03-104383City of Federal Way
Community Develelopment Services Mechanical Permit #:03 -104383 - 00 - ME
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: ALASKA USA CREDIT UNION
Project Address: 1207 S 320TH 91- Parcel Number: 150050 0020
Project Description: Install (1) split system a/c unit with associated duct work
Owner
Applicant
Contractor
1560 INVESTORS LLC
AMBIENT CONTROL CO INC
AMBIENT CONTROL CO INC
200 S BROAD ST #6
1020 S 344TH RD SUITE 203
1020 S 344TH RD SUITE 203
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
(253) 661-5844
A planning inspection must be scheduled and passed PRIOR to FINAL MECHANICAL inspection. Please contact David
Lee at (253) 6614154 during normal business hours to schedule an inspection.
PERMIT EXPIRES May 11, 2004.
Permit issued on November 13, 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.
Owner or
Date: //-/3 —C7--?
-palc*A— 6 3 -10,11
0 CONSTRUCTON PERMIT APPLICATION
CITY OF ppLICA-HON NUMBER: - g 3
Federal Way CENED ppLICATION NUMBER: - — — — - —
SEP
2 3 2003 PLICATION NUMBER:
—The following isrequired�! �Vmation — Please print (in ink) or type**
FF-DERAL WA
Please note: Electrical, F 8�1 t0gt,,%E*hs and Engineering permits may require a separate application.
UPROPERTY
SITE ADDRESS: �?�� S. ST ASSESSOR'S TAX/PARCEL #: 1 0 O So - O c Z V
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING o PLUMBING AMECHANICAL ❑ DEMOLITION
❑ ELECTRICAL o ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):A k-
Lam] 1 'Fly A�S� A-rt� LZi�-rL..��2.L
r
O
PEOPLE INFORMATION
PROPERTYOWNER: i NAME:
CONTRACTOR:
LTO
DAYTIME PHONE'
)
NAME:
I DAYTIME PHONE: ;
(�
Am Q,x g:w -r ��wt � C-8
I A
i MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): f
`J•
EVENING PHONE:
i �C7?jZ) 3�i�/Tz4 �I?r Z�3 Frc�OC,.K�3
( ) i
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER.
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:f f
/y�
I EXPIRATION DATE:
(cDpY of card required) _ 1_� 1 i
' e
APPLICANT: I NAME:
DAYTIME PHONE:
( )
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: j FAX NUMBER:
o ARCHITECT ❑ TENANT HER ( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT o CONTRACTOR
EXISTING USE: 6TLS3g,-re EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: 10 —'ri0210' &VtAkt— PROPOSED VALUATION FOR IMPROVEMENTS: $_
SPRINKLERED BUILDING? YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES NO
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE o TACOMA ❑ PRIVATE (WELL)
E-MAIL
y90 (z .moo
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION O6*
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE
■ PROJECT FLOOR AREAS
OOR
EXISTING SQ. FT.
PROP EDS. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
t AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S)
FAN(S)
FIREPLACEINSERT(S)
FURNACE(S)
GAS PIPE OUTLET(S)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
Value of Mechanical Work: $ WCa0 .uO
GAS LOG(S) REFRIG. SYSTEM(S)
HOOD(S) WOODSTOVE(S)
RANGE(S) MISC. ( )
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
DISCLATMFR/SiGNATHRF 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 information suppljd-t9 the city as a part of this appliesUen.
DATE: 9-,23-0-5
❑ PROPERTI-OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 s FAX: 253-661-4129
www.citvo tderalway.com
• Conslction Permit Fee Calculation Wet
*******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT.
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*****A`
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 59.00 for each additinna/SIAO.00or
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 S1B.00 for eaafi 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 additiona/SI.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 59.00 for each addition/
SI OW. or 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 57.00 for each addWona/S1000
00or 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 $6.00 for each addition/SI.000
db 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 19.50for each
additions1$1.000.00 or fraction thereof.
Bold number Is the base fee for the specified Increment
Raffdzed undeiAned number Is the fee ver adi f fonaf weclffed
Increment
.wu ba pencxrn ui uie base budding permiE fee for pian review fee.
rcent of the base mechanical permit fee for mechanical plan review fee.
A 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 ** (r 93 ✓ , 575
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)_
(a) Base Fee:
(b) Additional Increment Fee:
(a) Base Fee:
(b) Additional Increment Fee:
■ FIRE PREVENTION SYSTEM
PROPOSED4 •y
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
(a) Base Fee:
(b) Additional Increment Fee:
0 PLUMBING
Base Fee Number of Futures
$26.00 + { X $9.00/fixture} _ (8) Estimated Permit Fee
Estimated Pennit Fee
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)
S9"
FROM FAX N0.
......f'..,f..,,:�---_.. 21 P1
DEPARTMENT c:>i LAJ301k ANS*Mar.
7 tF..S 2003 07:33PM
REGISTERED AS PROVIDED BY LAW AS
CONST CO1JT:'- SPECIALTY,
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I✓ II E.i.D�,TE 9;9.0
7,0���.0/1990
AMBIENT CONTROL CO INC
1020 S 344TH ST STE 203
FEDERAL WAY WA 98003-6726
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