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02-102128City of Federal Way Community Development Services I /� �� 33530 1st Way S V u Federal Way, WA 98003-6210 Ph: 253.661.4000 Fax: 253.661.4129 M. Mechanical Permit #:02 -102128 - 00 - ME Inspection request line: 253.835.3050 Project Name: MAYOP��I v Project Address: 32216 16TH'SW Parcel Number: 010450 0940 Project Description: MECH - Repalce existing gas hot water heater in existing residence. Owner Applicant Contractor Edward & Leilani Mayo Edward & Leilani Mayo Edward & Leilani Mayo 32216 16TH AVE SW 32216 16TH AVE SW 32216 16TH AVE SW FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA 98023-5402 1 98023-5402 (253)835-1775 Mechanical Valuation..........................................550 Over the Counter Permit ...................................... Yes PERMIT EXPIRES November 18, 2002, IF NO WORK IS STARTED. Permit issued on May 22, 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: ' l�l� �— Date: �� O `-'V c:)-, RECEIVED !CM CWG_ CONSTRUCTION PERMIT APPLICATION MAY 2 ZOO2 APPLICATION NUMBER: d2 - Zd Z 8- ®O CITY OF FEDERAL WAY APPUCATION NUMBER: _ - - - - BUILDING DEPT. 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. PROPERTY INFORMATION SITE ADDRESS: , a�I �P LD`-'L� ASSESSOR'S TAX/PARCEL #: �2 Z Z2 � L9 LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): PR03ECT INFORMATION TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM PROJECT DESCRIPTION Q (Provide detailed description): �-2--o Z,/ ( S� )� C w \�1 V -\e to PROJECT ■ PEOPLE INFORMATION PROPERTY OWNER: CONTRACTOR: APPLICANT: NAME:I DAYTIME PHONE, V��tw�'k 1 '\' © - l-7-7 MAILING ADDRESS (STREET ADDRESS; CITY, STA,11, IIP): ;3C 03U UJA qcnj-�5 NAME: DAYTIME PHONE: MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: ( ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (cDpy of card required) DAYTIME K ( ) ADDRESS; CITY, STATE, ZIP): RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( ) - 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: FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** kNUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ 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: AIR HANDLING UNIT(S) BBQ(S) BOILERS) COMPRESSOR(S) DUCT(S) BATHTUB(S) DISHWASHER(S) DRINKING FOUNTAIN(S) GAS PIPE OUTLET(S) INTERCEPTORS) Indicate number of each type of fixture MECHANICAL EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S) FAN(S) HOOD(S) WOODSTOVE(S) FIREPLACE INSERTS) RANGE(S) MISC. [ 1 FURNACE(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS PLUMBING LAVATORY(S) RAIN WATER SYS. SHOWER(S) SINK(S) SUMP(S) URINAL(S) VACUUM BREAKER(S) WASH MACHINE OUTLET WATER CLOSET(S) �MCLAIMER/SIGNATURE RLC P WATER HEATER(S) ❑ ELECTRIC V(GAS 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 perforin 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. j/�j NAME/TITLE: �� u l/ DATE: a C�� -WPROPERTY OWNER ❑ APPLICANT ❑ CO CTOR COMMUNITY DEVELOPMENT SERVICES • 33S30 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.253-661-4000 • FAX: 253-661-4129 www,cbmffederalway.com Construction Pe7mit 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) $26.00 (2) $501.00 to $2,000.00 (2) $26.00 for the first $500.00 plus $3.50 for each additional $100.AOor fraction thereof, to and including $2,000.00 (3) $2,001.00 to $25,000.00 (3) $78.50 for the first $2,000.00 plus $15.50 for eaoh additional $1.000.40 or (radion thereof, to and including $25,000.00 (4) $25,001.00 to $50,000.00 (4) $435.00 for the first $25,000.00 plus SILOO for each additional $1.000.41! or fraction thereof, to and including $50,000.00. (5) $50,001.00 to $100,000.00 (5) $710.00 for the first $50,000.00 plus $8.00 for each additional $1.000.80 or fraction thereof, to and including $100,000.00. (6) $100,001.00 to $500,000.00 (6) $1,110.00 for the first $100,000.00 plus $6.40 for each additional $I.00o.00or fraction thereof, to and including $500,000.00 (7) $500,001.00 to $1,000,000.00 (7) $3,510.00 for the fist $500,000.00 plus $5.50 for each additional $1.000.00 or fraction thereof, to and including $1,000,000.00. (8) $1,000,001.00 and up (8) $6,260.00 for the first $1,000,000.00 plus 64.00 for each additional $1.000.00 or fraction thereof. Bold number is the base fee for the specified Increment Itaficlzeo, underlined numberls the fee oeradditional soedfied 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: (1) Estimated Plan Review Fee: (2) Estimated FW Fire Department Surcharge: (3) (COMMERCIAL ONLY) PROPOSED VALUATION: f 5-5-0 (a) Base Fee: (b) Additional Increment Fee: FEE FACTOR FROM TABLE A: Number: (a) Base Fee: (b) Additional Increment Fee: Estimated Permit Fee: Estimated Plan Review Fee: (5) W I 1 ;9 'I:QfI1 1 0P►A FEE FACTOR FROM TABLE A: Number. Estimated Permit Fee: (6) (a) Base Fee: (b) Additional Increment Fee: Estimated Plan Review Fee: (7) 0 PLUMBING Base Fee Nwtw of Fixxdnres $22.50 + t X $8.00/fixture) _ (8) Estimated Permit Fee Estimated Penn* ree X .65 = (9) Estimated Plan Review Fee Miscellaneous Fixture Charge: (10) Sub Total (Par one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)