03-104021City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #:03 -104021 - 00 - ME
Project Name: GRADDEN
Project Address: 441 S 305TH St
Project Description: Remove and replace gas furnace in the garage
Inspection request line: 253.835.3050
Parcel Number: 104250 0016
Owner
Applicant
Contractor
Gerald F Graddon
PERFORMANCE HEATING & A/C ELE
PERFORMANCE HEATING & A/C ELE
441 S 305TH ST
7649 S 180TH ST
7649 S 180TH ST
FEDERAL WAY WA
KENT WA 98032
KENT WA 98032
98003-4020
(425) 251-0356
Mechanical Valuation..........................................2800 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
PERMIT EXPIRES February 24, 2004.
Permit issued on August 28, 2003
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.
c (�j
Owner or agent: Date:
qI LIDS �
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t
• 2,v11 r INI�
L11% - 6� CONSTRUCTION PERMIT APPLICATIO14
CITY OF �•...� R M G I V E D APPLICATION NUMBER: - L Q d _ -
Federal Way APPLICATION NUMBER: _ _ -
AUG 2 8 2003 APPLICKRON NUMBER: _ _ - _ _ -
**The 1vflff6p WmWAPdTTgWation —Please print (in ink) or type**
Please note: Electrical, Fire PT�V� AN99xs and Engineering permits may require a separate application.
PROPERTY I• •
SITE ADDRESS: ASSESSOR'S TAX/PARCEL O y Z s C, - 6 a7
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT•• •
TYPE OF PROJECT (This application): o BUILDING o PLUMBING /MECHANICAL o DEMOLITION
o ELECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): Ck-C&%%< a V I^% r N4 f •C-.
r N 6ekrg �r2
PROJECT NAME:
PEOPLE•• •
PROPERTYOWNER: NAME: DAYTIME PHONE:
G EI�►�, � c F) 93y--733
MAILING ADDRESS (STREET ADDRESS; CM ST TE, ZIP): �
Yui 5- 3a sal S _ iw P 7�0(33
CONTRACTOR:
NAME:
r«k,fMavlc� I4tktIV%_
I DAYTIMEPHONE: i
c yts zs�—oar`
MAILING ADDRESS (STREET ADDRESS; STATE. ZIP):
7691 S,-
EVENING PHONE:
CTTY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
a 0 1
i FAX NUMBER:
-a'a 6Ci( ) -
CONTRACTOR'S REGISTRATION NUMBER:
t
1� O (' / r6 l� 17
I EXPIRATION DATE:
1 / /
(a)pr required)
of card
APPLICANT: NAME: 1 JDAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP : i EVENING PHONE:
74Y q S. 101-L k A - r i( ( ) _
RELATIONSHIP TO PROJECT: FAX NUMBER:
o ARCHITECT o TENANT OTHER( DESCRIBE):
i E-MAIL ADDRESS:
I
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER ❑APPLICANT o CONTRACTOR �
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: o YES o NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT 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 UNITS)
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. SYSTEMS)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. (
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC eGAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC.
■ DISCLAIMER/SIGNATURE BLOCK
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. G
NAME/TITLE: ,'rDATE: O / - ��6
❑ 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
www.ctvoffederalway.com
Construction Permit R�' 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:
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.W for each aaddtional $100.0r1
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
S1.000.00 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 $13.00 for ead� additional
SI.000.O0 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 for each adddional
S1.o00.00or 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 $7.00 for ead� additional
$1,000 00 or fraction thereof, to and
including $500,000.00
(7) $500,001.00 to $1,000,000.00
(7) $4,079.00 for the fist $500,000.00 plus 56.00 foread� addlbbwl
SLOW, 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 54.50 for eadi
additional S1.000.Q0 or fraction thereof.
Bold number Is the base fee for the spedded Increment
1talldzed. undedlned numberls the fee Per add/Honal sveoWed
Increment
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: JS 2,Y00
■ BUILDING
(a) Base Fee:
(b) Additional Increment Fee:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee: Z d ea y a
(b) Additional Increment Fee: o
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5)
■ FIRE PREVENTION SYSTEM
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
N PLUMBING
Base Fee Number of Fbdures
$26.00+( X $9.00/fixture) _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65 =
Miscellaneous Fixture Charge: (10)
Sub Total (Page one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)
(9) Estimated Pian Review Fee
Aug 28 03 10:16a
F6=3-052-000 r8/97)
Performance Heati
K Er_.? l,
DEPARTMENT OF LAE OR AND
(425) 251-0280 p.1
IND:USTR.[ES
REGISTERED AS p];.OV2DED BY LAW AS
CONST CONT . GENIiRAL
.FFFQii1` ORT EI4/2/'0Q5
EFEE.CT'�VE D1�TE-
-985
PERFORMANCE:HEATTNG & A/CINC*
7649 S. 180TH
KENT WA 980-32.
.State of Washington
County of King
I certiA that this is a true and covect copy of a document in the possession of
Performance Heating & Air Conditioning, Inc. as of this date.
Dated: 0 3
(Signature)
Title: Vice President of Finance
My appointment expires: 6/19/05
Residing at: Renton WA 98055