04-100522City or Federal Way
Mommunity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: PROGRESSIVE INSURANCE
Mechanical Permit #:04 -100522 - 00 - ME
Inspection request line: 253.835.3050
Project Address: 32001 32ND YvAte430- 14tee- 5 Si -e. L4 3 O Parcel Number: 162104 9001
Project Description: Adding 12 VAV terminal units & (1) 1.5 ton computer room unit and related duct work
Owner
Applicant
Contractor
FOSS DEVELOPMENT
P S F MECHANICAL INC
P S F MECHANICAL INC
FOSS DEVELOPMENT
P S F MECHANICAL INC
P S F MECHANICAL INC
1151 FAIRVIEW AVE N
9322 14TH AVE S
9322 14TH AVE S
SEATTLE WA 98109
SEATTLE WA 98108
(206) 764-9663
Mechanical Valuation..........................................54200 Over the Counter Permit ...................................... No
Mechanical Fixtures
L�Description Quantity Description Quantity Description Quantity
ructs 1
PERMIT EXPIRES August 25, 2004.
Permit issued on February 27, 2004
I hereby certify that the above information is correct and that the construction on the above described propertyrtd
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 l
Owner or agent: Date: —z/z -7/ 0 /K) -
J -3 -(;�- 0 Z/'r
L4 C—
j ctl L4 CcA, q1 0'�
�ce4 1�2
RSD
CONSTRUCTION PERMIT APPLICATION
- _Q
VV f3Y-4 1 7 20LV APPLICATION NUMBER: ' _
Cr gyw.Z f PPLICATION NUMBER: _ _
CWAY 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 se ica n.
SITE ADDRESS: 0 �C.r/7�0�-lGL[I/ A'SSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROIECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ,MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
1r,
L,
NAME:
N� GK
ZINC.
DAYTIME PHONE:
MAILING D DESS STREET ADDRESS; , STATE, ZIP):
``//��JJ ZZ 2 /y R �V)
S.
EVENING PHONE:
c >
-
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
2 o -
LQ 2 $ 8_ - L
FAX NUMBER:
( 2o6) 76 Z
CONTRACTOR'S REGISTRATION NUMBER:
P 5—r
TT �1
M E X o
EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME:DAYTIME MI/ (IM.) PHONE:
Z,6
MAILING ADDRESS (STREET ADDRESS; STA IP,: EVENING PHONE:
Z2 tl S� c�6>�26 -sy
ElARCHRELATIONSHIP TO ITECT IE ❑ TENANT 6"THER ( DESCRIBE): FAX NUMB]
r.06i;-Z& -
E-MAIL ADDRESS: ,1,
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CO RACTOR N 1 E^z PsrMa
EXISTING USE: 7 1-C�' 1 ' J LrF— EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ C
PROPOSED USE: O r r ��lL, PROPOSED VALUATION FOR IMPROVEMENTS: $ J !) wd * y
T
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) •
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY"
ESTIMATED SELLING PRICE:
t. R
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEME T
BUILDING SHELL ONLY? ❑ Y S ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? C1 YES El NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? 0 YES 11 NO
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL.
AIR HANDLING UNIT(S)
BBQ(S)
'BOILER(S)
COMPRESSOR(S)
DUCT(S)
m
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACEINSERT(S) RANGE(S) MISC.( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINALS)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S)
DRINKINGFOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S)
INTERCEPTORS) SUMP(S)
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
ATURE BLOCK
0 DISCLAIMER/SIGN
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 thp information supplied to the city a �rt this application.
NAMEyTITLE•
w / M�1 DATE: /
❑ PROPERTY OWNER El APPLICANT CONTRACTOR
rVR Vr�l\.L VJL VIL1.
❑ NEW ' ❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ Y S ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? C1 YES El NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? 0 YES 11 NO
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.
TABLE A
TOTAL VALUATION
FEE FACTOR
(1) $1.00 to $500.00
(1) $24.25
(2) $501.00 to $2,000.00
(2) $24.25 for the first $500.00 plus f3.27for each additional
$100.00 or fraction thereof, to and including $2,000.00
(3) $2,001.00 to $2S,000.00
(3) $71.46 for the first $2,000.00 plus $1500 f0i'00" adlOcrwt
51.000.00 or fraction thereof, to and including
$25,000.00
(4) $25,001.00 to $50,000.00
(4) $403.61 for the first $25,000.00 plus $10.82 for each aaAilional
$1.000.00 or fraction thereof, to and including
$50,000.00.
(5) $50,001.00 to $100,000.00
(5) $664.35 for the first $50,000.00 plus $7.50 for each addi0onal
$1.000.AOor fraction thereof, to and including
$100,000.00.
(6) $100,001.00 to $500,000.00
(6) $1,025.55 for the first $100,000.00 plus 55.00 for eadr
additional $1.000.00 or fraction thereof, to and including
$500,000.00
(7) $500,001.00 to $1,000,0(%.00
(7) $3,337.23 for the fist $500,000.00 plus $5.09 for each a0V60nal
$LOW.00or fraction thereof, to and including
$1,000,000.00.
(8) $1,000,001.00 and up
(8) $5,788.23 for the first $1,000,000.00 plus $3.91 for eadt
additional ll.0i00.00or fraction thereof.
Sold number is the base fee for the specified increment
Italicized underlined number is the fee per additional specified
incmmenl
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 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:
Estimated Plan Review Fee: (2)
Estimated FW Fre Department Surcharge: (3)
(COMMERCIAL ONLY)
■ BUILDING
(a) Base Fee:
(b) Additional Increment Fee:
PROPOSED VALUATION: _ � (o 10 a
FEE FACTOR FROM TABLE A: Number: S (a) Base Fee:
``
(b) Additional Increment Fee:
Estimated Permit Fee: (4) b -7 -/ • .5-
Estimated Plan Review Fee: (5) 1 4041 ' -64
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee:
Estimated Plan Review Fee:
Base Fee Number of Fixtures
$21.00+( X $7.00/fixture) _ (8) Estimated Permit Fee
Estimated Permit Fee
X .65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
r -..t.. T..4 -.t— ,. . ,. =(11)
DEPARTMENT OF LABOR AND INDUSTRIES
I F625-052-000 (8/97)
Detach And Display Certificate
REGISTERED AS PROVIDED BY LAW A
CONST CONT SPECIALTY
REGIST. # EXP. DATE
CCCGAF PSFMEI*090NZ 10/03/2005
EFFECTIVE DATE 08/09/1991.
P S F MECHANICAL INC -
9322 14TH AVE S
SEATTLE WA 98108
Signature
Issued by DEPARTMENT OF LABOR AND INDUSTRIES J
F625-052-000 (8/97)
Please Remove
And Sign
Identification
Card Before
Placing In
Billfold