The URL can be used to link to this page

05-100107 N•44 RECEIVED , TP are es 4,e 2k,......- 0 S'7.'. _1_ _t2 L o _7 Federal Way 2ooh PERMIT COMLWUN17YDEVELOPMENT SERVSF MF CO ME PL DE EN FP 33530 FIRST WAY SOUTH•PO BOX 9718 PEDERAL41IW15Y,FWz95.8 aiO- I-LDLRAI �P p L I C AT I O N TD / / u,�,�„.atmfredemlwmtem BUILDING DEPT The oiiowt • is re• fired in orvnat lon-an inco •late • • •lication will not be acce• d. Please •rint -• •1 (in or j• . � / PROPERTY INFORMATION / SITE ADDRESS I�"` I �P W 3 l 7 4-11 PL' SUITE/IINIT$ ASSESSOR'S TAX/PARCEL i - �_' '�/ LOT SIZE(sf) !v LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) -� £00Tit t r&- �v� ( NI✓ F / 9109 0,.... eparczepage for Nlegal deaai:non) J PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit only) J.9 yui i rU-U) 3.02,0 4 /Y)&tuL a / 1L~ 02-00 A- 16��-,e.L 1112-)Le 1-0 kt i.L,;k1 per,-L.� . PROJECT NAME(Name of Business or Owner Last Name) PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE OWNER j/n n E, Dai,;e.1f 6 (•5 ) 614 !- 70(0L/ MAILING ADDRESS CITY,STATE,ZIP Po kOx ,VI-71-7 reeu.uat, wa 1 LU& CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE Prmi - i to a (0253) &a/ - '7'1 50 MAILING ADDRESS C ,STATE,ZIP ELL PHONE PD / )$ 5 a 8� � ' �� ©�g ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER - - - _ _ / / (0253) 63/ - •775 B L CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE P2o V i e i t o 3c .2• a / aa / o6, APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE ( ) - MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) - RELATIONSIIIP TO PROJECT FAX NUMBER 0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) - CONTACT NAMEcuLe jyt PRIMARY PHONE E-MAIL ADDRESS (02ES) 73( - 1750 LENDER Per RCW19.27.095: Lender information is NAME required if project value exceeds$5;000 MAILING ADDRESS CITY,STATE,ZIP DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? C YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) 3 PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE/CARPORT HOW MANY FLOORS? TOTAL 5 ST15O TOTAL PROPOSED TOTAL E70STAO MD PROPOSED **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain. MECHAMCAL Value of Mechanical Work $ AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(Commeroiaq WOODSTOVES BOILERS FIREPLACE INSERTS RANGES _ MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/shower combo) SHOWERS WATER CLOSETS(Toilet) M1SC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS Bathroom sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS 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 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 claim(including costs, expenses, and attorneys'fees incurred 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 information supplied to the city as a part of this application. • NAME/TITLE `( IfY)-��I 0-'0-AAA) DATE () 10105 (Signature) (Title) RELATIONSHIP TO PROJECT ❑ Owner 0 Agent • Contractor ❑ Architect 0 Other FOR.OFFICE USE ONLY NEW ADDITION ❑ALTERATION c REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? c YES c NO BASIC PLAN? c YES =NO ZONING DESIGNATION CHANGE OF USE? c YES c NO NEW ADDRESS REQUIRED? ❑YES c NO UP/SEPA/SU? c YES c NO PLATTED LOT? ❑YES NO DEMO PERMIT REQUIRED? c YES c NO Bulletin#100—March 30,2004 Page 2 of 4 k\Handouts—Revised\Permit Application R . ELECTRICAL PERMIT INFORMATION • RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE ❑ Single Family Square Feet Service or Feeder Each Add'n (First 1300 ft2-$104.50;Each add'n 500 ft2-$33.50) ❑ 0 to 100 amp $113.50 $69.50 ❑ Detached outbuilding or garage ❑ 101-200 amp 141.00 89.00 • (Inspected with service) $44.00 ❑ 201-400 amp 264.50 104.00 ❑ Detached outbuilding or garage ❑ 401-600 amp 308.00 123.50 (Inspected separately) $69.50 ❑ 601-800 amp 398.50 168.50 NEW MULTI-FAMILY(three units or more) ❑ 801 1000 amp 486.50 203.50 Service Feeder ❑ Over 1000 amp 530.50 283.00 ❑ Up to 200 amp $113.50 $33.50 ❑ 201 -400 amp 141.00 69.50 ❑ Over 600 volts surcharge $89.00 ❑ 401.-600 amp 193.00 96.00 • ❑ Mast or meter repair $96.00 ❑ 601 -800 amp 247.00 132.00 ALTERED COMMERCIAL/INDUSTRIAL ❑ Over 800 amp 353.50 264.50 Service or Feeders ALTERED SINGLE/MULTI FAMILY ❑ 0 to 200 amp $113.50 ❑ 201 -600 amp 264.50 Service or Feeder ❑ 601 - 1000 amp 398.50 tO to 200 amp $87.00 ❑ over 1000 amp 443.50 201 -600 amp 141.00 ❑ over 600 amp 212.50 ❑ #of circuits to be added/altered (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 Mast or meter repair $52.00 ❑ Service- 1,000 amps or greater ❑ Medical/Educational/Institutional Facility SINGLE/MULTI FAMILY PLAN REVIEW ❑ Service Over 400 amps $74.00 plus 35%of Permit Fee MOBILE HOMES ❑ Service or feeder only $69.50 TEMPORARY SERVICE ❑ Service and feeder $113.50 Residential/Multi-Family/Commercial/Industriai $61.00 MOBILE HOME/RV PARK ❑ #of service or feeders Commercial/Industriai Service or Feeder Ampacity (First service/feeder-$69.50;each add'n-$45.00) ❑ 0- 100 amps $69.50 • ❑ 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'n sign$24.50/ea) ❑ Low Voltage U Swimming pool/hot tub $87.00 • Square Feet to be served by system(s) (Includes additional circuit,if required) ❑ Fire Alarm System U Yard Pole meter loops $104.50 ❑ Security Alarm System U Additional Plan Review $104.50/hour ❑ Voice Cabling (for modified submittals) ❑ Data Cabling 0 (Per System(s) 1f2 2500 ft2-$61.00; Each add'n 2500 ft2-16.00) 'Per WAC 296.46-910(5)(bpi&ii) Bulletin#100-December 8,2004 Page 3 of 4 k\Hartdouts\Permit Application