02-103267City of Federal Way
Conanunity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:02 -103267 - 00 - ME
Inspection request line: 253.835.3050
Project Name: CISCO 0&
Project Address: 34705 6TH�SW Parcel Number: 132172 0260
Project Description: MECH - Gas furnace changeout and electronic air filter in existing residence.
Owner
Applicant
Contractor
Marvin I & Sandra E Cisco
GATEWAY HEATING & AIR CONDITIO
GATEWAY HEATING & AIR CONDITIO
34705 6TH AVE SW
3802 AUBURN WAY N
3802 AUBURN WAY N
FEDERAL WAY WA 98023-8447
AUBURN WA 98002
AUBURN WA 98002
(253) 931-0610
Mechanical Valuation..........................................3073.78
Over the Counter Permit......................................Yes
Mechanical Fixtures
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy atSdItRe-ItNe willb dance with the laws, rules and regulations of the State of Washington and
the City of Federal Way.)11
Owner or agent: —eyl(flDate: 7 5 / — G
�"��) mr�Fankw�
JA
� L CONSTRUCTION PERMIT APPLICATION
y PPLICATION NUMBER: O Z_ — O Zi —
APPLICATION NUMBER: —
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.
SITE ADDRESS:
ASSESSOR'S TAX/PARCEL #: i 2
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROIECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING %, MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL �❑�EeNGINESRING❑ FIRE PREVENTION SYSTEM
PROJEC.q NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME:
DAYTIME PHONE:
(as 3 � - � I
MAILING AD 5 (STREET ADDRESS; CITY STATE ZIP): �aNL
/EVENING PHONE:
N 'WAl
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
—1C�; � -DO_
FAX NUMBER:
(aS3) 80 1 -oy
CONTRACTOR'S REGISTRATION NUMBER: �/�
(copy of card required) -FFW I 1 0� C
EXPIRATION OATS:
D& / ao / 0--S
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): y� EVENING PHONE:
V i
RELATIONSHIP TO PROJECT: FAX NUMBER: i
❑ ARCHITECT ❑ TENANT OTHER (DESCRIBE): 1 ) -
�. E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:
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)
0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE (SEPTIC)
"NEW RESIDENTIAL CONSTRUCTION ONLY*�`
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ P omcr FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNITS)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAINS)
GAS PIPE OUTLET(S)
INTERCEPTORS)
■ - FIXTURES
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTL-'M(S)
FAN(S) HOOD(S) WOODSTOVE(S1
FIREPLACE INSERT(S) RANGES)— MISC.( C )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
URINALS)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
'ITSClATMRR/STGNATHRE 6LC
WATER HEATER(S)
❑ ELECTRIC ❑ 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 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. h,
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANTCONT OR
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 ❑ NO
Mki Nit INfTY f)FVF1 OPMENT SERVICES - 33530 FIRST WAY SOUTH - P.O. BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253-661-4000 - FAX: 71;1•661-4129
1'
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.
PLUS:
a
TABLE A
TOTAL VALUATION
FEE FACTOR
(1) $1.00 to $500.00
(1)$24.2S
(2) $501.00 to $2,000.00
(2) $24.25 for the first $500.00 plus S-1.27/breach additional $100
or fraction thereof, to and including 52,000.00
(3) $2,001.00 to $25,000.00
(3) $71.46 for the first $2.000.00 plus 515.00 for each additional51.000.ODor
fraction thereof, to and including
$25,000.00
(4) $25,001.00 to $50,000.00
(4) $403.61 for the first $25,000.00 plus 510.81 foreach additional S/
000. or 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 57.50 for each adilitlonal 51.000.00
or fraction thereof, to and including
$100,000.00.
(6) $100,001.00 to $500,000.00
(6) $1,025.55 for the first $100,000.00 plus 56.00 for eadh additional
Sl 000 tN7or 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 S509 f0f each addioPnal
S1.000.00or 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 SJ.91 fareach addidovra1$1.00000or
fraction thereof.
Bold number is the base fee for the specified increment
Italicized. underfined number is the fee Per additional specified increment
.,.w.. ---j Nc,.,.c w� Niau icvIcw icc.
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:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (4
Estimated Plan Review Fee: (5)
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
■ BUILDING
(a) Base Fee:
(b) Additional Increment Fee:
(a) Base Fee:
(b) Additional Increment Fee:
■ FIRE PREVENTION SYSTEM
(a) Base Fee:
(b) Additional Increment Fee:
PLUMBING
Base Fee Number of Fixtures
$21.00+( X $7.00/fixture) _ (8) Estirttated Permit Fee
Estimated Permit Fee
X .65 =
Miscellaneous Fixture Charge: (10)
Suh Total ll+,n, n t; Line(,)(1)+(7)+(3)+(41+(S)+(6)+(7)+(8)+(9)+(10) _ (11)
(9) Estimated Plan Review Fee