03-104306r A
City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: MCLAUGHLIN
Project Address: 3316 SW 335TH 5i
Project Description: Remove replace gas furnace
Mechanical Permit #:03 -104306 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 954280 0320
Owner
Applicant
Contractor
David McLaughlin
COMPLETE HEATING & A/C
COMPLETE HEATING & A/C
3316 SW 335TH ST
15627 SE 178TH ST
15627 SE 178TH ST
FEDERAL WAY WA
RENTON WA 98058
RENTON WA 98058
114 itpg$laluation..........................................145
Over the Counter Permit..tg25)•254,0&3.1
......... yes
PERMIT EXPIRES March 16, 2004.
Permit issued on September 18, 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 Federa)�Way
Owner or agent: Date: ` Z& )e �O�
-Q I - --L t. - Q- Lt-'
1
MOF,
MY OF CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: 03 - L a4.splJ -
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: , / C� �. "J`Z35 ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION"
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING 1� MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECTti
lxo
■ PEOPLE INFORMATION r'
PROPERTY OWNER:
CONTRACTOR:
N M C L A U— � � DAYTIME PHONE: q/
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MAILING ADDRESS 1111 ini,' P)
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bra. "iT I /d.
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DAYTIME PHONE:
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M LING ADDRES (STREET ADDRESS; CITY,
Z1P
EVENING PHONE:
S
C[TTOF-fEDEPAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(copy of card required)
— — — — _
APPLICANT: NAME: ""� �• "' •"
• �AcS CCS ( ) -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
l
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
3FTOTLF0 RUTLDTNG INFORMATIC
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
O
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ �`��
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
v
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 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
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)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLETS)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. { )
_ FURNACE(S)
GAS PIPE OUTLETS) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
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/SiC,NATIIRF RI 1,
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 th 'ty as a part of this application.
' iNAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANT XCONTRACTOR
CDMMUNTTY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129
www.CRYoffedem[way.com
Construction Permit Frie 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.
TABLE 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 $1.50 for each adddlonl
$100..00 or 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 $15.50 for each addibonal
$1.000.Obor fraction thereof, to and
including $25,000.00
(4) $25,001.00 to $50,000.00
(4) $435.00 for the first $25,000.00 plus 511.00 for each additional
$1,000, or fraction thereof, to and
including $50,000.00.
(5) $50,001.00 to $100,000.00
(5) $710.00 for the first $50,000.00 plus 58.00 for each addition1$1.000.
or 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 $6.00 for each
additional51.000.00or fraction thereof, 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 $5.50 for each additional51.000.00or
fraction thereof, to and
including $1,000,000.00.
(8) $1,000,001.00 and up
(8) $6,260.00 for the first $1,000,000.00 plus $4.00foreach
additional51.00000or fraction thereof.
Bold number is the base fee for the specified increment
nwidzed, underlined number Is the fee per additional spedlied
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 Fre District #39 surcharge, commercial only.
Add $4.50 for WA State Building Code Council, plus $2.00 per unit for duplex & above.
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee:
Estimated Plan Review Fee: (2)
Estimated FW Fire Department
(COMMERCIAL ONLY)
PROPOSED VALUATION:
FEE FACTOR FROM TABLE At Number:
Estimated Permit Fee:
Estimated Plan Review Fee: (5)
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number.
Estimated Permit Fee:. (6)
Estimated Plan Review Fee: m
** Electrical, plumbing, and mechanical fees are calculated separately **
■ BUILDING . _ . _ ....._.... - -- -- - .. - . .. _ -.
(a) Base Fee:
(b) Additional Increment Fee:
(a) Base
Increment Fee:
■ FIRE PREVENTION SYSTEM
(a) Base Fee:
(b) Additional Increment Fee:
ease Fee Number d Fadwes
$22.50+( : X $8.00/fixture) _ (8) Estimated Permit Fee
Estimated Perndt Fee
X .6S= (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
Sub Total (P., on,): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) = (11)
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