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03-102869 City of Federal Way Community Development Services Electrical Permit #:03 - 102869 - 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: VERIZON WIRELESS Project Address: Ps,I I C 5 w' 3?,2 5' Parcel Number: 122103 9030 Project Description:,: t`' lgtia.up electrical service for cell tower facility Owner ApplicantCL" Contractor HAPPY VALLEY LAND COMPANY WIRELESS FACILITIES INC E H S LLC(ELECTRICAL CONTRACTORS) 575 ANDOVER PARK W 9510 STONE AVE N TUKWILA WA 98188 SEATTLE WA 98103 (206)527-4422 Electrical Fixtures Description Quantity Description Quantity Description Quantity Service/Feeder: 101-200 amps-Comr 1 PERMIT EXPIRES February 29,2004. Permit issued on September 2,2003 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. Owner or agent: ' // Date: 9- 2 -03 a RECEIVED CONSTRUCTION PERMIT APPLICATION CITY OF 1 APPLICATION NUMBER: - I Dc q-cro FederalWay'UL 4 2003 APPLICATION NUMBER: -CITY OF FEDERAL WAY APPLICATION NUMBER: -**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 SITE ADDRESS: 2105 SI 320th St., Raderal Way ASSESSOR'S TAX/PARCEL#:1 2 2 1 0 3 - 9 0 3 0 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): See Atter • PROJECT INFORMATION TYPE OF PROJECT(This application): o BUILDING o PLUMBING o MECHANICAL o DEMOLITION r►ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM PROJECTached � DESCRIPTION�1 � (Provide detailed description): ' At / // /, 7 '! 2 4Q C (��'�^d7 �G-MC! er 'i ff441,1i4totii./[..�i aL;i�r✓c. 4i;!J PROJECT NAME: SFA 5'620114 • PROJECT INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE: Happy Valley Lars 3 013., LLC c/o Bennis Perkins (i125 ) 455 -5K32 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): 1570 Skyline fir, 10900 NE 4th St., Bellevue, W .. 98004 CONTRACTOR: NAME: DAYTIME PHONE: IYiU ( ) - MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: ( ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: ( ) CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) APPLICANT: NAME: DAYTIME PHONE: Wireless Facilities, Inc. for Veriacn Wireless Ctntact: Jchn Wer ( 206 ) 574 -61)2 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: 575 An5over Park Wast, Shite 201, 'itilaaila, VA 9918E3 (253 ) 778 - 2Q07 RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ARCHITECT ❑TENANT Xi OTHER(DESCRIBE): 0-rmi tart (206 ) 574 - 6333 E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER )]APPLICANT o CONTRACTOR i.ecia.€awfirlet.ocm ■ PROJECT INFORMATION EXISTING USE: Raw Lam] EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ N/A PROPOSED USE: WJ-relms Oarrrmcaticn FacilitWROPOSED VALUATION FOR IMPROVEMENTS: $ 627;0670 SPRINKLERED BUILDING? ❑YES NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES )(NO WATER SERVICE PROVIDER: NA a LAKEHAVEN ❑ HIGHLINE ❑TACOMA o PRIVATE(WELL) SEWER SERVICE PROVIDER: �V�A'o LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** F-14 NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ • PROJECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL 1 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 EVAPORATIVE GAS LOG(S) REFRIG.SYSTEM(S) UNIT(S) COOLER(S) BBQ(S) FAN(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: o ELECTRIC ❑GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER VACUUM BREAKER(S) ❑ELECTRIC ❑GAS SYS. DRINKINGSHOWERS) OUTLET WASH MACHINE FOUNTAIN(S) GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) ■ 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 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 city,induding its officers and employees,upon the accuracy of the information supplied to the dty as aapp�art of this application.�� Jf NAME/TITLE: L�21 - J- (4ki rrrt l!lire4S5 DATE: �/�/0 3 o PROPERTY OWN 'APPLICANT ❑CONTRACTOR FOR OFFICE USE ONLY: o NEW .