02-104871 ; ;� G ��ECEIVEC.`� CONSTRuCTION PERMIT APPLICATION
VV �� PPLICATION NUMBER: - -
� ��OV O 4 _ PPLICATION NUMBER: - -
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PPLICATION NUMBER: _ _ - -
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4 **The follo��g�-�s`reqt�'i��d'information-Please print(in ink)or type**
� Please note: Electrical, Fire Prevention Systems and Engineering permitr may require a separate application.
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SITE ADDRESS: ��bZ� I`�qG1�iG ��A�'�'�^�A� SO��L� ASSESSOR'S TAX/PARCEL#: Q � 2 � O � - � � ;t �
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTNY): Zpn�� �t��
��1����, f!' �. �3 sF T � � �c�ri :T v-r� r;n1G * S� � : �� C�
'' 't�rGlYYtt. �(,.,""� �cvnanr� ' ry1
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TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING�FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): TY��nGh o�he� �nS'��s� VV�c��ru�Vv+t� 1'��re II�A-[_ ��-
�n � CXl 6}ir.o C\� vJwt t� Y�hai� - v
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PROJECT NAME: F�',. i',-�'�'/^, �, C't4'.h�!C. �U1I�; ,�. -, '�-
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� PROPERTY OWNER: �+F��E onrrtME PrioNE:
Nar�h �nvestmevr�- Serv�ccS (5�3 ) Zy2 -a9oo
MAILING ADDRE55(STREET ADDRE55;QTY,STATE,ZIP):
� i� a i sw Salmon st �yoo P�+Iq�,d, o,� q�a o�
� CONTRACTOR: NAME: OAYTIME Pf-fONE:
Srri�h ��re SYS+e�+nS, �nc. (253 ) SaSo - I S�O
I MAILING ADDRESS(SIREET ADDRE55;CITY,STATE,ZIP): � EVENING PHONE:
i I�O� S�! Ave►1u�. �uSt TGC.C}'vl1,R� W� / p
QTY OF FEDERAL WAY BUSINE55 LICENSE NUM6ER: ����` �2.s ? � ��-�p ' �q g Q
, FAX NUM6ER:
'� C►k ,?2��� i q- � Z - o 0 0 o s � - o o (�s 3 )9a� - a3so
k CONTRACTOR'S REGISTRATION NUMBER: IXPIRATION DATE:
` �� (cWY o(mrd reQ�ired) a� ti_I � L L � J 1 � �O � � � r � � ��0�3
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' APPLICANT: N�E= DAYTIME Pf10NE:
� S,D, 17eaco� Co�p G-� �.�>���+���,}�o� . � (�25 )y5y - So3a
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MAIUNG ADDRESS(STREET ADDRE55;Q-iY,STATE,ZIP): EVENING PFiONE:
' (�;'�.S ) �1=`� - 5�3�
RLLATIONSFiIP TO PRO)ECT: FAX NUMBER:
f ❑ ARCNITECT ❑ TENANT .�OTHER DESCRIBE G{wtlal �
. ( ): ovctruckw (y�5 ) Ns�{ - Y£1�2
, E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER �J APPLICANT ❑ CONTRACTOR .J �"'�^\`�'`�°e�����`
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EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: � NI � �`�
SPRINKIERED EiUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRNATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRNATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION� '**
NUME3ER OF f3EDROOMS: ESTIMATED SELLING PRICE: $
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FLOOR EXISTING S .FT. PROPOSED S .FT. TOTAL j
BASEMENT �
FIRST
;
SECOND '
THIRD . �
FOURTH �
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OTHER FLOORS(DESCRIE3E)
DECK
GARAGE �
NOW MANY FLOORS? '
TOTAL:
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Indicate number of each type of fixture
MECNANICAL
AIR NANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BE3Q(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACEINSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ 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)
