06-101590 A
Of Litc� G
A RECEIS
Federal Way MAR 31 2006 PERMIT — - �1 i
SF MF CO ME EL PL DE EN
COALILINTI'DEVELOPMENT SERVICES Fes/
333258"'AVENUE SOUTH•PO 639010 OF FEDEE LI CATION
FEDERAL WAY,WA 98063-9778. �
253-835-2607•FAX 253-835-2609 C.
BUIL DING Z
wmm.cllunl(ederafunu.cmn
-
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The ollowin, is re•uired in ormation-an incom.fete . ••lication will not be acce•ted. Please , ' t le''.i- (tn ink)or 4. .
C n • PROPERTY INFORMATION
L
SITE ADDRESS / li 9-- Lafr `� SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 1 J C> 2- ('i 5 V- 0 / O LOT SIZE(sf) ./.,c/ 1 C/
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) J(f' ...A20e, {
(Armrhseparate page for lengthy description)
• PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING 0 PLUMBING ❑ MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING (1 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of Mork included on this permit onto)
t—C)c.,.. 1k I ftp-` F;re— ,,met-K"").,"
PROJECT NAME(Name of Business or Owner Last Name) 6 11(7 ce b -
• PEOPLE INFORMATION
PROPERTY NAME _
OWNER ()F,- ((—E 7)/7011
7' PRIMARY PHONE
MAILING ADDRESS CITY,STATE,ZIP
Ate - /114c_. S-rYe-e-f -' lCE_rI/ a- Q72 2 )
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Fie-t- -C*C-b,.? U-. s41/1/16 (gaci 2‘76 - i&-tea
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
/73, 6,;h3c`_Yie,--d t"V� GN;,/9 l�'1 e,i f ( ) X1/11 -
MY OF FEDERAL WAY BUSINESS LICENSE NUMBER E,_4',
PIRATION DATE FAX NUMBER
2
Q.-b -1 11 c� Li-B z / / (i25) 35 3 -t 1 Stt
CONTRACTOR'S REGISTRATION NpMBER(copy of card required with each application) EXPIRATION DATE
ci E. EPI - c 2- ( M L_ 67 / /3 /n :,
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
/i,t.'� /rtie-C-I '6 -) 1e)c... (49.,,k,46,-,-
<9I (W ) 25 - `eL,e
MAILING ADDRESS CITY,STATE,Zr CELL PHONE ,
(?3r, £,/,sc:n 2Zc,_ eV'e.l 11)4- e-Migi ( )41/1 -
RELATIONSHIP TO PROJECT _
FAX NUMBER
0 Architect ❑Tenant ❑Agent lirOther(Describe) Ce-r+ir Cc(-/ ( (,-(2...c)3. --3
CONTACT _NA/ME -'-}-1t-4.
{• y PRIMARY PHONEcE-MAIL ADDRESS
1/X'1'17/9 }(t.i(� S (142!...) )21-e - iteer`t A /-
LENDER Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5.000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
A
• DETAILED BUILDING INFORMATION
EXISTING USE ' `S; 2(c -S S PROPOSED USEB.1.-1.3,-11-,)-- S.
EXISTING ASSESSED/APPRAISED/VALUE $ VALUE OF PROPOSED WORK $ Lr7,6 0 C
SPRINKLERED BUILDING? /YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? eYES o NO
WATER SERVICE PROVIDER VLAKEHAVEN ❑ HIG LINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER I LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
• 4111
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
BASEMENT SQ.FT. SQ.FT. SQ.FT.
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
NUMBER OF FLOORS SEATING PRO AL TOTAL EXISTING SF TOTAL PROPOSED Sr TOTAL,SF
lr37/ /5/ /Sr/S�
**NEW HOMES ONLY" NUMBER OF BEDROOMS _ ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain_
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commcrtiap WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(orTub/Shower Combo) SHOWERS WATER CLOSEIb troaet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bathroom sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
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 el.. including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE " i,,7
DATE /l• J/5&
(Signature) _ (Title)
RELATIONSHIP TO PROJECT o Owner o Agent I➢�Contractor 0 Architect ❑ Other
FOR OFFICE USE ONLY
❑NEW a ADDITION ❑ALTERATION o REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES a NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? ❑YES o NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? a YES o NO DEMO PERMIT REQUIRED? 0 YES a NO
Bulletin#100—January 1,2006 Page 2 of 4 k\Handouts\Permit Application
• 11111
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
❑ Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$107.50;Each add'n 500 ft2-$34.50) ❑ 0 to 100 snip $117.00 $71.50
❑ Detached outbuilding or garage 0 101-200 amp 145.00 91.50
(Inspected with service) $45.50 ❑ 201-400 amp 272.00 107.50
❑ Detached outbuilding or garage ❑ 401 -600 amp 317.00 127.00
(Inspected separately) $71.50 ❑ 601 -800 amp 410.00 173.50
0 801 - 1000 amp 500.50 209.50
NEW MULTI-FAMILY(three units or more) ❑ Over 1000 amp 546.00 291.00
Service Feeder
❑ Up to 200 amp $117.00 $34.50 ❑ Over 600 volts surcharge $91.50
❑ 201 -400 amp 145.00 71.50 ❑ Mast or meter repair $99.00
0 401 -600 amp 198.50 99.00
❑ 601 -800 amp 254.00 136.00 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 364.00 272.00
Service or Feeders
Li 0 to 200 amp $117.00
ALTERED SINGLE/MULTI FAMILY ❑ 201 -600 amp 272.00
Service or Feeder ❑ 601 - 1000 amp 410.00
❑ 0 to 200 amp $89.S0
Li
1000 amp 456.50
❑ 201 -600 amp 145.00 ❑ #of circuits to be added/altered
❑ over 600 amp 218.50 (1-5 circuits-$91.50;Add'n circuits.$7.00/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$71.50;Add'n circuits$7.00/ca) $91.50 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
❑ Mast or meter repair $53.50 ❑ Medical/Educational/Institutional Facility
MOBILE HOMES
❑ Service or feeder only $71.50
❑ Service and feeder $117.00
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $63.00
❑ #of service or feeders
(First service/feeder-$71.50;each add'n-$46.50) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $71.50
❑ 101-200 amps 91.50
❑ 201-400 amps 107.50
❑ 401-600 amps 145.00
❑ over 600 amps 157.00
MISCELLANEOUS SERVICE/EQUIPMENT
❑ #of Thermostats ❑ #of Signs
(First-$53.50;add'n-$16.50/ea) (First sign-$53.50;add'n sign$25.00/ea)
U'fLow Voltage xx 6) U Swimming pool/hot tub $107.50
Sq Feet to be served by system(s) U' I (Includes additional circuit,if required)
(r Fire Alarm System ❑ Yard Pole meter loops $71.50
❑ Security Alarm System
U Additional Plan Review
❑ Voice Cabling $107.50/hour
❑ Data Cabling (for modified submittals)
❑ ❑ Automation Fee on all Permits .. $5.00
(Per System(s)1.2500 ft2-$63.00;
Each add'n 2500 ft2-16.50)•Per WAC 296-46-910(5/@I(t&W
Bulletin#100-January 1,2006 Page 3 of 4 k\Handouts\Permit Application