01-101515 ����
�`�'±f�I
` ���F �— Y � CONSTRUCTION PERMIl- APPLICATION
� �^�!� PPLICATION NUMBER: � I - L O �� L� -�_v _ C��?
uV � -
PPLICATION NUMBER: �- -
�� `����UOLDING DEPT N� PPLICATION NUMBER: _ - _ _ _ _ _ _ - _ _
� **The following is required info�mation-Please print(in ink)or type**
� Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application:'
�
�
� • . • . • •
� SITE ADDRESS: 1��l � � �� /�✓G �/ ' ASSESSOR'S TAX/PARCc: #: 1 5 O ��1 -4� Z OOV
j LEGAL DESCRIPTION OF SUB]ECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
, �f��=���
� . . � .
TYPE OF PROJECT(This application): �BUILDING ❑ PLUMBING �MECHANICAL ❑ DEMOLITION
� ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PRO]ECT DESCRIPTION(Provide detailed description): �NS���vl�/Tj�J" � S// �'�"' � �/`�c
� �N��Iz- � �Sfia�,� Z sF j��� �i�� f�ys�i�G M���-
; 4l�'1��s onl �G��- 7� C-a�n ��y 6� C�n-r 5�,��. dy
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II PROJECT NAME: �� �_/'/`�GI S �/�I���GI L���Y J�/"'�/l�'� �����6
I
I • • • ' �
�
�I PROPERTY OWNER: NAME: �.,` DAYTIME PHONE:
, �. U Ti w /�L ( ) - I
MA[UNG AODRE55(STREET ADORESS;CffY,STATE,ZI : I
Thf �S6/i1�—�C'y�',q'L ��,�� $ 003 ;
COH�RACTOR' NAME: DAYTIME PHON �
,/
SE��',�I Gai�s v�T aN ( �6) �bs' 7/l �
���X� �� MAILING ADDRESS(STREET ADDRESS;CCfY,S�'ATE,ZIP): EVENING PHONE: l
k ��\� 7j� �'�� W � � � ) - �
� CTfY Of fEDERA�WAY BUSINE55 LICE 5E NUMBER: FAX NUMBER:
� rlio - 0 v / D / `��- L ( Zo6) �o.S -7Z/ �
�
CONTRACTOR'S REGIS�RATION NUM6ER: EXPIRATIO DATE: i
' ���vY or�.c������a, � � �i L �G � 'r 2_/�( G C�,�� o� � a� i
i APPLICANT: N LG 6 DAYTIME PHONE:L - � ��
� �S /,i ( Zr�C ) �6 j 6 �
AILING ADDRE 5(STR ET ADDRE55;C STATE,ZIP): EVENING PHONE: !
� � 6 C d ( ) -
� RELATIONSHIP TO PROJECT: FAX NUMB R: ��[ :
' RCHITECi" ❑ TENANT ❑ OTHER(DESCRIBE): �Za�� 6Z -T��I
E-MAIL ADDRE55: �
CONTACT PERSON FOR THIS PRO]ECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR I
I � � • � � • •
I
i EXISTING USE: • , . EXISTING BUIIDING ASSESSED/APPRAISED VALUATION $ �
� PROPOSED USE: /"'�,/��'`'r�' / ! ' "�- PROPOSED VALUATION FOR IMPROVEMENTS: $�;r�.7�/ � d u
' SPRINKLERED BUILDING? �YES ❑ NO FIRE SUPPR.ESSIUN SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
� WATER SERVICE PR4VIDER: LAKEHAVEN 0 NIGHLINE G TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
'*NEW RESIDENTIAL CONSTRUCTION ONLY** �
,
,
i
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ �
• • • • . �
i
FLOOR EXISTING S .FT. PROPOSED S .Fi. TOTAL !
BASEMENT � ��j '� �
i �
I
�Rsr Z � � Z ;
i
SECOND �
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL• �C/Z' �Z� b 2 Z
,
� 1
� 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)
� BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(5) GAS PIPE OUTLEf(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING !
BATHTUB(5) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(5) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACNINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(5) �
. •
I certify under penalty of pe�jury 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 Federat 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 o�cers and employees,upon the accuracy
of the information su lied to the city as a part of this application.
