03-1046399
City of Federal Way
Community Development Services Mechanical Permit #: 03 -104639 - 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: ROMERO
Project Address: 1810 SW 307TH Y'
Project Description: Replace 70,000 btu gas furnace.
Parcel Number: 770380 0110
Owner
Applicant
Contractor
Ben R Romero
ALL SEASONS, INC.
ALL SEASONS, INC.
1810 SW 307TH ST
5118 N HIGHLAND ST
5118 N HIGHLAND ST
FEDERAL WAY WA
TACOMA WA 98407
TACOMA WA 98407
I4%dn �pdj/aluation..........................................150
Over the Counter Permit..(253)•8794144
........ Yes
PERMIT EXPIRES April 7, 2004.
Permit issued on October 10, 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. /f
Owner or agent: Date: ® C%
r JC
p„a G RFCE-NEC? CONSTRUCTION PERMIT APPLICATION
- E17E�t—APPLICATION NUMBER:
uV A37 loCl 10 2003 APPLICATION NUMBER: -
CIvy OF FEDERAL WAY APPLICATION NUMBER:
RF�UILDING DEPT
**The followilig is required information — Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
(� PROPERTYO• •
SITE ADDRESS:/ 3'0 7 ASSESSOR'S TAX/PARCEL #: LQ
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION 11 (Provide detailed description): r S"y'� 9�f � ice-
PROJECT
ce
PROJECT NAME:
PROPERTY OWNER:
10 a..::jO b
CONTRACTOR:
APPLICANT:
DAYTIME PHONE: !may
NAME: OP K 0sn O� O Co?
)r7 Y- 9l(Ia
MAILING ADDRESS (STREET ADDRESS; CITY, STAE,ZIP): f'i' /c!--
� -e/ �_ b 2
NAME:
�� c
DAYTIME PHONE:
n �.�` _
®►�
/r encs ams �
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
— — — — — — —
FAX NUMBER:
— — —
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
DAYTIME PHONE:
VAME:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): `EVENING PHONE:
FAX NUMBER:
RELATIONSHIP TO PROJECT:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER
EXISTING USE:
PROPOSED USE:
❑ APPLICANT ETMNTRACTOR
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $ i{a oc-)
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
f
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
Indicate number of each type of fixture
MECHANICAL
HANDLING UNIT(S) EVAPORATIVE COOLER(S) LOG
(S) LOS) REFRIG. SYSTEM(S)
AIR
AIR HA FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) 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)
DISHWASHERS) 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. ( 1
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
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 daises out of the reliance of t�t�ityyinduding its officers and employees, upon the accuracy
of the information suq@h� to-thp rifv "c a na��c ann1'rat,n�_ / /// /
NAME/TITLE: _ a �y,�� . - DATE: ( %�
❑ PROPERTY OWNER ❑ APPLICANT -&CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129
Permit Fee Estimate Worksheet
❑ Building Permit I4-Kechanical Permit ❑ Fre Prevention System Permit
4 Ori.
PROPOSED VALUATION: %D
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
(Valuation from permit application- base fee increment)/1000 Round up to nearest whole number
(c) { 1 /1000 = (d)
OR
For valuations between $501.00 and $2,000 only:
(Valuation from permit application- base fee increment)/300 Round up to nearest whole number
(d) { } /100 = (d)
Value from (d)
(e) X
Permit Fee:
value from (b)
Base Fee from (a)
Permit Fee from (g)
= (f) —
Value from (f)
= (9)
Plan Review Fee
Plan Review Fee: X .65 = (h)
Permit Fee from (9) Surcharge Fee
FW Fire Department Surcharge: X .15
(COMMERCIAL ONLY)
•
❑ Building Permit` echanical Permit ❑ Fire Prevention System Permit
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
PermltFee
(Valuation from permit application- base fee increment)/1000
(c)
OR
For valuations between $501.00 and $2,000 only:
(Valuation from permit application- base fee Increment)/100
(cl) i
Value from (d) value from (b)
(e) X
Base Fee from (a)
Permit Fee:
Permit Fee from (g)
. = (f) —
Value from (f)
= (9)
Plan Review Fee
Plan Review Fee: X .65 = (h)
Permit Fee from (9) Surcharge Fee
FW Fire Department Surcharge: X .15
(COMMERCIAL ONLY)
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-1000 • FAX: 253-661-4129
Round up to nearest whole number
/1000 = (d)
Round up to nearest whole number
/100 = (d)
Permit Fee
11