02-105147 11110 RECEIVED • `B,4 7 i s
`;°'�nErzf-� CONSTRUC I ION PERMIT APPLICATION
VV Ry APPLICATION NUMBER:CZE, - L6{5 1_,21_1_ z5JE
/
NOV 1 200 APPLICATION NUMBER:
BASIC, PEKE`? IT - -
CITY OF END; RRAL WAY APPLI TI0 NUMBER: - -
**The followingUi rDeq-UrreraVigrmation-Pleas4 print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
. - h PROPERTY INFORMATION
•
SITE ADDRESS: I'I.I A, ASSESSOR'S TAX/PARCEL #: ia Ulm _ _ -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
...-•_ .:``: . "4 '. . ..11 'PROJECT INFORMATION::;.:', ,, ,. .
TYPE OF PROJECT(This application): BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): C rt JC T t 1.1E w s$13EDROOI-.-, 3 SAT H
5/NLE fA 11-y Res(D€-C-Q, WITH A-r-rt.c.e>e(7) GA2Ac
LE
P L.aM-lt Z52 - F A
PROJECT NAME: -TAR 1.-.4 ...E V/f1yA_ ,.S (11/\]t///!"(l LB ( C
.. -.: : : : . ►i PEOPLE INFORMATION 1/ j_ K. �. .•1
PROPERTY OWNER: NAME:(-1DAYTIME PHONE:
c+ 1 DR_ uoc.ES 1 NG. (,ZOto).2218 -2)17/
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
(0510 SOUTHCENTER, BLvD -UK\AY11,,}WA 923188
CONTRACTOR: NAME: DAYTIME PHONE:
LX}HNEfDER, HOMES ILII• ( )VTR -247/
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
6:51b Gov-rNC tJ-rEe, EL-vi) '5kwI A WA 98188 (2.0S) )z' -24W
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: J FAX NUMBER:
19_ - 191 b1 ., z ei - 00 el.- (201'0 )24Z -42D°t
CONTRACTOR'S REGISTRATION NUMBER: E
IM E. EXPIRATION DAT
(copy of card required) S C. RZ - S r{�Z' .8 — — D3 /e D/ /03
APPLICANT: NAME: DAYTIME PHONE:
-T DHEA (2o,)ZIIg -2z/7/
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
(.051 Q SkyTKC.E.N-rEe1 13Lv.2) ovaLk,,Wa 98188 (2O( )228 -2471
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ,OTHER(DESCRIBE)?go . J\N.,)Ac- . (2Z6 )z1
2 - /IZ�el
E-MAIL ADDRESS: "� I
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT. ❑ CONTRACTOR
- I:i DETAILED BUILDING INFORMATION ' -
EXISTING USE: VaIAM E EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: Y(, '7 4.01 Will PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES t4 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES I NO
WATER SERVICE PROVIDER: 1$LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: A LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTI ONLY** • C k �l
NUMBER OF BEDROOMS: _ 3 ESTIMATED SELLING PRICE: $
N•PROJECT FLOOR AREAS •
FLOOR EXISTING SQ. FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
135S i 355
SECOND c118 n1Ip,
THIRD `�
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE /�/ /�/ /
HOW MANY FLOORS? I 17 6,i - 1 IP 1
TOTAL: 273 4 273
.+...w a-W�wd.y•+..�M�F:. ;•�1.�'>+�• Mar`n."{„•:9NC NVAli�1�!:di QMSM PY`V/A' F+AfURES•}��!d 'w!Vs7siy4A:MYMA'+S'Ciyf3J�rri.-.i[r!!i°iM:. '747.1Tai•.?A��,W!ly w!kf'iia�
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) ' GAS LOG(S) I REFRIG.SYSTEM(S)
BBQ(S) ,5 FAN(S) / HOOD(S) WOODSTOVE(S)
BOILER(S) 1 FIREPLACE INSERT(S) I RANGE(S) MISC.( )
COMPRESSOR(S) / FURNACE(S)
DUCT(S) ei GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC )AS
PLUMBING '
3 BATHTUB(S) 9 LAVATORY(S) URINAL(S) I WATER HEATER(S)
I DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) ! _ SHOWER(S) / WASH MACHINE OUTLET
GAS PIPE OUTLET(S) 2 SINK(S) 3 WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
•
" - :4'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 daim(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),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 city,induding its officers and employees, upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE. —
DATE• -/ -
❑ PROPERTY OWNER .E4 APPLICANT ❑ CONTRACTOR
;.FOR OFFICE USE ONLY'
�pN�Ewu ..+.D ADD.If oN " ,El ILTERATION ;' �CREPAIR 5 ❑,TENAN.,T IM paQ.V,,/_MEN ' itta
O`INThG ' 6NATION2 t �� BIIILDT G.�N L oNLY?" 0 YES o
CO F DESIGNATION �'��
WIMP' iG OM ® ES ALT o 741 � ryMM
�aF+.rn..v.frn �. sry -Com. .Ttf .�,.ej'3Y,.i9.� 4€:$.t �3 d '_ ;"SI�2Y_
€SECTION 01NNSHIP f GRANGE �`;,NE N,�1DDi2ESS RECUIRED5 ESs ® NO
R"h.+'r,:� -�s " .,�,is * ,ems 4 Inw.;n�wwfin-y ; -�"�'x '�,a� "a" `-pis
Tt'L IVIZ ❑ ES ' - CHANGE or6sE? O;Yg f NO tT
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dt'Offedera Tway.Com
Conjction Permit Fee Calculation feet
*******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)$26.00
(2)$501.00 to$2,000.00 (2)$26.00 for the first$500.00 plus 13.50 for each additional$100.00 or fraction thereof,to and including
$2,000.00
(3)$2,001.00 to$25,000.00
(3)$78.50 for the first$2,000.00 plus 115.50 for each additional$1,000.00 or fraction thereof,to and
including$25,000.00
(4)$25,001.00 to$50,000.00
(4)$435.00 for the first$25,000.00 plus$11.00 for each additional$1,000.00 or fraction thereof,to and
including$50,000.00.
