004
• •
Permit Fee Estimate Worksheet
-
Section 1 -
Q Building Permit 0 Mechanical al Permit 0 Fire Prevention System Permit
PROPOSED VALUATION:,
FEE FACTOR FROM TABLE A:Number: (a)Base Fee:
(b)Additional Inaement Fee:
(Valuation from pellet spoecaoon-base fee Inaemeetyt000 Round w to newest**vie number
(`){ }/1000 = (d)
OR
For valuations between$501.00 and;2,000 only:
(Vawtkn hem park adbaamn-base fee teaeme etNICO Roved aro b nearest amok ruunmhQ
(W{ - }/100 = (g_
Value
from(d) value from(b)
(el X = (I)
ease Fee from(a) value from(fl Permit Fee
Permit Fee: + _(g)
rem*fee hem(9) nee ReA w Fee
Plan Review Fee; X .65 =(n)
ramp fee from(9) sum:hone fee
FW Fire Department Surcharge: X .15=
(COMrlER IAL ONLY)
$cctiOn 2
0 Building Permit 0 Mechanical Permit ❑ Flre Prevention System Permit
PROPOSED VALUATION:
FEE FACTOR FROM TABLE k Number: (a)Base Fee:
(b)Additional Increment Fee:
trout o from pmmk aioiraoan-base fee Ince•sent}11000 Rand up o manta rAmle number
(A{ }11000 = (e)
OR
For valuations between$501.00 and$2,000 only:
(Va6ratim hem wink'miaaon-base fee amzemgnt)/100 bound up le nearest eftle number
(a)
}1100 = (d)
value from(d) value from(b)
(e) X = (I)
Base Fee hum(a) Varve from(r) Permit Fee
Permit Fee; + =0)
•
Permit Fee From (9) Man Review foe
Plan Review Fee: X .65—cm)
Permit Fee hem(g) Sun:ha ve Fee
FW Fire Department Surcharge: X .15=co
ecommEPIUAL ONLY)
COMMUNITY OEVETOPMENT SERVICES 4 33530 FIRST WAY SOU1f1•P.O.BOX 9718•FEDERAL WAY,WA 99063-9718.253-G41-4000.FAX.253.661-129
12/27/00 WED 14:21 FAX 2536614129 CITY OF FEDERAL WAY 005
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--Section-3------
O Plumbing ❑ Electrical
IXTURE'DESCluI zONXA)*SfflatetWDZTURErEE B t7 !V • . ,, .
'3; '� � H8 F HITS, �^ .._•� ':f r'ST=::." 1 C.�D -�.„rF.r.
LiftriTOTALrtCO111MN''D: —
Plumbing `~
$21.00+{ X$7.00/fixture)= Estimated Permit Fee
&limited Primp Fee
X •65= Estimated Plan Review Fee
Miscehaneous Fixture Charge:
Electrical OR
Tod Column(0)
Estimated Permit Fee:
Esomaled Perm.t Fee hee,1ne 12
Estimated Plan Review Fee: $56.25+. X.35=
Section 4 -
O Plumbing 0 Electrical
Z�!J' kb. P�iO rl Q'9 '.apt! i; x aa� ti `:«:. '.. I' • i %,
Plumbing
$21.00+( X F7e .00/fixture)e• Estimated Petmit Fee
Migilted FMKX .65= Estimated Plan Review Fee
Miscellaneous Fixture Charge:
OR
Electrical
Total Gbtumr(0)
Estimated Permit Fee:
Estimated P m*Fee from line 12
Estimated Plan Review Fee: $56.25+ X.35=_
Section 5
0 Demolition 0 Engineering 0 Other Fees
Estimated Permit Fee:
Bond Amount
Estimated Permit Fee:
Bond Amount _
Estimated Permit Fee:
Bond Amount
Estimated Permit Fee:
Bond Amount
Ea/actin#101–A1igust 29,2000
12/27/00 WED 14:21 FAX 2536614129 CITY OF FEDERAL WAY 0 006
•
C:onstrucfiion Permit Fee Calculation
Sheet
*******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT.
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building,mechanical,and fire prevention system fees are based on the following schedule_
TABLE A
TOTAL VALUATION 1$FACTOR
Ok
(IJ$t oo m 2500.00 (I)$23.so ti
R)$SotMO to 52000.00 (2)$13so fur the rust$500.00 cArs sleifmeadueifamar fra den therea,to and
ire:L.ai.o s2.000-a9
(3)$2.003A0 0,SZS,030.00 (3)$69.25 for 00 the rest$:A00.00Caatzgartamanearazo2Or fraction theacW,b and Including
(4)$25,001.00 to 550,000,00 (4)$351.25 for the first$25,000.00 plus$10ab-rafi iglaitim�/fl Dov Ov or f
$50,000.00. r'cdO^ ' .to and Ndudfrp
(5)$50.001.00 to 5100.000.00 (5)$643.75 for the first$50.000.00 plus$7.rO&ttd. :+..d r1 MAMp fraction pip(,to and kid
5100.000.00. u 5
(6)5100.001.00 b 1500.000.00 (6)$953.75 for the first$100,000.oe plus$S.fb Ar anti ksti t1 ty»Ma�yei taeof.ea
$500,000.00 bad Including
(7)$S00.00L00 tp t1.000,000Ao (7)$2.233.75 ter the fist$500,000.00 rite 2 ae Fraction*emit,to&NI
$1.000,000.00. q
(a)51,000,001.00 and up (tp$5,608.75 for the grit$1,000,000.0.3 pk6$
1firtigLlirltifkiffiCayfl.000.0p or hocUon tneevf.
