03-105456 RECEIVED
CONSTRULI ION PERMIT APPLICATION
CITY OF ,...A..__+ IJEC 1 6 2003 APPLICATION NUMBER: Q 3 - 1 Q ��Li� -
Federal Way APPLICATION NUMBER: -CITY OF FEDERAL WAY APPLICATION NUMBER: - -
BUILDING DEPT.
""The following is required information-Please print(in ink)or type*a
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION _
SITE ADDRESS: )`flb So 3/7 )" ASSESSOR'S TAX/PARCEL #: -1- - 0d 100
� a Q aci
DE/SCRIPT NOF SUBJECT • Lm
LEGA CR PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY). itle0g4ntirtt
■ PROJECT INFORMATION '
TYPE OF PROJECT(This application): 0 BU G 0 PLUMBING ❑ MECHANICAL o DEMOLITION
CAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 'A ";,oA __ _ ,(! 4 ;'C4t
)1N 1Ai. Apea-ediq • ' .
A I S& vi cr1,. r u • I�1-Iv n o 4- 11 Ss fi ./
I.nol(,,,C)r5l
re v C4-t•-e- bC 'hrourn vex* kr‘s
PROJECT NAME:
`I PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
�-y� Kids ! (Z5-3) 3.8g-
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: I NAME: I DAYTIME PHONE:
ceilF/0 Wilier (253) Pt - 5%
MAILING ADDRESS(Sl`TREEEET AD SS;CRY,STATE,ZIP): `f EVENING PHONE:
CITY OF F DE R L Y BUSINESS�E NUMBER FAX NUMBER:
C0L/' 1 ie '19 CTOR'S REGISTRATI NUMBER: I EXPIRATION DATE:
(copy of card{required) / /
APPLICANT: ( NAME: l yr_ pr. DAYTIME PHONE
lir I[ I'` f .� z `) 91f - s C
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP):,, r EVENIt PHONE:
VV//!!//yy //``//__ �/) rj ,A{-/I-i ^ I F )
RELATION JIP'TO�PRO)ECT: 5 I 3 1 / 1r t j FAX NUMBER:
0 ARCHITECT 0 TENANT o OTHER(DESCRIBE): to wetipc ( ) -
E-MAIL ADDRESS:
I
CONTACT PERSON FOR THIS PROJECT: uefROPERTY OWNER 0 APPLICANT o CONTRACTOR
•■ DETAILED BUILDING INFORMATION
EXISTING USE: yLI 1)141.1
4 EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ 2 2 2/ d
fin
PROPOSED USE: �,1 ..i PROPOSED VALUATION FOR IMPROVEMENTS: $ /j �'
SPRINKLERED BUILDING? ❑ YES ❑ N FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑YES .ANO
WATER SERVICE PROVIDER: LIZAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: iAKEHAVEN 0 HIGHLINE 0 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) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) _ FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: a ELECTRIC a GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) a ELECTRIC a GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
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 claim(induding costs,expenses,and attorneys'fees incurred In the
investigation and defense of such claim),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 city as a part of this application. �/
NAME/ i LE: 414 i ii as DATE: /0- 2 l -v3
ROPERTY OWNER ❑APPLICANT a CONTRACTOR
FOR.OFFICE.USE.ONLY:s=
ANEW:._ T3-ADDITION�-,,.gin❑ALTERATION � L]REPMPROVEMENT,.�•�. ,. :�•;
=CENSUSCODE: 4
ZONING DESIGNATION'S T 41 ;-�� BUILDING SHELL ONLY? OYES a NO '
=COMP PLANDESIGNATION x . ABASIC PLAN? ¢YES , .❑.NO
SECTION _. TOWNSHIP_ RANGE,, NEW ADDRESS REQUIRED? -; 0 YES D.'`NO
''PLATTED LOT?,2'"❑YES n o=NO ` : CHANGE;OF USE? ; 5.T-=•-''d YES Vi=a NO
•
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.citvoffederalway.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 19.00 for each additional$100.00or 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 S18.00 for each additional/1,000.00 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 113.00 for each additional/1.00700 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 19.07 for each additional 51.000.00 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 eadr additional 51.000:00 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 S1,000,00 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 14.50 for each additional$1.000.07 or fraction thereof.
Bold number Is the base fee for the specified Increment
Balk/zed,underlined number Is the fee ver additional svedlfed Increment
PLUS: Md 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 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 Fbdures
$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 (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 #of Thermostats(First-$43.00;add'n-$13.O0ca)
(First 1300 ft'-$85.50.Each add'n 500 ft'-$27.50) _Service and feeder $93.00 _#of Low voltage fire or burglar alarms
Square Feet: _ First 2500 ft'-$50.00:Each add'n 2500 ft1-$13 00
_Each outbuilding or garage 535.50 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/ _#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 $5'7 00
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or more) Altered Service or Feeders
Service Fecdet Amps Service or Add'n 0 to 200 i 93.00
Up to 200 amp $ 93.00 S 27.50 Feeder 201 -600 216.50
201 -400 amp 115.50 57.00 0 to 100 1 93.00 1 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 202.50 108.50 201 -400 216.50 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 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
Sc ce 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 1 15.50
_a of circuits _over 600 125.00
(i-4 circuits-$57.00;Add'n circuits$6 ea)
i I
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'I plan review for other submissions is$85.50/hr.
FIXT RE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS(C) TOTAL(D)
7.5. Ir ltf �aK, r #
I .
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)
■ 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