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05-103055 RECEIVED arv.,A JUN Federal Way 2 b ' 1_ �ifMU d orDEVal PERMIT SF MF CO 33325 VW AVENUE SOUTH• � FEDERAL WAY 'L DE EN FP FEDERAL WAY,WA 98063-97 DING D E PTA P P LI C AT I O N 253-835-2607.FAX 353435-4609 www.dl uof federal wa y.co m in) The ollowi • is lied in ormation-an Inco •fete • ••licatlon will not be acce•ted. Please •rint le• •1 n in or ■ PROPERTY INFORMATION SITE ADDRESS - So 4'7 /` -U 0"777 _<'/ SUITE/UNIT# /o ASSESSOR'S TAX/PARCEL# - _ _ _ LOT SIZE Of) /. t.sy frt--- LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach Warat.M OO.len"legaldesalptlmy • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0PLUMBING 0 MECHANICAL - 0 DEMOLITION LECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this Hermit only) ' _ .4.4 r Zit/ iy (%/1 /_ PROJECT NAME(Name of Business or Owner Last Name) ��a4.L `‹.G.�rV.0 • PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE OWNER )jQ f"/ ( ©dx, Ka ? 4o,5( MAILING ADDRESS CITY,STATE,ZIP /7 4`S:-)--c AIL s/ tod27r- D t 6 2 ,9,:. o f_fr o o CONTRACTOR COMPANY NAME APPLICANT NAME OF E PHONE `7I -- C-"f ,Sl' 6Zó7 /,4 wilt so BA .228- 7)f-6"MAILING ADDRESS CITY,STATE,ZIP CELL PHONE te<ce ......<-4015C Pr ! ✓�q 4J �,f//r/E�'l. 7 (, H /"PCITY OF FEDERALWAYBUSINESS LICENSE NUMBER wyhON DATE FAX NUMBER - - _B. L / / ( ) CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE I / APPLICANT COMPANY NAME �s APPLICANT NAME OFFICE PHONE � MAILING ADDRESS 4c ("` 4- _ ( ) - CITY,STATE,ZIP CELL PHONE RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect a Tenant a Agent a Other(Describe) ( ) - CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS ( I - LENDER P. ,, # ¢t._.'.`. r.„r.r-. 1 g77,,teC. 4p4 , NAME MAILING ADDRESS CITY,STATE,ZIP ■ DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) ELEC11, Ft TION RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE ❑ Single Family Square Feet Service or Feeder Each Add'n (First 1300 ftp-$104.50;Each add'n 500 ft2-$33.50) ❑ 0 to 100 amp $113.50 $69.50 Li eta outbuilding or garage ❑ 101-200 amp 141.00 89.00 I (Inspected with service) $44.00 O 201-400 amp 264.50 104.00 ❑ Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50 (Inspected separately) $69.50 0 601-800 amp 398.50 . 168.50 O 801 - 1000 amp 486.50 203.50 NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 530.50 283.00 Service Feeder _ ❑ Up to 200 amp $113.50 $33.50 ❑ Over 600 volts surcharge $89.00 ❑ 201 -400 amp 141.00 69.50 0 Mast or meter repair $96.00 ❑ 401 -600 amp 193:00 96.00 ALTERED COMMERCIAL/INDUSTRIAL ❑ 601 -800 amp 247.00 132.00 ❑ Over 800 amp 353.50 264.50 Service or Feeders ❑ 0 to 200 amp $113.50 ALTERED SINGLE/MULTI FAMILY ❑ 201-600 amp 264.50 O 601 - 1000 amp 398.50 Service or Feeder 0 over 1000 amp 443.50 ❑ Oto 200 amp $87.00 ❑ 201 -600 amp 141.00 n f' #of circuits to be added/altered ❑ over 600 amp 212.50 (1-5 circuits-$89.00;Add'n circuits,$7.00/ea) ❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW (1-4 circuits-$69.50;Add'n circuits$7.00/ea) $89.00 plus 35%of Permit Fee ❑ Service- 1,000 amps or greater ❑ Mast or meter repair $52.00 ❑ Medical/Educational/Institutional Facility MOBILE HOMES ❑ Service or feeder only $69.50 ❑ Service and feeder $113.50 TEMPORARY SERVICE i MOBILE HOME/RV PARK Residential/Multi-Family $61.00 ❑ #of service or feeders (First service/feeder-$69.50;each add'n-$45.00) Commercial/Industrial Service or Feeder Ampacity U 0-100 amps _ $69.50 i ❑ 101-200 amps 89.00 ❑ 201-400 amps 104.50 ❑ 401-600 amps - 141.00 ❑ over 600 amps 152.50 MISCELLANEOUS SERVICE/EQUIPMENT ❑ #of Thermostats ❑ #of Signs (First-$52.00;add'n-$16.00/ea) (First sign-$52.00;add'nsign$24.50/ea) ❑ Low Voltage ❑ Swimming pool/hot tub $87.00 Square Feet to be served by system(s) (Includes additional circuit,if required) ❑ Fire Alarm System ❑ Yard Pole meter loops $104.50 ❑ Security Alarm System ❑ Additional Plan Review $104.50/hour ❑ Voice Cabling (for modified submittals) ❑ Data Cabling ❑ Automation Fee on all Permits .. $5.00 CI (Per System(s) Pt 2500 ft2-$61.00; Each add'n 2500 ft2-16.00) 'Per WAC 296-46-910(5)M&it) Bulletin#100-January 7,2005 Page 3 of 4 k\Handouts\Permit Application