02-105344 City of Federal Way
Community Development Services Electrical Permit #:02 - 105344 - 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: MORENO qv•
Project Address: 28813 20TH S Parcel Number: 422280 0100
Project Description: ELE-Altering up to 4 circuits for new addition
Owner Applicant Contractor
Belinda A&Lionel Moreno Belinda A&Lionel Moreno Belinda A&Lionel Moreno
28813 20TH PL S 28813 20TH PLS 28813 20TH PL S
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003-3834 98003-3834
Electrical Fixtures
Tib 1Ww; OflMAS111 MVx9 '- '`"'', 4 t
Circuits-Residential 4
PERMIT EXPIRES May 25,2003,IF NO WORK IS STARTED.
Permit issued on November 26,2002
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 agent: �QyL Date:
1
Yt —31 — ( 0/2- 2 c 4)s ,�-o Q-A,/
Rough-in inspection: tql /2,t, V S- 2-- - 1-
Date
- - ZDate
Service inspection:
n Date
FINAL inspection: !��r i2 0Li -C n 4- /
Date
(e3 �S �� ;;ice►
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. RECEIVEQ CONSTRUCTION PERMIT APPLICATION L
APPLICATION NUMBER: QA LQ$ j1-
A> NO� 6 Z3OZ APPLICATION NUMBER:
AOF FEDEBALWAY APPLICATION NUMBER: - -
GITY G DEPT
**I:tit: abiwing is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
- PA PROPERTY INFORMATION
SITE ADDRESS: 2 pg 13 24f)tl"' ' 1 -30 ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
S - i /' s , _ •
._-.._ _. _.: .__:_- .. . _ .._ - ' - .11 PRO3ECT INFORMATION-. "
TYPE OF PROJECT(This application): 0 BUILDING ❑ PLUMBING ❑ MECHANICAL 0 DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): ir)1.Ci E('4' Imo✓/
41-5 A-01.0 e
. -sit • Curl--l e.-Ls A.---,/ L.;r)Vldi
PROJECT NAME: - - Aida c-- � 8. iA(L P tare..-_o clAd
. .M PEOPLE INFORMATION -
r
PROPERTY OWNER: NAME: DAYTIME PHONE:
�/
MAILING ADDRESS r` � -) / 7� 6 less"
-
ZSTREET ADDRESS;CITY,STATE,ZIP):
2 j8 i' 2)4 e/ .ra 1 F.-04,a1 4/5, WA's- 98°d3
CONTRACTOR: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITTATE,ZIP): EVENING PHONE:
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME:
/r' DAYTIME PHONE:
r d Y�tX VIA.•�+-G✓1 (253 ) 1 Y/-6 Ors'
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
Das 13 2-0 )-t p/ Sa Cc to ,A.. c vn— (3..c3) 9Y/ - 6453'
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑TENANT 0 OTHER(DESCRIBE): 0-WnPAA. ( ) - ,
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
'
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION .• ' PROVEMENTS: $
SPRINKLERED BUILDING? ■ 0 NO Fl• -•PPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES 0 NO
WATER SERVICE PROVIDER: ❑ LAKEHAV ' ■ - GHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LA• • EN 0 HIGHLINE iii - -. • • E(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ETTIN4TED SELLING PRICE: $
• ■ PR07ECT FLOOR AREAS •
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL: Ai&
�. -,. ,.�.. .«.. . .. >,_y_ ,_ - . �..�� .,��•.��.Y. ,.:U FIXTURES. ,; . N.�>yt.. .,,...,.:. _,.,.:��..M :. -,,.-.,:.:�..�''', .t. �.
Indica - number of each type of i re
MECHANICAL
AIR HANDLING UNIT(S) •PORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) •AN(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 ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) S MP(S)
. . . g •DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that th- 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 dty,induding its officers and employees,upon the accuracy
of the information supplied t e dty as a part of this application.
