08-101222 4A. 1,,,,
Federal Way EC 1--
EF RMIT SF MF CO M
COMMUNITY DEVELOPMENT SERVICES
EL PL DE EN FP
33325AVENUE SOUTH• BOX 9718 MAR 12AP P I C A T I O N
FEDERAL WAY,WA 98063-9718 TD
253-835-2607•FAX 253-835-2609
www.fOLO'edemlwatf.nlu
The following is requiQiu, & f •n incomplete application will not be accepted. Please print legibly(in ink)or type.
ill PROPERTY INFORMATION V
SITE ADDRESS_ r "5 1 —1 _ _ g-4- - ......(/1<___ +.- LL SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# 3 V 2 I clq - 9 / Ci 4"'
`` LOT SIZE(sf)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
IN PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION /(:ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION/ �IO/(Provide detailed description of work included on this permit mill) -- (toy/700—
/�C 42'! 1 C ,(3.G . ,� 2 i(. .
ni,6 Co r neA
PROJECT NAME(Name of Business or Owner Last Name) '/At C & irkc 2251
• PEOPLE INFORMATION
PROPERTY NAME ` ���' 1 �W L/C (RIMARY PHONE
OWNER --_- L \\ \��i11 `'7 V i -
MA INO ADDRESS C CITY,STAT ,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
,=i f l'e2J-C. - ( ) Y, - lc.��r'SJ
M!AAItINO ADDRESS CITY,STATE,ZIP CELL PHONE
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
O
r•-CC- /C( `-=>V C Cc^- 1�l__. /Z -�J -Zeca ( ) C: e -�'�5-4J7
CONTRACTOR'S REGISTRATION NUMBER LXPIRATION DATE E-MAIL ADDRESS
APPLICANT COM NY NAME APPLICANT NAME OFFICE PHONE
c"`C: "C K Ci , (,; ) fFi zl - G1
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
/=?• ''-_ ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other ( ) -
PROJECT NAME�j t- PRIMARY PHONE E-MAIL ADDRESS
CONTACT ,/l- ��O f:=11- 6 (0-5-3)t%k' - 67 g
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) _
is DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
r'
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
BASEMENT SQ. FT. SQ. FT. SQ. FT.
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL=STING ST TOTAL PROPOSED Sr TOTAL Sr
**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$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commcrcw)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or1ub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS)roues
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best cf my
knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local,state,or federal laws regulating construction or environmental laws.
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, 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.
SIGNAT 4 DATE ^
Property Owner and/or Authorized Agent
a NEW a ADDITION o ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES o NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application
•
ELECTRICAL PERMIT INFORMATION
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
U Single Family Square Feet Service or Feeder Each Add'n
(First 1300 ft2-$115.50;Each add'n 500 ft2-$37.00) ❑ 0 to 100 amp $125.50 $76.50
❑ Detached outbuilding or garage U 101-200 amp 155.50 98.00
(Inspected with service) $48.50 ❑ 201-400 amp 291.00 115.00
❑ Detached outbuilding or garage U 401-600 amp 339.50 136.00
(Inspected separately) $76.50
U 601-800 amp 439.00 186.00
U 801 - 1000 amp 536.50 224.50
NEW MULTI-FAMILY(three units or more) U Over 1000 amp 584.50 311.50
Service Feeder
U Up to 200 amp $125.50 $37.00 U Over 600 volts surcharge $98.00
❑ 201 -400 amp 155.50 76.50 U Mast or meter repair $106.00
❑ 401 - 600 amp 212.50 106.00
❑ 601 -800 amp 272.00 145.50 ALTERED COMMERCIAL/INDUSTRIAL
❑ Over 800 amp 389.50 291.00 Service or Feeders
U 0 to 200 amp $125.50
ALTERED SINGLE/MULTI FAMILY U 201 -600 amp 291.00
U 601 - 1000 amp 439.00
Service or Feeder
U 0 to 200 amp $96.00
Li
1000 amp 489.00
U 201 -600 amp 155.50 U # of circuits to be added/altered
U over 600 amp 234.00 (1-5 circuits-$98.00;Add'n circuits,$7.50/ea)
❑ #of circuits to be added/altered COMMERCIAL/INDUSTRIAL PLAN REVIEW
(1-4 circuits-$76.50;Add'n circuits$7.50/ea) $98.00 plus 35%of Permit Fee