Seta number is the base fee Mr the specified Ieoreetent
Tui es y drsfine,rm«iA�ci z.narrrd.:.files rinaAigem ear
PLUS: Add 65 percent of the base building permit fee for plan review fee.
Add 25 percent of the base mechanical permit fcc for mechanical plan review fee.
Add 15 percent of the base building permit fee for Fire District 839 surcharge,commerdal only.
Add$4.50 for WA State Building Code Coundl,plus$2.00 per unit for duplex&above.
**Bbl,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 Rif Fire Department surcharge: (3)
(COMMERCIAL Otte»
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A:Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5) •
— — -- - -- -----■ PI<RE PREVENTION SYSTEM
PROPOSED VALUATION:
FEE FACTOR FROM TABLE k Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (71
Base ke Monter or ■ PLUMBING - -
$21.00+ >ba Parma Fee X$7.00/fixture)ow (8)Estimated Permit Fee
X .65= (9)Estimated Plan Review Fee
Miscellaneous Rxture Charge(10)
l(aa9e one): Une(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)_(11)
12/27/00 WED 14:22 FAX 2536614129 CITY OF FEDERAL WAY la 007
. 4
' IIIIIIIIMIIIIMINNiijLEMINMIMICIEEGEEanIIIIIIIMILIIIIIIIMIIIIIIIIIIIIIIIIIIIII.
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family Service or feeder only 544,25 _t of Thermostats(First-533.50;add'n-510.50ea)
(First 1300 ft'-567,00;Each add'n 5001t=-521.50) _Service and feeder 572.25 0 of Low voltage fire or burglar alarms
Square Feet: Fust 2500 0143E.75;Each add'n 2500 IPS 10.50
Each outbuilding or garage_......._........_..._..528.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _I of service or feeders •Per WAC 296-46-910(5)(14(i£C ii) '
Each outbuilding Of garage „......____544.25 (First service/feeder-544.25;Add'n service _k of Signs(First sign 533.50;add'n sign
(Inspected separately) fceder•S28 each) $16.00 Cacti)
_Progress inspection per t 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 unite or more) Altered Service or Feeders
Service Feeder Amps Service or Add'n 0 to 200. S 72.25
_Up W 200 amp______.S 7225__.. $21.50 Feeder _201-600 169.00
201-400 amp 89.75 44.25 _0 to 100 .5 72.25 S 44.25 _601-1000.._..„.„......-.............._..._ 254.50
_401-600 amp_.___._.._..12325 61.50 _101-200_......._..._..._.....89.75._........56.25 over 1000 282,75
_601-ZOO amp... 158.00 84.25 201-400„ 169.00 67.00 1 of circuits
Over 800 amp____ 225.25 169.00 _401-600._......._..._.......197.00-„........7$.75 (I-S circuits-S56.25:Add'rt circuits,S5 ea) I
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 XOver 1000 339.00__-_.111.00 _Oto 60 .--536.75
to 200 amp.... __._5 61.50 _Over 600 volts surcharge_......_..__.. 5625 61-100..____....__._.... 44.25
_201-600 amp_____ $9.75 Mast or meter repair 61.50 _101-200 _..._-_56.25
_over 600 amp __...13525 _201-400._.._.__ „ 67.00
Mast or meter repair 33.50 _401-600 89.75
^_Mot circuits over 600. 97.75
(I-I circuits-54425;Add'n circuits$5 ea)
I
If service is greater than 200 amp,a plan review is req•d.Fee is 35%of permit fee+556.25.Add'I plan review`or other submissions is 567.00/hr.
"i'iRXflIRE^DESCRIP„IIONCIO•N". :RflJRE:FEE FROM TABLET j(B)•i •.•,:NUMBEICOF!JNIT$(C) 1:: 1::-::.?Q'r,::'ttiOTAI't(D :, . .
TOTAIkeOt]U;$lt(0):;
Teat Cdwnr(0)
Estimated Permit Fee: (12)
Estimated Permit Pee from me 12
Estimated Plan Review Fee: $56.25+ X.35-(13)
Is DEMOLITION
Estimated Peimit Fee: (14)
Bond Amount(15)
• ENGINEERING
•
Estimated Permit Fee:(16)
Bond Amount (17)
• - - --- ■ OTHER FEES
Mitigation Fee:(18) (20) (22)
MCC Surcharge:(19) (21) (23)
Total(Pages One&- ): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)= (24)
I
bulletin*100-August 29,2000
• 1