00-105827City unity Development Services Federal Way
Community Mechanical Permit #: 00 - 105827 - 00 - ME
335301st ways Inspection request line: 253.661.4140
Federal Way, WA 98003-6210 h �l
Ph: 253.661.4000 Fax: 253.661.4129
(3:30pm cut-off for next day inspections)
Project Name: EDWARDS
Project Address: 2005 S 280TH Parcel Number: 422231 0370
Project Description: MECHANICAL - Gas furnace changeout in existing single family residence
Owner
Applicant
Contractor
JAMES EDWARDS
NATURAL GAS SERVICES
NATURAL GAS SERVICES
2005 S 280TH PL
NATURAL GAS SERVICES
FEDERAL WAY WA
38020 236TH AVE SE
NATURAL GAS SERVICES
98003
ENUMCLAW WA 98022
38020 236TH AVE SE
Mechanical Valuation..........................................1500
Over the Counter Permit......................................Yes
Mechanical Fixtures
Description Quant Description Quantity Description Quantity
Furnaces
PERMIT EXPIRES May 28, 2001, IF NO WORK IS STARTED.
Permit issued on November 29, 2000
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: Date: l ' �� 'C) o
14
**NEW RESIDENTIAL CONSTRUCTION ONLY'
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
■ PROSECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCTS)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLETS)
INTERCEPTOR(S)
'FIXTURE$
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC. (
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
'ITCCI ATMFR /CTMUMIRF RLC
WATER HEATER(
❑ ELECTRIC ❑ GAS
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, a
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 claim (Including costs, expenses, and attomeys' fees incurred in 1
investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City
Federal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accur.
of the information suppli to the d art of this application. l n rl
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
ODMMUN[IY DEVELOPMeNT SERVICES • 335M FIRST WAY SOUTH • P.O. BOX 9718 - FEDERAL WAY, WA 980639718.253!61-4000 • FAX: 2S3-661-4129
F -e .0
CONSTRUCTION PERMIT APPLICATIC
®v Z 9 APPLICATION NUMBER:jj20M
APPLICATION NUMBER:
G►riFEDERAL T. ~TAPPLICATION NUMBER:et)
**The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY..
SITE ADDRESS: ASSESSOR'S TAX/PARCEL #: _ _ -
�- AWI - (h C-' — — — —
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH S PARATE DESCRIPTIO IF LENGTHY):
-PRO3ECT INFORMATION ._ ..
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING'❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTYOWNER:
CONTRACTOR:
PEOPLEINFORMATION
ADDRESS; QTY,
NAME:
DAYTIME PHONE:
l(A
)
MAILING ADDRESS (STREET DRESS; QTY, STATE, ZIP):
EVENING PHONE:
C)'3 S
C--3 -�"3
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER
EXPIRATION DATE:
/d \
0 -C
C),
APPLICANT: I NAME:
' MAILING ADDRESS (STREET ADDRESS; CITY, NATE, ZIP):
❑ ARCHITECT ❑ TENANT
OTHER ( DESCRIBE):c �lXJ ✓-
;Pi f6d.4111-
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE:
PROPOSED USE:
■ DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
PROPOSED VALUATION FOR IMPROVEMENTS:
DAYTIME PHONE:
EVENING PHONE:
)
FAX NUMBER:
)
E-MAIL ADDRESS:
FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
2') � b j/ X5 5
Construction ermit Fee Calculation Sheet
*******PLEASE NOTE: ALL FEES MUSE' BI VtRIFIED BY CITY STAFF PRIORTO ACCEPTANCE OF PAYMI
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building, mechanical, and fire prevention system fees are based on the following schedule.
TABLE A
TOTAL VALUAT1ou
FEE FACTOR
(1) $1.00 to $500.00
(1) $23.50
(2) $501.00 to $2,000.00
(2) $73.50 for the first $500.00 Plus $3.05 for each addtonal
$100.00 or taction tfx-rcof, to and ktduding $2,000.00
(3) $2,001.00 to $25,000.00
(3) $69.25 for the first $2,000.00 plus $14.00 fW eadr addi6aiwl
S1.000.O17or traction thereof, to and kiduding
$25,000-00
(4) $25,001.00 to $50,000.00
(4) $391.25 for the first $25,000.00 plus $10.10 for eadi additional
SJ,000.00or fraction thereof, to and kidud ng
$50,000.00.
(S) $50,001.00 to $100,000.00
(S) $643.75 for the first $50,000.00 plus $700 forea05
bona/S1,Ol^O.Gb0r fraction thereof, to and krduding
$100,000.00.
(6) $100,001.00 to $500,000.00
(6) $993.75 for the first $100,000.00 plus $5.60 fore -0 ad
wylgl S1,000.A0or fraction thereof, to and kxlud ng
$500,000.00
(7) $500,001.00 to $1,000,000.00
(7) $3,233.75 for the fist $500,000.00 pius $4.75 foreadr adVifional51,000.00or
fraction die eo ; to and kxludirg
$1,000,000.00.
(8) $1,000,001.00 and up
(t3) $5,608.75 for the first $1,000,000.00 plus $3.65 foreadr
adoWti Wra/S1,000.00or fraction thereof.
"i number is fie base fee for the specified increment
rtaCcized, underrured number the fee peraddNae7af saeaffed
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 **
-
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number.
Estimated Permit Fee.
Estimated Plan Review Fee: (2)
Estimated FW Fre Department Surcharge: (3)
(COMMERCIAL ONLY)
-BUILDING
(a) Base Fee:
(b) Additional Increment Fee:
PROPOSED VALUATION: Ic3t--, 0 .6
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee:
Estimated Plan Review Fee:
- A FIRE PREVENTION -SYSTEM > - .
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee:
Estimated Plan Review Fee: (7)
Base FeeNumber of FahNes
$21.00 + { X $7.00/fixture} _
Estimated Permit Fee
X .65 =
Miscellaneous Fixture Charge: (10)
(a) Base Fee:
(b) Additional Increment Fee:
Sub Total (Page one): Line(s) (1)+(2)+(3)+(4)+(S)+{6)+(7)+(8)+(9)+(10) = (11)
(8) Estimated Permit Fee
(9) Estimated Plan Review Fee