❑ Service- 1,000 amps or greater
U Mast or meter repair $57.50 U Medical/Educational/Institutional Facility
MANUFACTURED HOMES
U Service or feeder only $76.50
U Service and feeder $125.50
TEMPORARY SERVICE
MOBILE HOME/RV PARK Residential/Multi-Family $67.50
Li #of service or feeders
(First service/feeder-$76.50;each add'n-$50.00) Commercial/Industrial Service or Feeder Ampacity
❑ 0- 100 amps $76.50
❑ 101-200 amps 98.00
❑ 201 -400 amps 115.00
❑ 401-600 amps 155.50
❑ over 600 amps 168.00
MISCELLANEOUS SERVICE/EQUIPMENT
U #of Thermostats U #of Signs
(First-$57.50;add'n-$17.50/ea) (First sign-$57.50;add'n sign$27.00/ea) •
U Low Voltage U Swimming pool/hot tub $115.00
Square Feet to be served by system(s) (Includes additional circuit,if required)
❑ Fire Alarm System U Yard Pole meter loops $76.50
❑ Security Alarm System
U Additional Plan Review $115.00/hour
❑ Voice Cabling (for modified submittals)
❑ Data Cabling
El Automation Fee on all Permits .. $5.50
1.2500 ft2-$67.50;
Each add'n 2500 ft2-$17.50) •Per WAC 296-46-910(5)(b)(i&ii)
Bulletin#100-January 1,2008 Page 3 of 4 k\Handouts\Permit Application
( l FEES
This is an overview of possible fees associated with the issuance of permits and is not intended to be inclusive.
BUILDING, MECHANICAL & FIRE PREVENTION PERMIT FEES
Building,mechanical, and fire prevention system fees are calculated based on the following schedule.
--4 Project valuation for new construction or additions is based on a set cost per square foot as determined by the
Building Official.
—► Valuation for remodels,tenant improvements,alterations,etc.shall be provided by the applicant based on a
legitimate bid or cost estimate which reflects the fair marke,ialue of all elements of the project.
TOTAL PROJECT VALUATION INCREMENTAL FEE FACTOR
(1)$1.00 to$500.00 (1)$34.00
(2)$501.00 to$2,000.00 (2)$34.00 for the first$500.00 plus$4.50 for each additional$100.00 or fraction thereof,to and
including $2,000.00
(3)$2,001.00 to$25,000.00 (3)$101.50 for the first$2,000.00 plus$20.50 for each additional$1.000.00 or fraction thereof,to
and including$25,000.00
(4)$25,001.00 to$50,000.00 (4)$573.00 for the first$25,000.00 plus$14.50 for each additional$1,000.00 or fraction thereof,to
and including$50,000.00
(5)$50,001.00 to$100,000.00 (5)$935.50 for the first$50,000.00 plus$10.00 for each additional$1,000.00 or fraction thereof,to
and including$100,000.00
(6)$100,001.00 to$500,000.00 (6)$1,435.50 for the first$100,000.00 plus$8.00 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)$4,635.50 for the fist$500,000.00 plus$7.00 for each additional$1,000.00 or fraction thereof,to
and including$1,000,000.00
(8)$1,000,001.00 and up (8)$8,135.50 for the first$1,000,000.00 plus$5.50 for each additional$1,000.00 or fraction thereof.
Table A
PLAN REVIEW FEES
-> Plan review fees are collected in addition to permit fees,based on a percentage of the associated permit fee
• Building Permit 65% of Building Permit Fees
• Mechanical Permit 25% of Mechanical Permit Fees
• Plumbing Permit 65% of Plumbing Permit Fees
• Fire Prevention Permit 65% of Fire Permit Fees
• Fire review fees 15% of building permit fees
(Commercial building permits only)
• Additional Building Division Review $70.00/hour
PLUMBING PERMIT FEES
• $29.50 Permit Fee plus $10.00 per fixture
OTHER FEES (Vary according to project type and scope)
• WA State Building Code Council (SBCC) Surcharge $4.50/issued permit
• Public Works review fees $130.00 for new single family
$782.00 for new commercial
• Zoning review fees $52.00 (residential only)
• School District impact fees (new residential only) $4,077.00/single-family residence
$1.820.50/multi-family unit
• Automation fee on all permits $5.50
If you need assistance completing the permit application form, or have
questions concerning the application process, please contact:
Community Development Customer Service Counter at (253) 835-2607
Bulletin#100-January 1,2008 Page 4 of 4 k\Handouts\Permit Application