01-100588REC;EIVEE)
CONSTRUCTION PERMIT APPL_IC_AT_I_ON
Ens- FEB 0 y 2001 - -- - ---- _
PPLICATION NUMBER: - f
�(L1�Y.
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CITY OF FEDERAL WAY APPLICATION NUMBER: _ _ - _ - - _ _ - - - -
BUILDING DEPT. PPLICATION 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• •
SITE ADDRESS: 33620-21 -qt Ave S.W. ASSESSOR'S TAX/PARCEL #: 2421039001 -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT• •
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
X}U{LECTRICAL ❑ ENGIXn
PREVENTION SYSTEM
�l,✓ r��u,( For �`4,Jernat '11LAr»Qh;
PROJECT DESCRIPTION (Provide detailed description): 4nU �RlOnument S 1 CJn
PROJECT NAME: Albertson'
PROPERTY OWNER: I NAME:
CONTRACTOR: / I NAME:
ATE, ZIP):
t Ave.
s Inc
CITY, STATE, ZIP):
FEDERAL WAY BUSINESS LICENSE NUMBER:
CO CTOR'S REGISTRATION NUMBER:
(copy o required)
APPLICANT: NAME:
Plumh
MAILING ADDRESS (STREET AD RESS; CITY,
RELATIONSHIP M PROJECT: "'
❑ ARCHITECT ❑ TENANT
in
S
kkO[WER ( DESCRIBE): Contractor
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT X8 CONTRACTOR
INFORMATIONDETAILED BUILDING
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:
PROPOSED VALUATION FOR IMPROVEMENTS: $
/DAYTIME PHONE
DAYTIME PHONE:
(253)473 3323 X16
EVENING PHONE:
FAX NUMBER:
EXPIRATION DATE:
11 / 10 /01
DAYTIME PHONE:
�.53 ) 473 -1��23 Exi
EVENING PHONE:
( )
FAX NUMBER:
(253) 472 -3107 1
E-MAIL ADDRESS
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)
I
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS I
FLOOR
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
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)
BOILERS)
FIREPLACEINSERT(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)
DISHWASHERS)
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)
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 of this application.
NAME/TITLE:
❑ PROPERTY OWNER ❑ APPLICANT ONTRACTOR
PnP (1FFTrF I KF ON Y-
DATE: / -�22 -e/
❑ 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
r'nmmf lhlrn nMlpl nDmPhrr CFRVirFS . "4152(1 F1R(T WAY rnI FFH . P n ROY 471R . FFnFRAI_ WAY. WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
ZMEMIL--.2
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) $S01.00 to $2,000.00
(2) $24.25 for the first $S00.00 plus $327for each additional $100.00or 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 $1,000.00or 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 B2 for each additional $1,000.00or fraction thereof, to and including
$50,000.00.
(5) $50,001.00 to $100,000.00
(S) $664.35 for the first $50,000.00 plus $7.M 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 foreoch additional $1.000.00or 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 inducing
$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 $1,000.00or fraction thereof.
Bold number is the base fee for the specified increment
Italicized underlined number is the fee per additional specified incremenf
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 **
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number
Estimated Permit Fee: (
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERCIAL ONLY)
■ BUILDING
(a) Base Fee:
(b) Additional Increment Fee:
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)
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): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)
TABLE B
NEW RESIDENTIAL SERVICES
MOBILE HOMES
MISC EQUIPMENT/TEMP SERVICES
Sin_lc Family
_ Service or feeder only .......... .._...._.....
$44.25
_ # of-rhennostats (First-$33.50; add'n-$1050ca)
_
(First 1300 ft2-$67.00; Each add'n 500 ft' -$21.50)
_ Service and feeder_ ................
$72-25
_ # of Low voltage lire or burglar alarms
First 2500 li'-$38.75, Each add'n 2500 ft2-$10.50
Square Fecc
Each outhuildingor garage.._ .......................
S28 00
MOBILE HOME/RV PARK
Square Fcct:
_
(Inspected with service)
_ # of service or feeders
' Per WAC 296-46910(5)(b)(i R ii)
Mach outbuilding or garage .....................
54 12
(First service/fecder-$44.25; Add'n smice/
ti of Signs (First sign-$33.50; add'n sign
_
(Inspected scparatcly)
fecder-$28 each)
$16.00 each)
_ Progress inspection per hr ...............$33.50
_ Swinmling 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 ant 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
_ # of circuits
_
Over 800 amp ................. 225.25..................
169.00
_ 401 -600 ........................ 197.00...........
78.75
(1-5 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 am
135.25
201 - 400................................................67.00
Mast or meter repair .......................................
33.50
_ 401-600 ................................................ 89.75
_
# of circuits
_ over 600.................................................97.75
_
(14 circuits-$44.25; Add'n circuits $5 ea)
It service is greater tnan tuu anup, a plan icvicw is icq u. rcc is >> io ui ticiiiur ice ".,., I................. .---. ----
Total Column (D)
Estimated Permit Fee: (1
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $S6.25 + X .35 = (13)
Estimated Permit Fee: (14
Bond Amount: (15)
Estimated Permit Fee: (16)
Bond Amount: (17)
■ DEMOLITION
■ 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
•
City of Federal Way
Community Development Services Electrical Permit #:01 - 100588 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210 Inspection request line: 253.661.4140
Ph:253 661 4000 Fax:253.661.4129
(3:30pm cut-off for next day inspections)
Project Name: ALBERTSON'S FOOD CENTER#460
Project Address: 33620 21ST SW Parcel Number: 242103 9001
Project Description: EL-Electrical for new internally illuminated monument sign.
Owner Applicant Contractor
ALBERTSON'S INC PLUMB SIGN,INC. PLUMB SIGN,INC.
PLUMB SIGN,INC. PLUMB SIGN,INC.
5838 S ADAMS 5838 S ADAMS
TACOMA WA 98409-2613 (253)473-3323/10
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Sign
PERMIT EXPIRES August 8,2001,IF NO WORK IS STARTED.
Permit issued on
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
D/Owner or agent: !i G /��/ _ �,i- ` Date: c�f�j �7
,' / /
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