03-104431 t
City of Federal Way Electrical Permit #:03 - 104431 - 00 - EL
Community Development Services
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: NAGY
Project Address: 35813 1ST AVe5 Parcel Number: 302104 9156
Project Description: Installing new thermostat
Owner Applicant Contractor
Alex S Nagy HERITAGE ENTERPRISES INC HERITAGE ENTERPRISES INC
14043 7TH PL S 9001 PACIFIC AVE 9001 PACIFIC AVE
SEATTLE WA TACOMA WA 98422 TACOMA WA 98422
98168-3505 (253)539-8709
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Thermostat 1
PERMIT EXPIRES March 24,2004.
Permit issued on September 26,2003
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. j]j] G
Owner or agent: See A plication rZ Date: l f°
I
M i\ I , _
,vift4
Rough-in inspection:
Date
,
FINAL inspection: 'I, i •� .... •-..-4,,,,�� Q 7j
D to
CCMMUN11YDEVEEp� D pF
F SEP DEPARTMENT CONSTRUCTION PEM A,F1 CATION
vv � 03 ''
04011:60:00. *t�: i,r: :11 •.i. , , .!--,-:;t=„/"„:7:,,7,,:- .......
y':L , j;ILI
**The following is required Information-Please print(in ink)or type"*
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
• PROPERTY INFORMATION
Si-
SITE ADDRESS: 3'� s, s% I Po C. S U , ASSESSOR'S TAX/PARCEL 1: -' 0 - i 0 t{ - C7 15 (P
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): Lo} l S.Lb�c._,,S,a., iL(_S(3
# 3- c %),(L to 1.1 opt roc k) St c_. 3k..) —,�:- c.Sti,A j..r , rCl/\ j
• PROJECT INFORMATION
TYPE OP PROTECT(This application): ❑BUILDING a PLUMBING o MECHANICAL o DEMOLITION
"'ELECTRICAL oE-NGINEERING a FIRE PREVENTION SYSTEM
t
PROSECT DESCRIPTION(Provide detailed description): ` ._
PROJECT NAME: -
• PEOPLE INFORMATION
PROPERTY OWNER: NAM DAYTIME PHONE:
wcI \e \\O`f�eS - ��[]\ (c�S3) -310 -XS 3`�
MAILING ADDRESS(�TREET ADDRESS;QTY,STATE,VP): V
X10 OCAtt 1 LT 1JJe:.. Q_ v.;\ c 3 A _
CONTRACTOR: NAME DAYTIME PHONE:
eIrk .\c,�c c" {\\-. . (,2S3) r).) -�� I)
t4AAJNG ADDRESS( REET ADD CTTY,STATE,VP): E ENING PHONE:
�U\ Va-i C. �x )
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER;
1 G - CA 9 t o .1 C12(0 CL CO gL ()y ) s s =>j
CONTRACTOR'S REGISTRATION HUMEER; DCRIRATlON DATE:
(copy of card required) \At, ( C c c cD \-U L / 14' / cc--i
APPLICANT: NAME; r DAYTIME PHONE:
SO-rte ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,IIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
CI ARCHITECT o TENANT a OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS;
CONTACT PERSON FOR THIS PROJECT: Q PROPERTY OWNER Q APPLICANT C CONTRACTOR
■ DETAILED CUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? O YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑TES O NO
WATER SERVICE PROVIDER: Q LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑PRIVATE(WELL)
SEWER SERVICE PROVIDER: a LAKEHAVEN 0 HIGHUNE a PRIVATE(SEPTIC)
' **NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS; ESTIMATED SELLING PRICE:
• PROJECT 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) HOODS) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERTS) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACES)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE; a ELECTRIC O GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) a ELECTRIC ❑GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
II 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,expanses,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 end employees,upon the accuracy
of the information� supplied to the city as a part of this application.
NAME/TXTLE: �l L( LLi U,'k u...'� DATE: `�- 3
tiC 3
O PROPERTY OWNER o APPLICANTdf CONTRACTOR
lior.ctIFIPIO U5fi3CMI0:
a NEIW. ADDITION o*LTERATIOKI'�' , dREPAIk ' " i 1'E 1M EIr d ,' >y ,
:CENSUS:CODE:.i i , . .1..: .0V s.I1; yw , {± .; ;.;
Zoigl ;PFs i l r i-,i .,i.T; . , t ' . ,eiaiuoitiia fdEu.orith....th.lis.i. ty iNo.: ,,
COMP:PIAN;DESIGNA N , s , :.,
b+�S1i��L+4M� ��i�'�s zx,l�lo ; , t
SECTION, TOWNSHIP RANGE 1 E,WADQiCES53REQUiRL'EDI t,,.'..,t.C►.YES:, ,�[O ND ,
y s .CHAi8G6'oit sii.i 1_.>..° Ll:itS: . 0 ,.
PkA'�'TED LpT?': CI lff�1,,..G1'�,.*.;:i..:::::: . . : . ....
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718-253-661.4000•FAX:253-661-4129 r
r
r •
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!*******
Budding,mechanical,and fire prevention system fetS are based on the following schedule.
®� TABLE A
TOTAL VALUATION FEE FACTOR
(1)$1.00 to$500.00 (1)$24.25
(2)$501.00 to$2,000.00 (2)$24.25 for the first$500.00 plus or fraction thereof,to and Including
$2,000.00
(3)$2,001.00 to$25,000.00
(3)$71.46 for the first$2,000.00 plus$1.i 0D foreatfi arfdlofrnalstlo 0.00or fraction thereof,to and
Including$25,000.00
(4)525,001.00 to$50,000.00
(4)$403.61 for the firer$25,000.00 plus 110.82 for each addA:bna/5100000er fraction thereof,to and
Including$50,000.00.
(5)$50,001.00 to 5100,000.00
(5)$66435 for the first$60,000.00 plus 17.50 for earn adddona/$4,000.0p or fraction thereof,to and
Including$100,000.00.
(6)$100,001.00 to$500,000.00
(6)$1,025.55 for the first$100,000.00 plus t6.00 for eat*pddflioffa/$1.000.OQor fraction thereof,to and
Including$500,000.00
(7)$500,001.00 to$1,000,000.00
(7)$3,337.23locule flat$500,000.00 plus 15.09f9raach add#riaa/Sldb0.Q0or fraction thereof,to and
Including$1,000,000.00.
(9)$1,000,001.00 and up
(8)$5,208.23 for the first$1,000,000.00 plus$3.91 for aad,addithnat$j,d2111or fraction thereof.
Bold number ts the base fee for the specified increment
Rolle red.uedrrrGred Bomber is the lee ear a//lbbart/',seared AxKmeat
PLUS: Add 65 percent of the base building permit fee for plan review fee.
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add 15 percent of the base building permit fee for Fire District*39 surcharge,commercial only.
Add$4.50 for WA State Building Code Council,plus$2.00 per unit for duplex 8 above.
!e Electrical,plumbing,and mechanical fees are akulated 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 RN Fire Department Surcharge: (3)
(COMMERCIAL ONLY)
III MECHANICAL
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A:Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5)
• FIRE PREVENTION SYSTEM
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A:Number. (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
• PLUMBING
Base Fee Number of Flxturf5
$21.00+( X$7.00/fixture)_ (8)Estimated Permit Fee
Estimated Penult Fee
X .65= (9)Estimated Plan Review Fee
Miscellaneous Fixture Charge:(10)
Sub Total(Page One): Une(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)= (11) _ •