�..�, i 6 . o �
NAME/TITLE: ✓"� DATE:
❑ PROPERTY OW ER L�PPLICANT ❑ CONTRACTOR
_. 1
FOR OFFICE USE ONLY: '
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATI�JN : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATfED LOT? ❑ YES ❑ NO CHANGE OF USF� ❑ YES ❑ NO
ffx�thti�nlrTV fiFVFI nPMFFfT SERVICES•33530 F1RST wAY SOUTTI•P.O.BOX 9718•FEDERAL WAY,WA 96063-9718•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,mechanicai,and fire prevention system fees are based on the following schedule.
TABLE A
TOTAI VALUATION FEE FACTOR
(i);i.00 ro;soa.00 �i�;�a.�s
(2)$501.00 to$2,000.00 (2)524.25 for the first;500.00 pl�s 5317(or each addifionalSIOO.00a fractan therep(,to and intluding;2,000.00
(3)SZ.D01.00 to j25,000.00 (3);71.46 for the first;2,000.00 plus SIS 00�or each addifional S1.000.00a fraction[hereof,to and irxluding
f25,000.00
(4)4Z5,001.00 to SS0,000.00 (4)$403.61 for the Tirst;25,000.00 plus 57081/oreach addilionalSI,OOO.00a fraction thereof,to and i�cluding
jso,000.00.
(S)$50,001.00 to 5100,000.00 (S)s66435 for tfie first�50,000.00 plus 5750lor each addib'ona/S1.00O.00or(raction thereof,to and irxluding
5100,000.00.
�6�;ioo,00i.00 co gsoo,000.00 (6);1,025.55 for the first;100,000.00 plus 56.00 for eadr additana/SI.000.01�a frxtion thereof,co a�,d u,cn,d��
Ssoo.000-oo
(7);500,001.00 to;1,000,000.00 (7)j3,337.23 fw tl�e fist SS00,000.00 plus�S 09(or each addiUa»/f1.0100.00or frac[ion tlx�eof,to and induding
S1,00o.000.00.
(8)$1,000,00].00 and up (8);5,788.23 tor the first$1,000,000.00 plus 53.91 foreach additiona/SI.00O.00or frxtion Mereof.
Bold number is the base fee for the specified increment
Ita/icized undeiJined number is the fee cer addi[iona/speciTed intrement
PLUS: Add 65 percent of the base building permit fee for plan review fee.
Add 25 percent of the base mechanicai 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: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (1)
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERCIAI ONLI�
PROPOSED VALUATION: � ����/ G�� G��
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
�
(b)Additional Increment Fee:
f Estimated Permit Fee: (4)
I
, Estimated Plan Review Fee: (5)
�
.
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 FixWres
$21.00+{ X$7.00/fixture}_ (8)Estimated Permit Fee
Estimated Vermi[Fec
X .65 = (9)Estimated Plan Review Fee
Miscellaneous Fixture Cha�ge:(10)
Sub Total cv�ea,e�: Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(l0) _ (11)
,.,,
TABLE B
NEW RESIDENTIAI SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Sin�lc family i _Scrvicc or fccdcr only.........................544.2� _tl of Thcrmostats(first-$33.50;add'n-S I O.SOca)
(fi�st 1300 ft''-5G7.00;[:acli add'n S00 ft -$21.�0) _Scrvicc and fccdcr...............................$72.2� _N of Lo��•volta�c firc or burglar alamis
Syii��`�.��� first 2500 ft'-�38.7>;Gach add'n 2500 ft=-510.50
f:ach outbuildin;or_ara�c...........................�2R.00 MOBILE HOME/RV PARK Squarc Fcct:
(Inspcctcd��•ith scrvicc) _N of scrvicc or fccdcrs ' Pcr WAC 29G-4G-410(�)(b)(i R ii)
I:acli outbuildinaor garagc...........................$44.2� (f�irst scrvicc/fccdcr-$44.2�:Add'n scn•icc/ _�l of Si;ns(first si�_n-533.50;add'n sign
(Inspcctcd scparatcl}�) $IG.00 cach)
fccdcr-$28 each) Pro�ress inspcction per Yz hr...............$33.j0
S��•immin�pool.hot tub,spa..............._G7.00
Yard Polc mctcr loops...........................4425
