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02-104323
City of Federal Services Way Commw�ity DMechanical Permit #: 02 - 104323 - 00 - Mf, 33530 1 st Way S Federal Way, WA 98003-6210 Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.30-50 Project Name: FRED MEYER Project Address: 33702 21STIS U Parcel Number: 93010x? 0010 Project Description: MECH - Mechanical only for the installation of rooftop condensor unit for (4) refrigerated uses located in grocery portion of retail store. Owner Applicant Contractor FRED MEYER PORTLAND MECHANICAL CONTRS INC PORTLAND MECHANICAL CONTRS INC 6521 SE CROSSWHITE WAY 6521 SE CROSSWHITE WAY PORTLAND WA 97206 PORTLAND WA 97206 (503) 656-7400 Mechanical Valuation..........................................12000 Over the Counter Permit ...................................... No 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 agent: Date: A�341 /C9 Z ✓'c,SAS C4, tis o v� C/ti S a IG am 3;? ld -7 bZ Ccj 155 I qT7 � G_ IN vo CONSTRUCTION PERMIT APPLICATION OF u fAPPLICATION NUMBER: U� PPLICATION 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. PROPERTY INFORMATION SITE ADDRESS: s3-5702 ,1ST , ,4 ye SW ASSESSOR'S TAX/PARCEL #: LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): TYPE OF PROJECT (This application): El BUILDING WING MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): INr5'//4G{�� S Q -4 7" S• ON PROPERTY OWNER: CONTRACTOR: ■ PEOPLE INFORMATION NAME:DAYTIME PHONE: f tky T( MAILING ADDRESS (STREET ADDRESS CITY, STATE, IIP): NAME: _ DAYTIME PHONE: - MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: 3 S w 1Z q 0 CITY OF FEDERAL WAY BUSINESS LICE SE NUMBER: FAX NUMBER: - - - - - - - - - - - - - (503) 65� - Cn3' , CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) APPLICANT: NAME: �DAYTIME PHONE: � oRT[-4Ayz> /q�, ezw1 (�3) An(" MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: ( ) RELATIONSHIP TO PROJECT:/1 FAX NUMBER: 11ARCHITECT El TENANT ❑ OTHER ( DESCRIBE):_ e61V4vACT-b2 ( ) - E-MAIL ADDRESS: CONTACT PERSON'FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT XCONTRAcTOR DETAILED 13UILDING INFORMATION' EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED'VALUATION PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 11 PRIVATE (SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** ' NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ 7m ■ 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 UNIT(S) BBQ(S) BOILERS) COMPRESSOR(S) DUCT(S) BATHTUB(S) DISHWASHERS) DRINKING FOUNTAIN(S) GAS PIPE OUTLET(S) 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 OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS PLUMBING LAVATORY(S) RAIN WATER SYS. SHOWER(S) SINKS) SUMP(S) URINAL(S) VACUUM BREAKER(S) WASH MACHINE OUTLET WATER CLOSET(S) WATER HEATER(S) ❑ ELECTRIC ❑ GAS _ MMISC (q n 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 attomeys' 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 aJs alparrt of this application. NAME/TITLE: _L!7i ©/�PU�'t ii�.� DATE: ❑ PROPERTY OWNER ❑ APPLICANT 4CONTRACTOR ODMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129 www.dtvoffederaWay.com Construction Permit Fee 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. i PLUS: 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 #3.50 for eadi addtk 1-f100.A7or fraction thereof, to and indudirg $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 additional $1,000. or 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:OOor 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 $8.00 for each additional $1,000. 00 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 additional.41000 or 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 $550 for each additional $1.000.Ob or 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 $4.00 foreach additional $1.000.00 or fraction thereof. Bold number Is the base fee for the specified increment Italiozed, underlined number Is the fee Per additional sneofied 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 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 '# PROPOSED VALUATION: FEE FACTOR FROM TABLE A: Number: Estimated Permit Fee: (1) Estimated Plan Review Fee: (2) Estimated FW Fre Department Surcharge: (3) (COMMERCIAL ONLY) ■ BUILDING (a) Base Fee: (b) Additional Increment Fee: ■ MECHANICAL PROP. s• FEE FACTOR FROM TABLE A: Number: Estimated Permit Fee: Estimated Plan Review Fee: (S) PROPOSED VALUATION: (a) Base Fee: (b) Additional Increment Fee: ■ FIRE PREVENTION SYSTEM FEE FACTOR FROM TABLE A: Number: (a) Base Fee: (b) Additional Increment Fee: Estimated Permit Fee: (6) Estimated Plan Review Fee: m Base Fee Number of Fatmes $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 (Page one): Une(s)(1)+(2)+(3)+(4)+(S)+(6)+(7)+(8)+(9)+(10) = (11)