NAME/TITLE: DATE: 1/ ;6/0
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
E.CQROFFICE USE"ONLY:_A
NEW. ❑ADDITION `.0ALTERATION .r LIREPAIR--£]jENANT-IMPROVEMENT
Z' _ ESIGIVATrON= �_�WftW BUILDING=SiiEL1 -ONLY?s0WES13NO�'�€�}-���
COMP LgAN DESIGNATION - '' '� _S' aW7- B '� 0
�:.. ,-> �� �,__. ��xBASYG PLAN?�.,� ��.�� :_, ���_ =�
SECTiONM TOWNSHIP_„ tAN6Es yam`=NEWADDRESS,REQUIREQ? <:t k, :r_1�.ES' `NO =
ir�r-f-'bl--_ •x _______-,�___�;. ,�.=`.,�_s - _ _ _ t�3ti' r,y =� WAa I K`y3`M_=--
.LOT?: _❑Nig�r�:-�VU- - -- _ CHANGE OF;l1SE?�<,, . ,�:YE5.€-.�=wC�;NO;��__���,a
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 980639718.253-661-4000•FAX:253-661-4129
www_dtvoffederalway.com
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$3.50 for each additional$100:00 or fraction thereof,to and induding
$2,000.00
(3)$2,001.00 to$25,000.00
(3)$78.50 for the first$2,000.00 plus$15.50 for each additional$1,000.00 or 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 111.00 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$1,000.00 or fraction thereof,to and
including$100,000.00.
(6)$1",'i 1.00 to$500,000.00
(6)$1,110.00 for the first$100,000.00 plus$6.00 for each additional$1,000.00 or fraction thereof,to and
including$500,000.00
(7)$500,001.00 :$1,000,000.00
(7)$3,510.00 for the fist$500,000.00 plus . • each additional 11000.00or fraction thereof,to and
including$1,000,000.00.
(8)$1,000,001.00 and u•
(8)$6,260.00 for the first$1,000,000.00 pl ;$4.00 for each additional$1.000.00 or fraction thereof.
Bold number Is the base fee for the • . ed increment
Italicized,underlined number Is the f= per additional snecifed Increment
PLUS: Add 65 percent of the base buildi •permit fee for plan review fee.
Add 25 percent of the base mechan..I permit fee for mechanical plan r '• fee.
Add 15 percent of the base building .• it fee for Fre District#39 surch. •e,commercial only.
Add$4.50 for WA State Building Code • ndl,plus$2.00 per unit ford .lex&above.
*Electrical,plumbing .nd 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 Sur, arge: (3)
(COMMERCIAL ONLY)
■ MECHANICAL •
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: umber: (a)Base Fee:
(b)Additional Increment •••
Estimated Permit Fee: •)
Estimated Plan Revie Fee: (5)
• FIRE PREVENTION SYSTEM
PROPOSED VALUA ON:
FEE FACTOR FR. TABLE A:Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated P•rmit Fee: (6) •
Estimated •lan Review Fee: (7)
• • •. . . . . •■ PLUMBING .• . . • .
Base Fee Number d Fbctur s
$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(Page one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)= (11)
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-$75.00;Each add'n 500 112-$24.00) _Service and feeder $81.00 _#of Low voltage fire or burglar alarms
Square Feet: First 2500 ft1-$43.50;Each add'n 2500 ft'-$11.50
_Each outbuilding or garage $31.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _#of service or feeders *Per WAC 296-46-910(5)(b)(i&ii)
_Each outbuilding or garage $50.00 (First service/feeder-$50.00;Add'n service/ _#of Signs(First sign-$37.50;add'n sign
(Inspected separately) feeder-S32 each) S 17.50 tach)
_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 S 81.00 S 24.00 Feeder _201-600 189.00
_201-400 amp 101.00 50.00 _0 to 100 $ 81.00 S 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-$63.50;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
Wl of circuits _over 600 109.00
(1-4 circuits-$50.00;Add'n circuits$5 ea)
If a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps,a plan review is required.Fee is 35%of
permit fee+563.50.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):,
Total Column(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from hne 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)
,
IL • OTHER FEES
Mitigation Fee:(18) (20) (22)
SBCC Surcharge:(19) - (21) (23)
total(Pa9esOne&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)= (24)
Bulletin#100-February 19,2002