NEW MUITI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includcs ihrce units or morc) Al�cred Scrvice or Pccders
Scrvicc fccdcr Amps Scrvicc or Add'n _0 to 200...............................................$72.2i
_Up to 200 amp...............S 72.25.................$21.50 fecdcr _201-600..............................................169.00
201-400 amp..................89.75....................44.25 _0 to 100..........................$72.25........S 44.25 _601-1000............................................254.50
401-600 amp................123Z5....................61.50 _101-200..........................89.75...........56.2� _over 1000.............................................282.75
G01-800 amp................ 158.00....................84.2� 20l-400....................---. I G9.00.......----67.00 ll of circuits
Ovcr 800 amp.................225.25.................. 169.00 _40l-600----.--................. 197.00...........78.7i (1-i circuits-$i6.2�:Add'n circuits.$5 ea)
ALTERED SINGLE/MULTI FAMILY _601-800........................254.50......... 107.2�
(Whcn inspected scparately from tlic serviccs.) _801-1000......................310.75.........129.75 Temporary Service
Scrvice or Fcedcr _Over 1000......................339.00......... I81.00 _0 to 60.................--.--.........................---538.75
0 to 200 amp................................................$61.50 _Ovcr 600 volts surcharge.-----.......---......56.25 _61 - 100..................................................4425
201-600 amp................................................89.75 _Mast or meter repair....................--•----...61.50 _101-200................................................56.25
ovcr600am I35.25 201-400................................................G7.00
_ p................................................ —
MaSt or mctcr rcpair.......................................33.50 401-600................................................89.7i
N of cirttiits ovcr G00.................................................97.7>
(I-0 circuits-5442i;Add'n circuits$�ca)
II scrvicc is grcatcr U�an 200 amp,a plan rcvicw is rcq'd.1=cc is 3�%of permit fee+$jb.2�.Add'I plan review I'or othcr submissions is$67.00/hr.
FIXTURE DESCRIPTION A FIXTURE FEE FROM TABLE B B NUMBER OF UNITS C TOTAL D
TOTAL COLUMN D :
Total Cdumn(D)
Estimated Permit Fee: (12)
Estimated Permit Fee from line 12
Estimated Plan Review Fee: $56.25+ X.35 =(13)
. • .
Estimated Permit Fee: (14)
Bond Amount:(15)
Estimated Permit Fee:(16)
Bond Amou�t: (17)
.
Mitigatiq�Fee:(18) (20) �2Z)
SBCC Surcharge: (19) (21) �23)
TO�I (PagesO�e6Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23)_ (24)
B�dlatin #1(1(1—lannarv'2 7�nt
0
+t
15.00 I 11
W
0
12
O
r
rZnl
KEYED NOTES
O CEMENTCCONCRETE CURB AND GUTTER PER DETAIL 3 is KEYSTONE WALL, SEE WALL PROFILE SHEET C1.9.
SHEt� HANDRAIL PER DETAIL 8, SHEET C1.12.
O2 CEMENT CONCRETE CURB PER DETAIL 3 SHEET C1.12.
CAST -IN -PLACE CONCRETE STEPS PER DETAIL 8, SHEET y
O3 WHEELCHAIR RAMP PER DETAIL 1 SHEET C1.12. to C1.12 (KING CO. ROAD STANDARD DRAWING 5-008). SEE '
aO INSTALL CEMENT CONCRETE SIDEWALK PER DETAIL 3 GRADING PLAN FOR STAIR LAYOUT.
SHEET C1.12, SIDEWALK WIDTH PER PLAN 19 GAS SERVICE ENTRY -SERVICE PIPE ALIGNMENT TO BE
O DETERMINED BY P.S.E.
O SAWCUT SIDEWALK, FULL DEPTH, OR REMOVE PANEL AT 6
CONSTRUCTION JOINT. O APPLY TACK COAT TO EXISTING PAVEMENT EDGE OR
20 o
�s SAWCUT A.C. PAVEMENT, FULL DEPTH, IMMEDIATELY GUTTER EDGE BEFORE PAVING.
