02-101016City Federal Way
Community Development Services Mechanical Permit #:02 - 101016 - 00 - ME
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: HILL P�v
Project Address: 30835 22ND S
Project Description: MECH - Changeout gas furnace
Parcel Number: 053700 0567
Owner
Applicant
Contractor
Pamela A Hill
THURMAN'S HEATING AND AIR
THURMAN'S HEATING AND AIR
30835 22ND AVE S
110 179TH ST E
110 179TH ST E
FEDERAL WAY WA
SPANWAY WA 98387
SPANWAY WA 98387
98003-4931
(253)875-0094
'4\ 0 b�'
�AA
Mechanical aluationl........................................500
Descriptiorl . s � Qi> J
Furnaces 1
Over the Counter Permit ...................................... Yes
Mechanical Fixtures
PERMIT EXPIRES September 3, 2002, IF NO WORK IS STARTED.
Permit issued on March 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 Wa
7
Owner or agen Date: 3~ — V
SITE ADDRESS: ,/ �� a,�— /`IL1-( S ASSESSOR'S TAX/PARCEL #: 0 5 3
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING 1q MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
CONTACT PERSON
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
NAM DAYTIME PHONE:
is YYl ( w�j)MAILING
ADDRESS axe:-CjSTATES c ra ��a��, LLQ-
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 0 PRIVATE (SEPTIC)
DAYTIME PHONE:
(�53) F, 115
MAILING ADDRESS (STREET ADDRESS; , STATE, ZIP): (y�
D • Tom(] S 3- � _ � Cl") �-<... �lJ
EVENING PHONE:
( ( t ) s
CITY OF FEDERAL WAY BUSINESS E NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: •'(
(copy of card required) 1
Y,A y� �y
9 1 �4 N j! C ' �j �<
EXPIRATION DATE:
o / 31
l o l y
+E'
4
DAYTIME PHONE:
tb1U(-m0-�S4ed' C' i;(
LL -c-
(�3) cq�-D09
AILING ADDRESS (STREET ADDRESS; CITY ATE, ZIP):
,0 , &-,h sj 17
'18,3&'
EVENING PHONE.
-
L
,,Y+
( r' )
-
RELATIONSHIP TO PROJECr: L_ /,,
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE):�`�Y( 9) ?� e,/ -V
FAX NUMBER:
`
E-MAIL ADDRESS:
FOR THIS PROJECT: E] PROPERTY OWNER
El APPLICANT El CONTRACTOR
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 0 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
PROJECT••• AREAS
FLOOR EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
BASEMENT r
FIRST
SECOND
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)
BOILERS)FIREPLACE INSERTS) RANGE(S) MISC.( 1
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS-
PLUMBING
AS-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) SINKS) WATER CLOSET(S) MISC.
INTERCEPTORS) SUMP(S)
I certify udder 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 cl s a part of this application.
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 - 253-661-4000 • FAX: 253-661-4129
A
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, mecthanical, and fire prevention system fees are based on the following schedule.
TABLE A
TOTAL VALUATION
FEE FACTOR
(1) $1.00 to $500.00
(1) $24.25
(2) $501.00 to $2,000.00
(2) $24.25 for the first $S00.00 plus f3.27hxeaa h a"bbW1 fj00.00or
faction U)ereor, to and inducing $2,000.00
(3) $2,001.00 to $25,000.00
(3) $7146 for the first $2,000.00 plus SIS.010Ibreafi aUtlonal
S1.000.000r fraction thereof, to and kndudag
$25,000.00
(4) $25,001.00 to $50,000.00
(4) $403.61 for the first $25,000.00 plus SIO 82 for additiowl
S! IXIO 00 or fraction thereof to and kndudag
$50,000.00.
(S) $50,001.00 to $100,000.00
(5) $664.35 for the first $S0,000.00 plus 1750 for ejd/ &Uig/
11000 GOor fraction thereof, to and kxk di g
$100,000.00.
(6) $100,001.00 to $500,000.00
(6) $1,025.55 for the first $100,000.00 plus 56.00 /arrarh a ya
V/V -00,00 or fraction thereof, to and kndudnp
$500,000.00
m $500,001.00 to $1,000,000.00
(1) $3,337.23 for the fist $500,000.00 plus JS09IfxeaaA addih2nal11.0100
00« fraction themof, to and a ckaling
$1,000,000.00.
(8) $1.000,001.00 "up
(8) $5,788.23 for the first $1,000,000.00 plus 13.91 farearh arH0031
1." 000r fraction #weof.
Bold number is the base fee for the specified increment
Ifardzed undefined number Is the fee Per adoMtral soeaired
In meet
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 VAUJATION: ,
FEE FACTOR FROM TABLE A: Number. _ (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee: (1)_
Estimated Plan Review Fee: (2)
Estimated FW Fre Department Surcharge: (3)
(COMMERCIAL ONLY)
PROPOSED VALUATION
FEE FACTOR FROM TABLE A: Number: �� (a) Base Fee: _ -)L4 a
(b) Additional Increment Fee:
Estimated Permit Fee: (4) ry
Estimated Plan Review Fee: (S)
_ .., .. , .. FIRE PREVENTION SYSTEM
•••••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 FbAm
$21.00+( X $7.00/fixture) _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65 =
Miscellaneous Fixture Charge: (10)
Sub Total (Pageonne): Line(s).(1)+(2)+(3)+(4)+(S)+(6)+(7)+(8)+(9)+(10) = (11)
(9) Estimated Plan Review Fee
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