04-102754c i . y f Federal Way
'C";m"Unity Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: GORSCH
Project Address: 32119 27TH�SW
Mechanical Permit #:04 - 102754 - 00 - ME
Project Description: Install an 2 -ton A/C Unit and a 50 -gallon water heater.
Inspection request line: 253.835.3050
Parcel Number: 873180 0730
Owner
Applicant
Contractor
Karl H Grosch & Helga H Grosch
PERFORMANCE HEATING & A/C INC
PERFORMANCE HEATING & A/C INC
7649 S 180TH ST
7649 S 180TH ST
KENT WA 98032
KENT WA 98032
(425) 251-0356
Mechanical Valuation..........................................5566 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Description Quantity '�_ Description __ _ Quantity] Description_ IF
�Quan6
Air Handling Units
PERMIT EXPIRES January 8, 2005.
Permit issued on July 12, 2004
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:/' " t/t-'----`� -
Date:
THIS CARD IS TO- REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04 -102754 -00 -ME
Owner: KARL H GROSCH
Address: 32119 27TH AVE SW
FEDERAL WAY, WA 98023-2279
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
❑
Mechanical Rough -in (4165)
❑
Gas Piping (4125)
❑
Final - Mechanical (4065)
By
Approved
Date
By
Approved to release test
Date
By
Approved
<f,_j Dat — --��
INSPECTION LOG
DATE
INSPECTOR
OK
CORR/REJ
AREA AND TYPE OF INSPECTION
/ 20gU :�-r
• AM �n G CONSTRUCTION PERMIT APPLICATION
CITY OF 1 y, e, PPUCKRON NUMBER: - 1-0,1:2 5 J - b
Federal Way,�� 1 Z�� PPLICATION NUMBER:-
,ITY OF FEDERAL WAy PPLICATION NUMBER:
BUILDING DEPT,
—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.
ERTY
MATION
/..O. O.
SITE ADDRESS: d II `7 fJ11 (.41I�.y �U ASSESSOR'S TAX/PARCEL #:+ 3
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): T-w`l N L" 5
■ PR03ECT INFORMATION
TYPE OF PROJECT (This application): o BUILDING o PLUMBING w ECHANICAL O DEMOLITION
o ELECTRICAL o ENGINEERING O FIRE PREVENTION SYSTEM
Provide detailed description)::rc r� (.. /4 LL a �/•L (l . 14
r"
PROJECT NAME:
`PEOPLE INFORMATION
PROPERTY OWNER: j NAME:
CONTRACTOR:
APPLICANT:
MAILING
91
DAYTIME PHONE'
(953) $319 - b
980 a 3
NAME:
i \
DA ME PHONE:
�A5/ / -4fp3st
i MAILING ADDR (STREET ADDRESS; CITY, STATE. ZIP)-
EVENING PHONE:
CITY OF FEDERAi_ WAY BUSINESS LICENSE NUMBER:
- 5
FAX NUMBER:
a - { asp -oa;5
COWTdCTOWS REGI6i A ON NUMBER:
I EXPIRATION DATE:
(ropy of card required) L� L�
/ ZQ / 0 5 -
NAME: ! DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: (/�' j FAX NUMBER:
O ARCHITECT ❑ TENANT q,OTi"ER ( DESCRIBE): �✓)Ti^C3Cii7� ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE: L-�ol�� EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: J kC PROPOSED VALUATION FOR IMPROVEMENTS: $-J5fw-0
SPRINKLERED BUILDING? o YES e-" FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES M-KOI-
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE o TACOMA O PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
of fixture
FIRST
AIR HANDLING UNIT(S)
SECOND
GAS LOGS)
REFRIG. SYSTEM(S)
BBQ(S)
THIRD
HOOD(S)
WOODSTOVE(S)
BOILERS)
FOURTH
RANGE(S)
MISC. ( )
COMPRESSOR(S)
OTHER FLOORS (DESCRIBE)
DUCT(S)
DECK
HEAT SOURCE:
❑ ELECTRIC ❑ GAS
GARAGE
HOW MANY FLOORS?
BATHTUB(S)
TOTAL:
URINAL(S)
WATER HEATER(S)
DISHWASHER(S)
]TCCLATMFR/STGNATURE RLC
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 infortnation supplied to the city as a part of this application. ' l
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APP NT ior.ONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.cttyoffederalway.com
77k
Indicate number of each type
of fixture
MECHANICAL
AIR HANDLING UNIT(S)
EVAPORATIVE COOLER(S)
GAS LOGS)
REFRIG. SYSTEM(S)
BBQ(S)
FAN(S)
HOOD(S)
WOODSTOVE(S)
BOILERS)
FIREPLACE INSERTS)
RANGE(S)
MISC. ( )
COMPRESSOR(S)
FURNACE(S)
DUCT(S)
GAS PIPE OUTLET(S)
HEAT SOURCE:
❑ ELECTRIC ❑ 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)
SINKS)
WATER CLOSET(S)
MISC. ( )
INTERCEPTORS)
SUMP(S)
]TCCLATMFR/STGNATURE RLC
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 infortnation supplied to the city as a part of this application. ' l
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APP NT ior.ONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
www.cttyoffederalway.com
Construction Permit Fee Calculation Sheet
*******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CbY 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) $30.00
(2) $501.00 to $2,000.00
(2) $30.00 for the first $500.00 plus $4,00 for each add6onal $100,
or fraction thereof, to and including
$2,000.00
(3) $2,001.00 to $25,000.00
(3) $90.00 for the first $2,000.00 plus $18.00 for each additional
$1.000.00 or fraction thereof, to and
including $25,000.00
(4) $25,001.00 to $50,000.00
(4) $504.00 for the first $25,000.00 plus 513.00 for each additional
11.000.00 or fraction thereof, to and
Including $50,000.00
(5) $50,001.00 to $100,000.00
(5) $829.00 for the first $50,000.00 plus $9,00 (oreadi addNona151.000.00or
fraction thereof, to and
Including $100,000.00
(6) $100,001.00 to $500,000.00
(6) $1,279.00 for the first $100,000.00 plus 17.00 foread� addit0iml
S1.000.A9or fraction thereof, to and
including $50,000.00
(7) $500,001.00 to $1,000,000.00
(7) $4,079.00 for the fist $500,000.00 plus 16.019 for ead� additbna111,000.0Y1
or fraction thereof, to and
Including $1,000,000.00
(8) $1,000,001.00 and up
(8) $7,079.00 for the first $1,000,000.00 plus 19.50 for eaoh
addibbnal $1.000.A9 or fraction thereof.
Bold number Is the base fee for the spedfled Increment
Ital/dzed, undeiYlned number Is the lee per adMonafsnedlfed
Increment
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)
■ BUILDING
(a) Base Fee:
(b) Additional Increment Fee:
0 MECHANICAL
PROPOSED VALUATION: s5ap .
FEE FACTOR FROM TABLE A: Number: (a) Base Fee: �v •uot
(b) Additional Increment Fee: ��
Estimated Permit Fee: (4) J (tea . DO
Estimated Plan Review Fee: (5) 19--
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee:
Estimated Plan Review Fee: (7)
0 FIRE PREVENTION SYSTEM
(a) Base Fee:
(b) Additional Increment Fee:
Base FeeNumber of Foctures
$26.00 + ( X $9.00/fixture) _ (8) Estimated Permit Fee
Estimated Permit nee
X .65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
Sub Total (Page one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)