03-103344 410
I City of Federal Way
Community Development Services Mechanical Permit #:03 - 103344 - 00 - ME
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 r � Inspection request line: 253.835.3050
Project Name: NORTHWEST CHURCH
Project Address: 34830 21ST SW Parcel Number: 542350 0630
Project Description: Install 6 HVAC units,3 exhaust fans and associated ductwork.
•
Owner Applicant Contractor
NONE NORTHWEST CHURCH &MIKE LE. EVERGREEN REFRIGERATION INC
34800-21ST AVE SW 727 S KENYON
P.O.BOX 23085(98093) SEATTLE WA 98108
lytAygiical Valuation 1690)q'EDERAL WAY WA 980Dver the Counter Permit...(206).763-4744 No
Mechanical Fixtures
Description 1 Quantity Description JQuantity Description !Quantity
Ducts t _-- -__---
Fans r 3 Gas Piping 1F 2
FRefrigeration Systems 6
CONDITIONS:
1)Per FWCC,Sec.22-960,Mechanical vents,penthouses or equipment that extends above the roofline must be
surrounded by a solid sight-obscuring screen that meets the following criteria: a)The screen must be integrated into the
architecture of the building. b)The screen must obscure the view of the appurtenances from adjacent streets and
properties.
2)A PLANNING inspection must be scheduled and passed prior to final mechanical inspection.Please call David Lee at
(253)661-4154 during normal business hours to schedule an inspection.
PERMIT EXPIRES March 9,2004.
Permit issued on September 11,2003
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way. �/ /
Owner or agent: (�� ' " A.Rlr Date: 1///0
SU (4 1/1 t140/40' all
pfrick
Af/- clape/ 184075 A71
9 AI.):4:i -4-"Pe •5S4I.V.- S#o /� C/- zer— o
Above Cei.i l 3Vd3 iZ sr; .17
-F,plat/° �
POSTIIS CARD ON THE FRONT OF BUILDIN
CITY OF
Federal Wa BUI NG DIVISION
Y INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT #: 03-103344-00-ME
OWNER'S NAME: NONE-NOR.fl4t 3E S-r C NU-P..( �4
SITE ADDRESS: 34830 21ST SW
O FOOTINGS/SETBACKS () FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
( ) DRAINAGE: Ling ( ) Connection
DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
O UNDERFLOOR FRAMING
( ) ROUGH PLUMD.i ; L WV Water piping
( ) ROUGH MECHA_'_:AL Gas pipi:
( ) Il ATHiNG Roof FI• :: _ —
I i VJ L:
) _;,_.'TRIC'_.,RG JrGH -- Ditch Caver
( ORE/LRAF'1' TOPS
TIOVE '1V."1J'_'1'BE T.; /ED PRIOR TO Fi'Alyi I :.'' . a.' '.: ::1
f ) 4:NG/F 'JPFING -- --
"HE ABOVE MUST BE AT MOVED FRIOR TO INSULATING 07.SH !.'r ROCKING
( ) INSULATION: Floors Walls _ Atti-
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEE FROCK
O WALLBOARD NAILING () SUSPENDED CEILING
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTA'.LI C 7?ILIW TILE
() ELECTRICAL FINAL
() PLANNING FINAL
O PUBLIC WORKS FINAL
( ) FIRE FINAL
THE ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL
() BUILDING FINAL
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
•
• CONST �
RUN PERMIT APPLICATION
1211111
APPLICATION NUMBER: 03- 1_ 033q
-V(
CITY OF
Federal Way -RECEIVED APPLICATION NUMBER: -
AUG 1 5 2003 APPLICATION NUMBER: - -
*--pigoaQyigp9� o ud.jnformation—Please print(in ink)or type**
Please note: Electrical, Fah N ti DEAR`TVstteems and Engineering permits may require a separate application.
