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03-102924 I t City of Federal Way Community Development Services Electrical Permit #:03 - 102924 - 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: NELLENBACH Project Address: 30002 3011-WW HPa Number: 41, ,\ 1350 Project Description: Alteration of up to(4)circuits for the installation of(2)exha fans a witches. Owner Applicant .ntractor Stefan J Nellenbach &Vicki L Nellenbach DAINES ELECT SERVICE LL INES ELE . RVICE LLC 30002 30TH AVE SW PO BOX 5255 PO BOX 5255 FEDERAL WAY WA • WA - SPANAW A 98387 98023-2318 - 503 fixtures ,� a ..iQu • d ©e~8c1I•tlSCl ' " Q. tilt Circuits-Residential 4 Ilit PE ' , Ja. ,ry 12,2004. Pe 'ssue, ly 1, ,003 I -reby certify that the . 11v information• o the construction on the above described property and th- cupancy and = .e will be in accord th la rules and regulations of the State of Washington and the .ay. Owner or agent: 1O • 6 QMtiQd.., Date: 7 —i —623 CONSTRUCTION PERMIT APPLICATION 6 7 r, ; - tT1r�a u L APPLICATION NUMBER: 0346.:,», g d, _. rr Federal Way APPLICATION NUMBER: B UL..,. ' APPLICATION NUMBER: - - **The following is required information-Please print(in ink)or type** Please note: Electrical,Fire Prevention Systems and Engineering penults may require a separate application. ■ PROPERTY INFORMATION SITE ADDRESS: 3060 2 3Oth /9d P S w ASSESSOR'S TAX/PARC'EL:: 1gho.Q- '02,5-0 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): • PROJECT INFORMATION TYPE OF PROJECT(This application): ❑ BLDING a PLUMBING ❑ MECHANICAL a DEMOLITION !ELECTRICAL a ENGINEERING ❑FIRE PREVENTION SYSTEM / / 1 / 2 / / / PROJECT 1 • i ON(Provide;fetal description): - . 4 . L.. . - ,• 0 _0 _4 4L'.i / I • i � ,__ /i_� - - � A e i_lfil .�� _!..,......A.,.. ., de,��,, � �' � � PROJECT NAME: . ■ PROJECT INFORMATION PROPERTY OWNER: NAME: //IiL!i DAYTIME NE: v! MAILING ADD STREET ADDRESS; ATE,IIP); 3©©0d,2 5C0 d. /,(Jai OA 93023 CONTRACTOR: DAYTIME PHONE: ` �,1.L 969876- 25-03 (STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:2r� / CITY OF FEDERAL.WAY BUSINESS --, rva_L, con 9 -92'7 NUMBER: LIS3 )875c 3 FAX NUMBER: f! La lire0& - - C263)57. g/74, cONrRACrORs REGI TION NUMBER: �'�+ q EXPIRATION DATE: .. ,(COPY of card required) D 4X�EZ .s. 9 22 A-S 3 / /0 '"'/�`/f d. APPLICANT: NAM DAYTIME PHONE: LING (STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: PO 60 cc gNaL 4)1 Lc 319- T�38'7 3)8� --.03 RELATIONSHIP TO E ,,rr�� ,/ / FAX NUMBER: �,/ ❑ARCHITECT ❑TENANT THER(DESCRIBE):Lf7/V/JOG 1 fir-- 96-3)S'7s'j/ 77 / E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: a PROPERTY OWNER it PLICANT jNTRACTOR lad 5 cc CQ, j,Jk,A1 lL 1M ,p • PROJECT INFORMATION 'Y EXISTING USE: i Std&JCe. EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? a YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES a NO WATER SERVICE PROVIDER: a LAIEHAVEN ❑HIGHLINE ❑TACOMA a PRIVATE(WELL) CCIAICD CC*VTPO DDAVTTICD. n I AVCYAVew r,UMW TMC n D TUATE fCCDTTPI **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: N FIXTURES Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) 2.. FAN(S) HOOD(S) WOODSTOVE(S) BOILERS) 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 SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑GAS DRINKING FOUNTAIN(S) SHOWERS) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( J 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 claim(including costs,expenses,and attorneys'fees Incurred in the investigation and defense of such claim),which may be made by any per,including the undersigned,and Sled 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 , 1 -1 to/the. at...t.;164 s a part of this application. ,e� NNAME/TME: �, /. / DATE: 7 _ //r-v 3 o PROPERTY OWNER /w IICANT G COV1iRACTOR FOR OFFICE:USE i ONLY: Ct NEW _ .. __o ADD17:'ION o ALTERATION 0.REPAIR "'ci TENANT:IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION: BUILDING SHELF.ONLY? o YES [i::NO COMP PLAN DESIGNATION BASIC PLAN? a YES n NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? t YES ci NO PLATTED LOT? : o YES CI NO :CHANGE OF USE? Q::YES o NO IY1I.I11.11T,nf1T1 nN.e.T erasnrFP n-inn man f...,,Pnf T f.nn nn,n9.n _fTlnrfl 111 f.f.V ..f. Mnr,n..n 1M II. AMA.r.v.'len/'F'. A4 5S 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 44.00 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 addtbna/SL000.00or 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 513.00 for each addiiional51.000.00or 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 addbona/S1,A�.00or 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 1'7.00 for each addrbbna/4,000.00or 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 S6.00for each additonalSLOGI2.00or 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 eddlionalSL(XV 00 or fraction thereof. Bold number is the base fee for the specified increment Jfaficfred anded&ved member is the fee Der additionalsvecHfed 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 Rre District#39 surcharge,commercial only. Add$4.50 for WA State Building Code Council,pits$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) • ■ ELECTRICAL TABLE B NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES _Single Family _Service or feeder only $57.00 _#of Thermostats(First-$43.00;add'n-$13.00ea) (First 1300112-$85.50;Each add'n 500112-$27.50) _Service and feeder $93.00 _#of Low voltage fire or burglar alarms Square Feet: First 25001t-$50.00;Each add'n 2500 112-$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(5Xbxi&ii) _Each outbuilding or garage $57.00 (First service/feeder-$57.00;Add'n service/ _#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 $ 93.00 $ 57.00 _601-1000 326.50 _401-600 amp 158.50 78.50 _101-200 115.50 72.50 _over 1000 363.00 _601-800 amp 202.50 108.50 _ (1- 201-400 216.50 85.50 _#of circuits _Over 800 amp 289.50 216.50 _401-600 252.50 101.00 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 Itesidential/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 #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); :. .FIXTURB>FEE FROTH TABLE 1!(B) IBJMBER OF IJNTTS(C) _ TOTAL(:Q) t TOTAL GOLUMM(1 ): Total Column(D) Estimated Permit Fee: (12) 57. CI 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) III OTHER FEES Mitigation Fee:(18) (20) (22) SBCC Surcharge:(19) (21) (23) Total(Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)= (24)