01-102706 •
City of Federal Way
Community Development Services Electrical Permit #:01 - 102706 - 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: AARRESTAD ,
Project Address: 28912 19TH S 'e5 Parcel Number: 422300 0190
Project Description: ELE-Electrical work for alteration of(1)circuit.
Owner Applicant Contractor
Asbjom&Mary Aarrestad MADSEN ELECTRIC MADSEN ELECTRIC
28912 19TH AVE S 1929 TACOMA AVE.S. 1929 TACOMA AVE.S.
FEDERAL WAY WA 98003-3812 TACOMA WA 98402 TACOMA WA 98402
' (206)383-4546
•
Electrical Fixtures
Description ,Quantity Description Quantity Description Quantity
Circuits-Residential 1 •
PERMIT EXPIRES January 6,2002,IF NO WORK IS STARTED. •
Permit issued on July 10,2001
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 Wa
..ocOwner or agent: Date: 7//CI/0/
7-//- / 61
i
ear
T10f y
UCONSTRUC I ION PERMIT APPLICATION
VV ir-i�f�i_ APPLICATION NUMBER: 6 - bZ1O ®G2 7
APPLICATION NUMBER: - -
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: z3-94:72 /4,14 Ave.. ASSESSOR'S TAX/PARCEL #: 1 7 2 .1) - °eV°
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): `
,r ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINRING F ' PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description lik`; - _ w
._
, rte. S•-.t h`
PROJECT NAME: a , :� ')
■ PEOPLE'NFORMATION
PROPERTY NER: NAME: " -y - .. DAYTIME PHONE: i
R M i sNG ADDRESS(STREET ADD i SS;CITY,SATE,ZIP):
g• / / ,1-4. al
CONTRACTOR: I NAME: DAYTIME� )
/ 7A- 6e ' z
JL �- 3 ! / ,
AILING ADDRESS(STREET ADDRESS,CITY,STATE,ZIP. C ? EVENING PHONE:
-37 �Q Cr 6,4 ''1,.. -t,7‘ 5 ( ) v---4-...,,c
of FEDE L WAY BUSINESS -x SE NUMBER .. cc FAX NUMBER:
iio
-
CONTRACTOR'S REGISTRATI.i NUMBER: EXPIRATION DATE:
(copy of card required) / /
NAME; DAYTIME PHONE:
APPLICANT: �."e �j , , ( ) _
CD{� r�
MAILING ADDRESS(STREET AD ESS;CITY, ATE,ZIP):-'-::. -- EVENING PHONE:
( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
- ■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ 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: ❑ 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) 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 (including costs,expenses,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 and employees, upon the accuracy
of the information supplied to the city as a part this application.
NAME/TITLE: 129,QM�y-4C- /e DATE: , .//a/O/
❑ PROPERTY OWNER ❑ APPL CANTCONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ 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? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
(Y1MMI UNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
•
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)$24.25
(2)$501.00 to$2,000.00 (2)$24.25 for the first$500.00 plus$3.27 for each additional$100.00 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$15.00 for each additional$1,000.00 or fraction thereof,to and including
$25,000.00
(4)$25,001.00 to$50,000.00 (4)$403.61 for the first$25,000.00 plus$10.82 for each additional$1,000.00 or fraction thereof,to and including
$50,000.00.
(5)$50,001.00 to$100,000.00 (5)$664.35 for the first$50,000.00 plus$7.50 for each additional$1,000.00 or fraction thereof,to and including
$100,000.00.
(6)$100,001.00 to$500,000.00 (6)$1,025.55 for the first$100,000.00 plus$6.00 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)$3,337.23 for the fist$500,000.00 plus$5.09 for each additional$1,000.00 or fraction thereof,to and including
$1,000,000.00.
(8)$1,000,001.00 and up (8)$5,788.23 for the first$1,000,000.00 plus$3.91 for each additional$4.000.00 or fraction thereof.
Bold number is the base fee for the specified increment
Italicized,underlined number is the fee oer additional specified 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
$21.00 +{ X$7.00/fixture)= (8)Estimated Permit Fee
Estimated Permit Fee
X .65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge:(10)
Sub Total (Pane one): Linels)(1)+(2)+(31+(4)+(Sl+(61+(7)+(8)+(9)+(10) = (11)
- ■ ELECTRICAL .
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
Singlc Family _Service or fcedcr only $44.25 _ft of Thermostats(First-$33.50;add'n-$I0.50ca)
(First 1300 ft2-$67.00;Each add'n 500 ft -$21.50) _Service and feeder $72.25 ft of Low voltage fire or burglar alarms
Square Fcct: First 2500 lie-$38.75;Each add'n 2500 ft2-$10.50
_Each outbuilding or garage $28.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _ft of service or feeders * Per WAC 296-46-910(5)(b)0 R ii)
_Each outbuilding or garage $44.25 (First service/feeder-$44.25;Add'n service/ _ft of Signs(First sign-$33.50;add'n sign
(Inspected separately) feeder-$28 each) $16.00 each)
_Progress inspection per 1/2 hr $33.50
_Swimming pool.hot tub,spa 67.00
_Yard Pole meter loops 44.25
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 $72.25
_Up to 200 amp $72.25 $21.50 'Feeder _201-600 169.00
_201-400 amp 89.75 44.25 _0 to 100 $72.25 $44.25 601-1000 254.50
_401-600 amp 123.25 61.50 _101-200 89.75 56.25 _over 1000 282.75
_601-800 amp 158.00 84.25 _201 -400 169.00 67.00 _f of circuits
_Over 800 amp 225.25 169.00 _401-600 197.00 78.75 (I-5 circuits-$56.25;Add'n circuits,$5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800 254.50 107.25
(When inspected separately from the services.) _801- 1000 310.75 129.75 Temporary Service
Service or Feeder _Over 1000 339.00 181.00 _0 to 60 $38.75
_0 to 200 amp $61.50 _Over 600 volts surcharge 56.25 _61 - 100 44.25
_201-600 amp 89.75 _Mast or meter repair 61.50 _101-200 56.25
_over 600 amp 135.25 _201-400 67.00
_Mast or meter repair 33.50 _401-600 89.75
I_ft of circuits _over 600 97.75
(1-4 circuits-$44.25;Add'n circuits$5 ea)
- If service is greater than 200 amp,a plan review is req'd.Fee is 35%of permit fee+$56.25.Add'I plan review for other submissions is$67.00/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: $56.25 + 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-January 3, 2001