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I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and J
furtfie�,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
furtfler agree to hold harmless the City of Federal Way as to any claim (induding costs,expenses,and attorneys'fees incurred in the �
investigation and defense of such daim),which may be made by any person,induding tfie undersigned,and filed against the City of +
Federal Way,but only where such daim arises out of the reliance of the city,including its officers and employees,upon the accuracy i
of tfie information supplied to the city as a part of this application. '
NAME/TITLE: �u� ����w�`" � ��:j1!�� �►'1GInf!! DATE: I ��� � ��- �
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❑ PROPERTY OWNER ,� APPLICANT ❑ CONTRACTOR
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��FOR OFFICE USE ONLY:;' �
L�=NEW=`._ `_- ❑ ADDITION _ � AITERATION . - :� REPAIR �- ❑TENAfYT°IMPROVEMENT._�c -- I
=CENSUS�CODE _= _ - � _ `_ �LOT�SIZE _� == �_
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�ONTNG DESIGNATION_ y __-�,,,,y , ;:,,; - , , � <BUILDING SHELL ONLY? '�YES' ':� NO � .�-'. --
COMP PLAN_DESIGNATION.'- , �*' E3ASTC PU1N? :C7 YES �'❑ NO -' ��_ � _ '"'=�`-
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�SECTION � � TOWNSHIP " ' ' RANGE _NEW ADDRESS REQUIRED?; '-`-❑ YES`:-`�tNO `;-
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PLATTED�LOT? ❑ YES �� ❑ NO� �' � `'- CNANGE OF USE? - � � ❑ YES '����-❑ Nb ` . ;-• _��:�
OOMMUNITY DEVELOPMENT 5[RVICES•33530 FIRST WAY SOUTti•PO BOX 9718•FED[RAL WAY,WA 980G3 9718•253 G61�000•FAX:253-661-4129
www.dq�onedcra Iway.com
C�truction Permit Fee Calculati�Sheet
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*******PLEASE NOTE: ALL FEES MUST E3E VERIFIa D fsY CITY STAFF PRIORTO 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
(i);i.00 co;soo.00 (i)#i6.00
(2);SO1.00 to;2,000.00 (2)$26.00 for tfie first�500.00 pius 53.50 foreach addifanalSIA7.A7or fraction thereof,to a�d'uxluding
$Z,000.00
t3)5�.001.00 to 525.000.00.
(3)#78.50 for the first�2,000.00 plus SIS.50 fo�each additiona/SI.A�O.A�or f2d"qn tl�ereof,to and
i�cludirtg�25,000.00
(4)575,001.00 to$50,000.00
(4)�435.00 for the first$25,000.00 plus SII.00 for each addifionalSl,(X�O.00or f2ction thereof,to a�d
induding$50,000.00.
�s��so,00i.00 co Sioo,000.00
' (S)5�10.00 for the first$50,000.00 plus 43.00 for each addi[iona/41,OCO.q7or fradion thcrcof,to and
■ includin9$100,000.00.
(6)Sioo,00i.00 co ssoo,000.00
(6)$1,110.00 for the first$100,000.00 plus S6G1�fore.�ch additionalSl O170G1�or fraction thereof,to and
induding$500,000.00
(�)Ssoo,00i.00 co;i,000,000.00
. (7)$3,510.00 for the fist SS00,000.00 plus SS.50�or each addifionalSl,O(�.DOor fraction thereof,to and
indudirtg$1,000,000.00.
(8)$1,000,001.00 a�d up
(8)$6,2G0.00 for the first�1,000,000.00 plus,f4.00�oreach additionalSl,00000or fradion thereof.
Bold number is the base fee for the specified increment
�ta/idzed underlineAnumbe�ls the fee pe�additiona/speciTed incsemenf
PLUS: Add 65 percent of the base buiiding permit fee for plan review fce.
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,commeraal oniy. "
Add$4.50 for WA State Building Code Council,plus$2.00 per unit for duplex&above.
