01-103411 CITeY Of
RECEIVED CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: / I - _10_314 1 L - 52,,,
\>\> FI - AUG 2 9 2001 APPLICATION NUMBER: - -
APPLICATION NUMBER: - -
GI I Y OF FEDERAL WAY
*TainialMarWTequired information-Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
• PROPERTY INFORMATION
315449 -- l(o*. AVE. sov-Rt 1 2 1 0 - - O o 2 y
SITE ADDRESS: Fg-DEP-AL.. WAY, l liik ASSESSOR'S TAX/PARCEL #: Z 9 2 I o4 - 01 i
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
(Sff..E ATTAc-14F-v)
:+. • • PROJECT INFORMATIONS
TYPE OF PROJECT(This application): BUILDING 1,JtPLUMBING ;s MECHANICAL CI DEMOLITION
XELECTRICAL ;ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): "2. '7 OP- 1 .1 Cif O -
(()H IGlib IIUcL.uvEg -- . a oA)sTR.uc---rlofl, ' 1i t1JaFF -)
M� 1f-4Ak1tGAL N • ...LEG'R-1 CAL + L,VQ(z-K- . J
1— V Ei VC a2/ - ' 4 il I 41-e4l 1 'D 0 2--vv-.4-frr/, 22)-7i 101.44,
i / 3 (l 3l — Gr)
P tOJECT NAME: N .LU HI(i} -gyp(_ DJ FE-0_(✓ cL IAIAY
(
• PEOPLE INFORMATION
PROPERTY OWNER: NAME:TQ 1di I? - Eke h sci o( DAYTIME PHONE:
IOD L- AN P, EAAL W AI ' .11-10(!)I-- Piedr. (23)6l4 -*134'
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
lo(aP SWTl4 X7.0+L .t'.) FEn& L- WA`f, L,iP, q8 3
CONTRACTOR: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING
ENING PHONE:
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - ( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: DAYTIME PHONE:
"MN•( MAT 1fi,TO , / t!iAe1:TT) 1a.RGH. (-ZtV )34b - diyO
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
11 Go LU Mt INA -T•'_ si)pr ao S TT w1k ( )
RELATIONSHIP TO PROJECT: le it{{{) FAX NUMBER:
Pt ARCHITECT ❑ TENANT CI OTHER(DESCRIBE): /� ��� ( P) ,4o - gym.
E-MAIL ADDRESS:1
CONTACT PERSON FOR THIS PROJECT: CI PROPERTY OWNER CI APPLICANT ❑ CONTRACTOR CL1MQt-- ck.+0g6
•• . -4-4-1 Ol IA.rico%
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: +-I&-A-t Gj cAi tQL.. PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? )0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:YES ❑ NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 44 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
T**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 UNITS) 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: Cl 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 of this application.
NAME/TITLE: ! 74-G/ DATE: , ' •e:.1 oI
❑ PROPERTY OWNER APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION El 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
COMMUNITY 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$1,000.00 or fraction thereof.
Bold number is the base fee for the specified increment
Italicized,underlined number is the fee per 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 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)
■-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 (Paneone): Line(s)(11+(2l+(31+(41+(5)+(6)+(7)+(8)+(9)+(10) = (11)
■ ELE - ,/.1;'
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Singlc Family _Service or feeder only $44.25 _4 of Thermostats(First-$33.50;add'n-$I0.50ea)
(First 1300 ft1-567.00;Each add'n 500 ft'
-$21.50) _Service and feeder $72.25 4 of Low voltage fire or burglar alarms
Square Feet First 2500 It--$38.75;Each add'n 2500 ft2-$10.50
_Each outbuilding or garage $28.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) _4 of service or feeders *Pcr WAC 296-46-910(5)(h)(i&ii)
_Each outbuilding or garage $44.25 (First service/feeder-$44.25;Add'n service/ _4 of Signs(First sign-$33.50;add'n sign
(Inspected separately) feeder-$28 each) $16.00 each)
_Progress inspection per Y hr $33.50
_Swimming pool.hot tub,spa 67.00
_Yard Pole meter loops 44.25
NEW MULTI-FAMILY ,it COMMERCIAL/INDUSTRIAL kCOMMERCIAL/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 $2l.50 Feeder _201-600 169.00
_201-400 amp 89.75 44.25 /Z0 to 100 $72.25 $44.25 _601-1000 254.50
_401-600 amp 123.25 61.50 L 101-200 89.75 56.25 _over 1000 282.75
_601-800 amp 158.00 84.25 y_O__201-400 169.00 67.00 _4 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 l= 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
_4 of circuits _over 600 97.75
(1-4 circuits-$44.25;Add'n circuits$5 ca)
-If service is greater than 200 amp,a plan review is rcq'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) -
+ooC? N-1? Imo. I
_ _Etf-G pc( h'� Kok1 4 1=7 eF
$LIP �- A !2t-t lep9', eF
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