03-105037CiY,-nf Federal Way
f Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: LAZZARETTI
Project Address: 2913 SW 337TH 5-t
Project Description: Replace gas furnace.
Mechanical Permit #:03 -105037 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 9542801690
Owner
Applicant
Contractor
HEATHER LAZZARETTI
ROSSOE ENERGY SYSTEMS INC
ROSSOE ENERGY SYSTEMS INC
2913 SW 337TH ST
9367 RAINIER AVE S
9367 RAINIER AVE S
FEDERAL WAY WA 98023
SEATTLE WA 98118
SEATTLE WA 98118
(206) 725-7555
Mechanical Valuation..........................................2572 Over the Counter Permit...................................... Yes
Mechanical Fixtures
Description QuantiF Description I Quantity I Description Quantity
Furnaces
PERMIT EXPIRES May 5, 2004.
Permit issued on November 7, 2003
I hereby certify that the above information is correct and that the construction on the above described propertyand
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: Date: 1/-7-03-
RECEIVED
m.a G CONSTRUCTION PERMIT APPLICATION
• NOV 0v 7 2003 APPLICATION NUMBER: O 3- O S0 3 v n�lov �L
APPLICATION NUMBER:
CITY FEDERAL WAY APPLICATION NUMBER:
BUILDING
DING DEPT. -
**The following is required informatiod — Please print (hi ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
N!--PROPIERTY INFORMATION
SITE /ADDRESS: 72) <" ` :33T""s+ ASSESSOR'S TAX/PARCEL #: 'I S —[ Z$ O
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PRO3ECTINFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING X MECHANICAL ❑ DEMOLITION
f ELECTRrCAt " ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
1.4
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:NAME:
MAID
CONTRACTOR: NAME:
MAILIP
Cm C
CONTE
(copy 4
~ APPLICANT:NAME:
MAILING ADDRESS (STREET ADDRESS.- CITY, STATE, Z
I
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): -
E-MAIL ADDRESS: I
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ACONTRACTOR
DETAILED 13UZLDING INFORMATZ
ON
EXISTING USE: 1-0,d1Ajenjt4 EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:
PROPOSED VALUATION FOR IMPROVEMENTS: S
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
❑ NO'.
i
**NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT'
Indicate number of each type of fixture
FIRST
AIR HANDLING UNIT(S)
SECOND
GAS LOG(S)
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)
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
'0irther, 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
avestlgation 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.
i
i&ME/TITLE: DATF:
Q. PROPERTY OWNER
I PLATT
❑ APPLICANT CONTRACTOR
Y:
:TION 11 ALTERATION
1tblGNAI IUN
TOWNSHIP RANGE
? 11 YES ❑ NO
:PAIR' C
SHELL ONLY?
N? ❑ YES
NEW ADDRESS RE
CHANGE OF USE?'
17
❑ YES ❑ NO
❑ NO
? ❑ YES ❑ NO
❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253661-4000 - FAX: 253-661-4129
WWW .CitV0ffCderal Way -Com
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 INSERT(S)
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)
RAINWATER 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 under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
'0irther, 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
avestlgation 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.
i
i&ME/TITLE: DATF:
Q. PROPERTY OWNER
I PLATT
❑ APPLICANT CONTRACTOR
Y:
:TION 11 ALTERATION
1tblGNAI IUN
TOWNSHIP RANGE
? 11 YES ❑ NO
:PAIR' C
SHELL ONLY?
N? ❑ YES
NEW ADDRESS RE
CHANGE OF USE?'
17
❑ YES ❑ NO
❑ NO
? ❑ YES ❑ NO
❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES - 33530 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253661-4000 - FAX: 253-661-4129
WWW .CitV0ffCderal Way -Com
Construction Permit Fee Calculation Sheet
**.*****PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT.
s CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building, mechanical, and fire prevention system fees are based on the following schedule.
PLUS:
TAai i= 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 53.50 for each adddional
S100.00or 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 515.50 for each addltlonal
S1.000.00or fraction thereof, to and
including $25,000.00
(4) 225,001.00 to $50,000.00
(4) $435.00 for the first $25,000.00 plus 51100 for each additional
Sl 000 or fraction thereof, to and
including $50,000.00.
(5) $50,001.00 t0 $100,000.00
(5) $710.00 for the first $50,000.00 plus $8.00 for each additional51.000.QOor
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 56.00 foreach additional
$1.000- or fraction thempf, 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 55.50 for each additional
57.000.00 or fraction thereof, to and
including $1,000,000.00.
or
(8) $1,000,001.00 and up
(8) $6,260.00 for the first $1,000,000.00 plus S4.00 for eadr
additional $1.000.00 or fraction thereof.
Bold number is the base fee for the specified increment
AAA LC ..
ritardred underlined number is the fee per additional spearted
lacrement
Add 25 percent of the base mechanical permit fee for mechanical plan review fee.
Add'15 percent of the base building permit fee for Fre 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 **
■ BUILDING -
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
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:
PROPOSED VALUATION:
(a) Base Fee: C\ 0 C3
(b) Additional Increment Fee:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
Base Fee Number of Fxtures
$22.50 +( X $8.00/fixture) _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
Sub Total (ragea,c): Line(s) (1)+(2)4(3)+(4)+(5)+(6)+(7)+(8)+(9)4(10) = (11)
S