02-101863City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:02 - 101863 - 00 - ME
Project Name: CHRISTMAS
Project Address: 29915 21ST,,S
Project Description: MECH - Installation of 80,000 BTU gas furnace
Inspection request line: 253.835.3050
Parcel Number: 798310 0160
Owner
Applicant
Contractor
Deborah A Christmas
NORPAC HEATING & A/C INC
NORPAC HEATING & A/C INC
29915 21 ST AVE S
3414 "A" ST SE SUITE
3414 "A" ST SE SUITE
FEDERAL WAY WA
AUBURN WA 98002
AUBURN WA 98002
980034247
(253)931-0610
Mechanical Valuation..........................................2300 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Descrlptiotl „y ._„ Quanti G3escrl tf iaantlt : Descri tion Qtlanti
Furnaces 1
PERMIT EXPIRES November 3, 2002, IF NO WORK IS STARTED.
Permit issued on May 7, 2002
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: 4—SaL gopif � i �
#� ("X t E, V -L Ck I C) �C
Date: S- 7 - 4 2-
G —S : 6 2GC14'-)
n
�Y�
RECEIVED BY CONSTRUCTION PERMIT APPLICATION
!F-LJL
VV [fY COMMUMTY DEVELOPMENT DEPART LIGATION NUMBER: O 1 Q� -
APPLICATION NUMBER:
MQY 0 2 200
APPLICATION NUMBER: - -
**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.
INFORMATIONVROPERTV
SITE ADDRESS: (e!1 15 9 1 S' Ave, S . ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERINGTD FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): 1 ✓-��d,�s9 1 1, GN o SC COV IS 7
A'Wane
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
CONTACT PERSON I
EXISTING USE:
• =■ VEOPLE INFORMATION .
NAME: DAYTIME PHONE:
1�-)_1n &,gma S I ( 253 > -
MAILING ADDRESS (STREET ADDRESS; CTV, STATE, ZIP):
NAME:
�
DAYTIME PHONE:
�
`
qSW 1 -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EEVENING PHONE:
Sqj<j- 1 to V1
II
( I
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: A '/�,
A(copy of card required) �j L � m
EXPIRATION DATE:
NAME:.DAYTIME
l ndse
PHONE:
(2- ) % -opo
MAILINGADDRESS (STREET AD RESS; CITY, STATE, ZIP);
EVENING PHONE:
;SL
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT OTHER ( DESCRIBE):0-cry'as`6-,c
FAX NUMBER:
( -
E-MAIL ADDRESS: -
=0R THIS PROJECT: ❑ PROPERTY OWNER APPLICANT r4 CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
❑ NO
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE: $
FLOOR
EXISTING S4. FT_
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEMS)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC A GAS
PLUMBING
LAVATORY(S) URINAL(S) WATER HEATER(S)
RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINK(S) WATER CLOSET(S) MISC. ( )
SUMP(S)
.%Teci eiMERiSIGNATURE 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 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 officers and employees, upon the accuracy
of the information supplied to the city as a part of this application. r�
NAME/TITI , it iLl �,L/�Y/Y'LCA _r���S�P DATE:
❑ PROPERTY OWNER L APPLICANT jLX\CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES 0 NO
I
PLUS: Add 6S percent of the base building permit fee for plan review tee.
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 $1.50 for WA State Building Code Council, plus $2.00 per unit for duplex & above.
** Electrical, plumbing, and mechanical fees are calculated separately **
0 .4?
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
FEF FACTOR
(1) $1.00 to $500.00
(1) $24.25
(2) $501.00 to $2,000.00
(2) $24.25 for the first $500.00 plus $0.27/or each a dditicya100.00or (radion thercof, to and including $2,000.00
(3) $2,001.00 to $2S,000.00
(3) $71.46 for the first $2,000.00 plus $15.00 for each addtionaL$l 000.00 or fraction thereof, to and including
$25,000.00
(4) $25,001.00 to $;0,000.00
(1) $403.61 for the first $25,000.00 plus $10.82 foreach adSitlonal $1,000.(Uor fraction thereof, to and including
$50,000.00.
(5) $50,001.00 to $100,000.00
(5) $664.35 for the first $50,000.00 plus $7.50 /or each additional $1,000.00 or fraction thereof, to and including
$11)0,000.00.
(6) $100,001.00 to $S00,000.00
(C) $1,025.55 for the first $100,000.00 plus $6.00 /or eadi additional $1,000.00or fraction thereof, to and including
$500,000.00
(7) $500,001.00 to $1,000,000.00
(7) $3,337.23 for the fist $500,000.00 plus $5.09 foreachadditional $1, 000.00 or fraction thereof, to and including
$1,000,000.00.
(8) $1,000,001.00 and up
(8) $5,788.23 for the first $1,000,000.00 plus $3.91 /oreach additional S1.000. or fraction thereof.
Bold number is the base fee for the specified increment
Italicized underlined number is the tee per additional specified increment
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (1
Estimated Plan Review Fee: (2)
Estimated FW Fire Department Surcharge: (3)
(COMMERCIAL ONLY)
(a) Base Fee:
(b) Additional Increment Fee:
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (1)
(a) Base Fee:
(b) Additional Increment Fee:
Estimated Plan Review Fee: (5)
-FIRE PREVENTION SYSTEM, -
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (6
(a) Base Fee:
(b) Additional Increment Fee:
Estimated Plan Review Fee: (7)
Base Fee Number of Fixtures
$21.00+{ X $7.00/fixture) _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65 =
Miscellaneous Fixture Charge: (10)
C'..l'Ti.1-,l - 1.1.., ., /.- /'N. r7h, t'\, r". r ,/c%, t7\, to),(O\i.f1 n N -f11\
(9) Estimated Plan Review Fee