• ;PROPERTY INFORMATION
sw
SITE ADDRESS: ��O t �� ASSESSOR'S TAX/PARCEL #: 702 5 - 0 6 3
LEGAL DESCRIPTION OF SUBJECT PROPE TY(ATTR H SEPAR TE DESCRIPTION IF LENGTHY):
1 PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING MECHANICAL o DEMOLITION
❑ ELECTRICAL o ENGINEERING
❑ FIRE PREVENTION SYSTEM` I^
PROJECT DESCRIPTION(Provide detailed des(cription): Cn 4l4 It V k-4\111- e„, 5)/6�vti-
PROJECT NAME:
xI PEOPLE.INFORMATION` _ t
PROPERTY OWNER: NAME. DAYTIME PHONE
N \,%) G��cc ,
(. 3)V S -0939
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
IP d , nam `), 511C Fececat tJ4y , 10A gO 13 -alto
CONTRACTOR: NAME: DAYTIME PHONE:
�vec c een fie,-Cc i esesc., 1 Oen !! (a%)763 -1-11414 STATE.i MAILING ADDRESS(STR ADDRESS;CITY, ZIP): I. EVENING PHONE:
s kenGn SeaHk 1 ) 4 9 IoP ! ( ) -
CITY OF FED RAL WAY BUSINESS LICENSE MBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
ET(
(� '( PIRATION DATE:
G
(copy of card required) C.�V 'e ( ►` .3/
APPLICANT: NAME' a a ( D- DAYTIME PHONE: 111
SPtiiN�C At5 coLrcYLiNcTCc2 ( ) _ -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE'
( )
RELATIONSHIP TO PROTECT: j FAX NUMBER:
o ARCHITECT o TENANT o OTHER( DESCRIBE): ( ) -
I
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT >e CONTRACTOR
-•■ DETAILED BUILDING INFORMATION
EXISTING USE: ` U S L EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: I, 11 ((, L. PROPOSED VALUATION FOR IMPROVEMENTS: $ PL 6i ,oar
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES o NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION 01.*
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NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
r. . ■ PROJECT FLOG• AREAS .
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
. :: _ ': . : . .,_. `;: ■..FIXTURES ,
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) ' X REFRIG.SYSTEM(S)
BBQ(S) 3 FAN(S) HOOD(S) -_
BOILER(S) FIREPLACE INSERT(S) RANGE(S)
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC ,kGAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ 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(including costs,expenses,and attorneys'fees incurred in the
Investigation and defense of such claim),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,including its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application. f�
S'I
NAME/TITLE: 04 -� IJ DATE: / 5/ O 3
❑ PROPERTY OWNER o APPLICANT CONTRACTOR
FOR OFFICE USE,ONLY:
,I; NEW °,. -o A DDITION r i]ALTERATION-0'';O REPAIR n TENANT-IMPROVEMENT- ''
CENSUS CODE: -. 4-00r4ft �a f"el *" a`LOT SIZE 04 :Alkr ,.:`, ,, .r-
'ZONING DESIGNATION:'YE T kBUILDING SHELL ONLY?.=a YES .-❑ NO -
COMP PLAN'DESIGNATION ' Rr' BASICPLAN? EoYES ❑.NO;
SECTION ,. ,+TOWNSHIP_ ' RANGE NEW ADDRESS RE„QUIRED? -.. ❑YES .❑ NO
PLATTED LOT? '`❑YES.,` 0`NO ,'CHANGEOF USE?.•`r svAti3.yES=''=fl'NO
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COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,citvoffederaiwaV.com
Conipluction Permit Fee Calculationelueet
*******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)$30.00
(2)$501.00 to$2,000.00 (2)$30.00 for the first$500.00 plus$4.00 for each additional$100.00 or fraction thereof,to and including
$2,000.00
(3)$2,001.00 to$25,000.00
(3)$90.00 for the first$2,000.00 plus$16.00 for each additional$1,000.00 or fraction thereof,to and
including$25,000.00
(4)$25,001.00 to$50,000.00
(4)$504.00 for the first$25,000.00 plus$13.00 for each additional$1,00000 or fraction thereof,to and
Including$50,000.00
(5)$50,001.00 to$100,000.00
(5)$829.00 for the first$50,000.00 plus$9.00 for each additional$1,000.00 or fraction thereof,to and
Including$100,000.00
(6)$100,001.00 to$500,000.00
(6)$1,279.00 for the first$100,000.00 plus$7.00 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)$4,079.00 for the fist$500,000.00 plus$6.00 for each additional$1,000.00 or fraction thereof,to and
Including$1,000,000.00
(8)$1,000,001.00 and up
(8)$7,079.00 for the first$1,000,000.00 plus$1,50 for each additional$1,000.00 or fraction thereof.
Bold number Is the base fee for the specified Increment
a/Idzed underf/ned number/s the fee per eddlt14nafsoeclfied 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,commerdal only.
Add$4.50 for WA State Building Code Coundl,plus$2.00 per unit for duplex&above.
**Electrical,plumbing,and mechanical fees are calculated separately**
■ BUILDING
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)
PROPOSED VALUATION: \V !r 4' /277
FEE FACTOR FROM TABLE A: Number: (a)Base Fee:
(b)Additional Increment Fee: / ?GA ^ tr.P✓F
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5) .
• ■ FIRE PREVENTION 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
$26.00 +{ X$9.00/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)