PRIOR TO PAVING. zt MEMORIAL MONUMENT AND TREE. COORDINATE ,
RELOCATION WITH HOSPITAL 20
O CROSS WALK MARKINGS PER WSDOT STANDARD PLAN ,4 5
H-5C. ALL MARKINGS ARE 5' LONG UNLESS SHOWN 22 RELOCATE EXISTING SIGN AS DIRECTED BY HOSPITAL Tim ;
OTHERWISE.
23 7" CONCRETE CROSSWALK PER DETAIL 3 SHEET C1.12. r
Oa HANDICAPPED PARKING STRIPING PER DETAIL 2, SHEET
C1.12.
CURVE TABLE 1 g 4
4 ® O HANDICAPPED PARKING SIGN PER DETAIL 2, SHEET C1.12.
to 18" WIDE STOP BAR, REFLECTIVE WHITE, LENGTH EQUAL
TO DRIVING LANE WIDTH.
t t STOP SIGN PER MUTCD R 1-1.
t2 NO PARKING - LOADING ZONE" SIGN PER MUTCD R7-6.
0 t3 LOADING ZONE PAVEMENT MARKING, 4" SOLID YELLOW
LINE AT 24" O.C. ORIENTED AT 45' FROM TRAFFIC LANE.
LETTERING SHALL BE 12" NOMINAL HEIGHT CENTERED IN
8' WIDE TURNOUT
1
15.50'
COMPACT
STALL,
8'x17.5'
3
2
to PARKING STRIPING, 4" WIDE SOLID WHTE LINE.
is CURB STOP PER DETAIL 5 SHEET C1.12.
15
14
14
14
CURVE
LENGTH
RADIUS
DELTA
C1
65.44'
135.00'
27'4629"
C2
121.29'
250.00'
27 47'51 "
C3
24.74'
23.51 '
1444654"
C4
84.96'
56.93'
85 2957"
C5
36.59'
40.00'
52 2423"
C6
11.29'
5.00'
129 21'54"
C7
37.69'
48.00'
4459'40"
C8
101.43'
130.07'
44*40'48"
C9
8.19'
35.00'
13 2421 "
O.,�,.EXISTING HOSPITAL
N BUILDING
15
14
i
13.50,
7
N86'44'11 "E
19.02
4 d
10
11
99.00
F7
e
PROPOSED AMBULATORY
SERVICE BUILDING
z
_ 2
10
t
INTERSECTION
1
3
7
5
V'
\ P
HORIZONTAL CONTROL POINTS
6
23
20 0 10 20 40
SCALE IN FEET
CALL 48 HOURS
BEFORE YOU DIG
1-800-424-5555
NOTE.
SEE SHEET C1.8 FOR GENERAL SITE PLAN NOTES
Q
uj
6 W
N88 26'19"W 177.96
23 '
7
4 a 3 W, --
Z
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Q�
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CENTERLINE OF DRIVE
ALIGNMENT W
\ Z \
` Lu
it
PT#
NORTHING
'=ASTING
5000
5254.10
9355.80
9336.65
5001
5058.44
5002
5119.24
9393.15
5003
5115.78
9553.29
5004
505516
9395.94
- -
9394.58
5005
- -
499218
5006
4985 71
9693 86
5007
5048.70
9695.21
5008
5318.39
9676 24
5009
5266.55
9819.79
5610
5261.70
9997.68
5011
5140.95
9974.71
5012
5020.98
9972.10
5013
4930.28
- 9990.31
50141
4938.39
9692.82
5015
5095.91,
9630.22
5016
5141.75
--
5278.80
9567 71
- - -
9690 27
9779.95
5017
5018
5213.04
52
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CITY OF FEDERAL WAY, WA
COMMUNITY DEVELOPEMENT DEPARTMENT
FILE No. 01-101515-CO
APPROVAL DATE:
SIGNATURE: SCALE: AS SHOWN
F.B.: 217
3`L1L9e #01-101515-00 w.o.: S12195
FILE NO.: S218-96F
NEW COMMERbIAL SHEET
ST FRANCIS HOSPITAL AMBULATORY CTR V17/01 .6 OF 4