;*Electricai,plumbing,and mechanical fees are calculated separately�*
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PROPOSED VALUATION:
FEE FACTOR FROM TAE3LE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (1)
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERC]AL ONLI�
PROPOSED VALUATION:
FEE FACTOR FROM TAE3LE A: Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Pla�Review Fee: (S)
PROPOSED VALUATION:
�y� IoO �
FEE FACTOR FROM TAE3LE A: Number: (a)Base Fee:
(b)Additional Inaement Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
&ne Fee Nurt�af�vcGxrs
$22.50+{ X$8.00/fixture}_ (8)Estimated Permit Fee
Estlmacca vermlt Fcc
X .65= (9)Estimated Plan Review Fee
Miscellaneous Fxture Charge:(10)
Sub Total tr�o�>: Line(s)(1)+(z)+(3)+(4)+(5)+(G)+(7)+(s)+(9)+(10)_ (11}
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TABLE B
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/iEMP SERVICES
• Single Fam�ly _Service or feeder only..................._...:550.00 _tJ of Thermostats(Firsl-S37.50;add'n-51 I.SOca)
(First 1300 ft'-575.00;Gach add'n 500 ft'-524.00) _Service and feeder...............................581.00 _fl of Low voltage fire or burglar alam�s
Square Feet: First 2500 ft2-S43.50;Each add'n 2500 ft'-$.I I.50
Each outbuildingor garage...........................$31.00 MOBILE HOME/RV PARK Square Feet:
(Inspected with service) #oCservice or feedcrs 'Per WAC 296�6-910(5)(b)(i&ii)
Each outbuildingor garage...........................550.00 (First service/feeder-$50.00;Add'n service/ _#of Signs(First sign-$37.50;add'n sign
(Inspected separately) fceder-S32 each) _SwimmOng pool,hot tub,spa...............$75.00
Yard Polc metcr loops.........................$50.00
NEW MUITI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/►NDUSTRIAL
(Includcs thrce units or more) Altcred Scrvice or Fceders
Servicc Fceder Amps Service or Add'n _0 to 200..............................................$ 81.00 �
Up to 200 amp..............$ 81.00................$ 24.00 Feeder _20 t-G00..............................................1 fi9.00
201-400 amp................ 101.00....................50.00 _0 to 100.........................$ 81.00.......$ 50.00 _G01-1000............................................284.50
401-600 amp................138.00....................68.50 _101-200........................ l O 1.00...........63.50 _over 1000.............................................317.00
60l-800 amp................176.50....................94.50 201-400........................ 189.00...........75.00 t!of circuits
Over 800 arnp.................252.50.................. 189.00 _401-600........................220.�0...........88.50 (l-5 circuits-$63.50;Add'n circuits,$5 ca)
AITERED SINGLE/MULTI FAMILY 601-800........................284.50......... 120.50
(When inspected separatcly Gom the services.) _801-1000......................348.00.........145.50 TEMPORARY SERVICE
Service or Feeder _Over 1000......................379.00.........20250 Residential/Multi-Pamily/Commercial/Industrial
0 l0 200 amp...............................................$ 68.50 _Over 600 volts surcharge......................63.50 _0-100................................................$ 50.00
201-600 am 101.00 Mast or meter re air..._...................._...68.�0 _ 101-200................................................63.�0
p......-...�-._......................... _ p -
ovcr600 amp................................................ I S l.50 _201 -400................................................75.00-
Mast or mcter rcpair..............--......................37.�0 _401-600..............................................I O L00
!1 of circuits ovcr 600...............................................109.00
(1-4 circuits-$50.00;Add'n circuits$5 ea)
If a new or altered commercial service is 200 amps or breatcr,or a new or altered residential service is grcater than 400 amps,a plan review is required.Fee is 3�%of
permit Cee+$63.50.Add'I plan revie�v for other submissions is$75.00/hr.
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FIXTURE DESCRIPTION A FIXTURE FEE FROM TA6LE B B NUMBER OF UNITS C TOTAL D
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TOTAL COLUMN D : I
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Total Column(D) I
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Estimated Permit Fee: (12)
[stimated Permi[Fee from line 12
Estimated Plan Review Fee: $63.50+( X.35) _ (13)
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Estimated Permit Fee: (14)
Bond Amount:(15)
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Estimated Permit Fee:(16) ;
E3ond Amount: (17) �
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rrtisas«,r-ee: �i8� �Zo� �Zz� �
SBCC Surcharge: (19) - �21) (23) �
�O�) ��so�,eaTWo�: Line(s)(11)+(12)+(13)�(19)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) _ (24) I
Bulletin #100—February 19, 2002