00-105533City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: COX
Mechanical Permit #:00 -105533 - 00 - ME
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspect Rns)
Project Address: 36138 24TH S Parcel Number: 51310 , 60
Project Description: MECHANICAL - Replace electric furnace with new gas furnace and install approxi 'ely 25 feet of gas
piping in existing single family residence.
Owner
Applicant
Cot ` ctor
JOEL COX
NOR PAC HEATING & A/C INC
OR C ING & A/C INC
36138 24TH PL S
NOR PAC HEATING & A/C INC
I
FEDERAL WAY WA
3414 A ST SE UNIT 102 •
N HEATING & A/C INC
AUBURN WA 98002
J p ST SE UNIT 102
I hereby certify that the above inf,
the occupancy and the use will be
the City of Federal Way.
sdon on the above described property and
regulations of the State of Washington and
Date: A�—�
9
V G CONSTRUCTION PERMIT APPLICATION
uV air- Z= L APPLICATION NUMBER:
PPLICATION NUMBER:
APPLICATION NUMBER: - -
**The following is required Information — Please print (in ink) or type**
Please note: Electrical, Fre Prevention Systems and Engineering permits may require a separate application.
PROPERTY•. •
r ,✓f� c� Z�
SITE ADDRESS: 3b ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
G PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING 0 MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): L Vs A C -e— 0 q qq s I✓s n U L<.
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PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
�1 PEOPLE INFORMATION
NAME:
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DAYTIME PHONE:
(1s ) 31 o dV
DAYTIME PHONE:
ZIP
MAILING ADD613
St a2
RKADORESSYCIJY,STA
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NAME:
mol ac, HcA
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DAYTIME PHONE:
(1s ) 31 o dV
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
St a2
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
/D/ /LO®i
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1
APPLICANT: NAME: DAYTIME PHONE:
211 (�S3 ) 131 - o o1
MAILING ADDRESS (STRE ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
b _ it 61 Soh ju pyl (253 ) -7357 - 5-0
RELATIONSHIP TO PROD FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ElPROPERTY OWNER 11APPLICANT CONTRACTOR
BUILDINGDETAILED •• •
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
r::r e:f;. ..,., ■
PR03ECT FLOOR AREAS ,.
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
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 INSERTS) RANGE(S) MISC. ( %L )
COMPRESSOR(S) _L FURNACE(S)
DUCT(S) 2 GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC pI 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. [ ]
INTERCEPTORS) SUMP(S)
")TSCI-ATMFR/STr.NATURE BLC
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 claim (Including costs, expenses, and attorneys' fees Incurred in the
Investigation and defense of such daim�, 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 officers and employees, upon the accuracy
of the information supplied to the city as a part of this application. k -1-0o
NAME/TITLE: ��Q.V\ IL �� DATE:
❑ PROPERTY OWNER 0 APPLICANT ❑ CONTRACTOR
CDMMUNM DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-961-4000 • FAX: 253-961-4129
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, 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) $23.50
(2) $501.00 to $2,000.00
(2) $23.50 for the first $500.00 plus $3.05 for each addiidona/ 5100.00
or fraction thereof, to and indudhV $2,000.00
(3) $2,001.00 to $25,000.00
(3) $69.25 for the first $2,000.00 plus $14.00 for each addVoW
51.000.00 or hacdon there&, to and induding
PROPOSED VALUATION:
$25,000.00
FEE FACTOR FROM TABLE A: Number:
(4) $25,001.00 W $50,000.00
(4) $391.25 for the first $25,000.00 plus $10.10 f rew h additbro
1.000.00 or fraction thereof, to and including
Estimated Permit Fee: (6)
$50,000.00.
Estimated Plan Review Fee: (7)
(5) $50,001.00 W $100,000.00
(5) $643.75 for the first $50,000.00 plus $7.00 for each &J1A loW
51.000.00 orfraction thereof, W and ktdudhrxl
$100,000.00.
(6) $100,001.00 W $500,000.00
(6) $993.75 for the first $100,000.00 plus $5.60 hx each add/daha/51.000
00or fraction thereof, W and indudlng
$500,000.00
(7) $500,001.00 W $1,000,000.00
(7) $3,233.7S for the fist $500,000.00 plus $4.75 for earn ack8b
$1.000.00or fraction dhereof, W and tndu&V
$1,000,000.00.
(8) $1,000,001.00 and up
(8) $5,608.75 for tue first $1,000,000.00 plus $3.65 for eadh add0onaf
51,000.00 or fraction d>ereof.
Bold number Is the base fee for the specified increment
edlnednumberls Me fee neraddiftmlsaedrred
Italkized and
lnarement
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 Fire Deparbnent Surcharge: (3)
(COMMERCIAL ONLY)
■ .BUILDING
(a) Base Fee:
(b) Additional Increment Fee:
- PROPOSED VAI I1Al7nN- , 1 . hn
FEE FACTOR FROM TABLE A: Number:
(a) Base Fee:
(b) Additional Increment Fee:
Estimated Pennit Fee: (4)
Estimated Plan Review Fee: (5)
PREVENTION1111 FIRE
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 Fb
cbrres
$21.00+( X $7.00/fixture} _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65 =
Miscellaneous Fixture Charge: (10)
Sub Total (Page one): une(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)
(9) Estimated Plan Review Fee