03-103350 City of Federal Way
Community Development Services Electrical Permit #:03 - 103350 - 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: EVERGREEN BANK
Project Address: 1300 S 320TH 5.1' Parcel Number: 082104 9241
Project Description: Install alarm and closed circuit video system
Owner Applicant Contractor
Derald E Martin &Margaret A Martin DIEBOLD INC DIEBOLD INC
DIEBOLD INC DIEBOLD INC
3315 S 116TH ST 3315 S 116TH ST
SEATTLE WA 98168 (206)241-3600
Electrical Fixtures
smt I Wall
Low Voltage-Other Commercial 2000 Low Voltage Burglar Alarm Comme_._
o2000
PERMIT EXPIRES February 14,2004.
Permit issued on August 18,2003
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: ir Date: —l d-
er
7,
RECEIVED
CONSTRUCTION PERMIT APPLICATION
CITY OF �.,../ APPLICATION NUMBER: 03- to 3a SQ -
Federal Way AUG I S 2003 APPLICATION NUMBER: -CITY OF FEDERAL WAY kPPLICATION NUMBER: -"The DEP type"
The following required information—Please print(in ink)or
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
_ - :R •PROPERTY INFORMATION -
SITE ADDRESS: 1.. M tS3�1: sr ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
_; • ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING ❑ MECHANICAL o DEMOLITION
ELECTRICAL ❑ ENGINEERING/off FIRE PREVENTION� SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 1P4-5r (i1--- l4 /
4am � C—LcSf7Tj
Gtrlcc.e t r v1 I
PROJECT NAME: V 12.-�-1 ' (?y `J&
R PEOPLE INFORMATION
PROPERTY OWNER: NAME: ; DAYTIME PHONE.
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: I NAME: DAYTIME PHONE:
- b Joy- c ) -4 - Er:c
MAILING ADDRESS(STREET ADDR CITY,STATE.ZIP): C. EVENING PHONE:
3C-S S l t O`k- sr f rrl , L-t 1 qe168
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER. FAX NUMBER:
- - i (9-C4 W--1 -3444--
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
(copy of card required) i E (3 c, Cr 1 Let- -•�; / /
APPLICANT: NAM DAYTIME PHONE: zo
MAILING _ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): EVENING PHONE:
Z31s r C sr zrtl W4 ' i (
RELATIONSHIP TO PROJECT: j FAX NUMBER.
o ARCHITECT o TENANT OTHER( DESCRIBE): '//QCI ii(11 (
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER o APPLICANT o CONTRACTOR
- a DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES o NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT 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) 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 o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTORS) 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 dty,induding Its officers and employees,upon the accuracy
of the information supplied to the dty as a part of this application.
NAME/TITLE: Jam— /qri tc7, GSE DATE: —16 --o3
❑ PROPERTY OWNER ❑APPLICANT sKCONTRACTOR
...FOR,OFFICE.USE,ONLYJ
NEW,` . ,p;ADDr ION� s .[7 ALTERATION 'A TENANT IMPROVEMENT }
CENSUS`CODEi - ar"tIlft •LOT:SIZEV4w• t_. ' p a.
ZONING DESIGNATION - i3UILDING.St1ELLONIY? DYES °>j NO
COMP PLAN DESIGNATION k' (BASIC PIAN? „o YES'. o NO x�`- .. r: :. •`=
SECTION �' - TOWNSHIP. ,''RANGE -NEW�`ADpRESS REQUIRED?`;, ,r❑YES :0 NO
PLATTED LOT? ,❑YES. o NO CIJANGE OF USE? • .° ,n YES '= NO ,,
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,dtvoffederalway.00m
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 14.00 for each additional S100.00 or fraction thereof,to and induding
$2,000.00
(3)$2,001.00 to$25,000.00
(3)$90.00 for the first$2,000.00 plus 118.00 for each additional$1.000.0Q or fraction thereof,to and
induding$25,000.00
(4)$25,001.00 to$50,000.00
(4)$504.00 for the first$25,000.00 plus 113.00 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 11.000.00 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$600 for each additional 11.000.00 or fraction thereof,to and
Inducing$1,000,000.00
(8)$1,000,001.00 and up
(8)$7,079.00 for the first$1,000,000.00 plus$9.50 for each additional$1.000.OQ or fraction thereof.
Bold number is the base fee for the specified Increment
Jtalldzed.underlined number Is the fee Deraddltlonal svedheet 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 Coundl,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 FIN 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) , _
N 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)
h Total (Page one): Line(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 _It of Thermostats(First-$43.00;add'n-$13.00ca)
(First 1300 ft2-$(5.50:Each add'n 500 ft'-$27.50) Service and feeder $93.00 _#of Low voltage fire or burglar alarms
Square Feet: _ First 2500(t'-$50.00:Each a.•'' '500 ft'-$13.00
_Each outbuilding or garage $35.50 MOBILE HOME/RV PARK Square Feet: Ij(0J9 it.
(Inspected with service) _#of service or feeders ''Per WAC 296-4.-9 •(5)(b)(i&ii)
_Each outbuilding or garage $57.00 (First service/feeder-$57.00;Add'n service/ _#of Signs(First sign-$4 .00;add'n sign
(Inspected separately) feeder-537 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 5 93.00
_Up to 200 amp 5 93.00 $ 27.50 Feeder _201 -600 216.50
_201 -400 amp 115.50 57.00 _0 to 100 1 93.00 Si 57.00 601 -1000 326.50
_401 -600 amp 158.50 78.50 _101 -200 115.50 72.50 _over 1000 363.00 Il
_ f 1 601-800 amp 202.50 108.50 _201 -400 216.50 85.50 _#of circuits
_Ovcr 800 amp 289.50 216.50 _401 -600 252.50 101.00 -5 circuits-$72.50:Add'n circuits,$6 ear
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/Commerciai/Industrial
_0 to 200 amp S 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.Fce is 35%of
permit fee+$72.50.Add'I plan review for other submissions is$85.50/hr.
FIXTURE DESCRIPTION(A) FIXTURE.FEE FROM TABLE B(B)• NUMBER OF UNITS(IC) TOTAL(D)
t I i
i
TOTAL COLUMN(D): I
Total Column(0)
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) i
■ ENGINEERING
Estimated Permit Fee:(16)
Bond Amount: (17)
. • 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)
Bulletin #100-December 23,2002