(5)$50,001.00 to$100,000.00
(5)$710.00 for the first$50,000.00 plus$8.00 for each additional$1,000.00 or fraction thereof,to and
including$100,000.00.
(6)$100,001.00 to$500,000.00
(6)$1,110.00 for the first$100,000.00 plus$6.017 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)$3,510.00 for the fist$500,000.00 plus 15.50 for each additional$1,000.00 or fraction thereof,to and
including$1,000,000.00.
(8)$1,000,001.00 and up
(8)$6,260.00 for the first$1,000,000.00 plus$4.00 for each additional$1.000.00 a 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**
__._-r.: . --= ■ BUILDING' " . -.. ....... .. -_....c._
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)
• •Ell•EVENTION 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
$2250+{ X$8.00/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)
. s , ;. • •_ELECTRICAL c .
TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only $50.00 #of Thermostats(First-537.50;add'n-$1 I.50ca)
(First 1300 ft2-$75.00;Each add'n 500 ft2-$24.00) Service and feeder $81.00 _if of Low voltage fire or burglar alarms
Square Feet: First 2500 ft2-$43.50;Each add'n 2500 ft2-$11.50
_Each outbuilding or garage $31.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) tl of service or feeders •Per WAC 296-46-910(5)(b)(i&ii)
_Each outbuilding or garage $50.00 (First service/feeder-$50.00;Add'n service/ _X of Signs(First sign-537.50;add'n sign
(Inspected separately) feeder-$32 each) $17.50 each)
Swimming pool,hot tub,spa $75.00
Yard Pole meter loops $50.00
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 $ 81.00
Up to 200 amp $ 81.00 $ 24.00 Feeder _201-600 189.00
_201-400 amp 101.00 50.00 _0 to 100 $ 81.00 $ 50.00 601-1000 284.50
_401-600 amp 138.00 68.50 _101-200 101.00 63.50 _over 1000 317.00
_ (I
601-800 amp 176.50 94.50 _201-400 189.00 75.00 _it of circuits
_Over 800 amp 252.50 189.00 _401-600 220.50 88.50 -5 circuits-$63.50;Add'n circuits,$5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800 284.50 120.50
(When inspected separately from the services.) _801-1000 348.00 145.50 TEMPORARY SERVICE
Service or Feeder _Over 1000 379.00 202.50 Residential/Multi-Family/Commercial/Industrial
_0 to 200 amp $ 68.50 _Over 600 volts surcharge 63.50 0-100 $ 50.00
_201-600 amp 101.00 Mast or meter repair 68.50 _101-200 63.50
_over 600 amp 151.50 _201-400 75.00
_Mast or meter repair 37.50 _401-600 101.00
_if of circuits _over 600 109.00
(1-4 circuits-$50.00;Add'n circuits$5 ea)
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+$63.50.Add'I plan review for other submissions is$75.00/hr.
FIXTURE DESCRIPflON (A) FIXTURE FEE FROM TABLE B"(B)" •NUMBER OF UNITS(C) ;; 1TOTAL(D)
_ 1 :TOTAL COLUMS.(D i
Total Column(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $63.50+( X.35) = (13)
. •• • • DEMOLITION •
Estimated Permit Fee: (14)
Bond Amount:(15)
• . . . . ■ ENGINEERING . :. ,
Estimated Permit Fee:(16)
Bond Amount: (17)
i : • • ■ 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-February 19,2002