❑ADDITION ❑ALTERATION ❑REPAIR o TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION: BUILDING SHELL ONLY? ❑YES ❑ NO COMP PLAN DESIGNATION BASIC PLAN? ❑YES ❑ NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑YES ❑ NO PLATTED LOT? o YES ❑ NO CHANGE OF USE? o YES ❑ NO 1 I COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.cityoffederalway.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)$30.00 (2)$501.00 to$2,000.00 (2)$30.00 for the first$500.00 plus$4.00 for each additional$100,00 or fraction thereof,to and Including $2,000.00 (3)$2,001.00 to$25,000.00 (3)$90.00 for the first$2,000.00 plus$18.00 for each additional$1,000.0Q or fraction thereof,to and including$25,000.00 (4)$25,001.00 to$50,000.00 (4)$504.00 for the first$25,000.00 plus$13.00 for each additional$1,000.00 or fraction thereof,to and including$50,000.00 (5)$50,001.00 to$100,000.00 (5)$829.00 for the first$50,000.00 plus$9.00 for each additional$1,000.00 or fraction thereof,to and including$100,000.00 (6)$100,001.00 to$500,000.00 (6)$1,279.00 for the first$100,000.00 plus$7.00 for each additional$1.000.00 or fraction thereof,to and including$500,000.00 (7)$500,001.00 to$1,000,000.00 (7)$4,079.00 for the fist$500,000.00 plus$6.00 for each additional 31,000.00 or fraction thereof,to and including$1,000,000.00 (8)$1,000,001.00 and up (8)$7,079.00 for the first$1,000,000.00 plus$4.50 for each additional$1,000.00 or fraction thereof. Bold number is the base fee for the specified increment Jtalicized,underlined number is the fee Der additional snedled increment 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&above. **Electrical,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 FW Fire Department Surcharge: (3) (COMMERCIAL ONLY) ■ 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 Fixtures $26.00+{ X$9.00/fixture}= (8)Estimated Permit Fee Estimated Permit Fee X .65= (9)Estimated Plan Review Fee Miscellaneous Fixture Charge:(10) Sub Total (Paye one): Une(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)= (11) ELECTRICAL TABLE B NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES _Single Family _Service or feeder only $57.00 _4 of Thermostats(First-$43.00;add'n-$13.00ea) (First 1300 ft2-$85.50;Each add'n 500 ftZ-$27.50) _Service and feeder $93.00 4 of Low voltage fire or burglar alarms Square Feet: First 2500 ft2-$50.00;Each add'n 2500 ft2-$13.00 _Each outbuilding or garage $35.50 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 $57.00 (First service/feeder-$57.00;Add'n service/ _4 of Signs(First sign-$43.00;add'n sign (Inspected separately) feeder-$37 each) $20.00 each) _Swimming pool,hot tub,spa $85.50 Yard Pole meter loops $57.00 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 $ 93.00 _Up to 200 amp $ 93.00 $ 27.50 Feeder _201 -600 216.50 _201 -400 amp 115.50 57.00 _0 to 100 $ ' I I $ 57.00 _601 -1000 326.50 _401 -600 amp 158.50 78.50 X 101-200 115.50 72.50 _over 1000 363.00 _601 -800 amp 202.50 108.50 _201-400 .. 0 85.50 _#of circuits _Over 800 amp 289.50 216.50 _401 -600 252.50 101.00 (1-5 circuits-$72.50;Add=n circuits,$6 ea) ALTERED SINGLE/MULTI FAMILY _601-800 326.50 138.00 (When inspected separately from the services.) _801-1000 399.00 166.50 TEMPORARY SERVICE Service or Feeder _Over 1000 434.50 232.00 Residential/Multi-Family/Commercial/Industrial _0 to 200 amp $ 71.50 _Over 600 volts surcharge 72.50 _0-100 $ 57.00 201-600 amp 115.50 _Mast or meter repair 78.50 -101-200 72.50 _over 600 amp 174.00 _201-400 85.50 Mast or meter repair 43.00 _ _401-600 115.50 _4 of circuits _over 600 125.00 (1-4 circuits-$57.00;Add'n circuits$6 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+$72.50.Add=1 plan review for other submissions is$85.50/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 line 12 , Estimated Plan Review Fee: $72.50+( X.35) = (13) • DEMOLITION Estimated Permit Fee: (14) Bond Amount:(15) • ENGINEERING Estimated Permit Fee:(16) Bond Amount: (17)