03-101284City 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: GAINES VJ&
Project Address: 31304 31ST SW
Project Description: Changeout gas furnace
Mechanical Permit #:03 -101284 - 00 - ME
Inspection request line: 253.835.3050
Parcel Number: 438801 0070
Owner
Applicant
Contractor
Danny L Gaines & Roberta C Gaines
GATEWAY HEATING & AIR CONDITIO
GATEWAY HEATING & AIR CONDITIO
31304 31 ST AVE SW
3802 AUBURN WAY N
3802 AUBURN WAY N
FEDERAL WAY WA
AUBURN WA 98002
AUBURN WA 98002
98023-7838
1 (253)931-0610
PERMIT EXPIRES September 29, 2003.
Permit issued on April 2, 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 W
Owner or agent: Date:
CIT
FE
- Axv�
APRO2
CONSTRUCTION PERMIT APPLICATION
PPLICATION NUMBER: j93- Z3
APPLICATION NUMBER:
PPLICATION NUMBER: - -
C;imw11wzwj5A0ired information — Please print (in ink) or type**
� LOING DEPT.
Please note: Electric , ire Prevention Systems and Engineering permits may require a separate application.
ASSESSOR'S TAX/ PARCEL
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
■ PEOPLE INFORMATION
NAME:
C, -z:
)A /G
DAYTIME PHONE:
U15-3) q3t -
o
MAAILIINNG ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): 1 , jp ,
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
Iq 9 e - Lc - 3L-
FAX NUMBER:
() -
Dtlbd
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
ION l a a
o3
(�, of caro required)
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT OTHER ( DESCRIBE): �s ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER PPLICANT CONTRACTOR
/k6
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
❑ YES
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $� _
❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
*4! NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
FIRST
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
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)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
■ -FIXTURES .,
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)
SINK(S)
SUMP(S)
URINAL(S)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
11TSCUATMFR I-Q=NATIIRF RI [7
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
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 the city as a part of this application.
/1n
NAME/TITLE: W 03
P DATE:
❑ PROPERTY OWNER ,�APPLICAN CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE-
ZONING DESIGNATION:
BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION
BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO
CHANGE OF USE? ❑ YES ❑ NO
CO NINn iNFTY nFVFI OPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 - FEDERAL WAY. WA 98063-9718 • 253-661-4000 • FAX: 251-661-4129
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.
PLUS:
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 53.27foreoch additional
$10000 or fraction thereof, to and including $2,000.00
(3) $2,001.00 to $25,000.00
(3) $71.46 for the first $2,000.00 plus $15.00 for each adWonal
$1.000, or fraction thereof, to and including
525,000.00
(4) $25,001.00 to $50,000.00
(4) $403.61 for the rust $25,000.00 plus $10.82 for each additional
$1.000. or fraction thereof, to and including
$50,000.00.
(S) $50,001.00 to $100,000.00
(5) $664.35 for the first $50,000.00 plus $7.50 for each additional
$1.000, or fraction thereof, to and including
$100,000.00.
(6) $100,001.00 to $500,000.00
(6) $1,02S.SS for the first $100,000.00 plus $6.00 for each
additional $1.000, or fraction thereof, to and including
$500,000.00
(7) $500,001.00 to $1,000,000.00
(7) $3,337.23 for the fist $500,000.00 plus $5.09 for each
additonaf $1.000 00 or 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 each
additional51.000.00or fraction thereof.
Sold number is the base fee for the specified increment
Italicized underlined number is the fee per additional sneciled
increment
huu of pci Lxn IL Un ane ud5e uununty permlL tee for plan review lee.
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 **
■ BUILDING
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
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:
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee: (6)
Estimated Plan Review Fee:
(a) Base Fee:
(b) Additional Increment Fee:
■ FIRE PREVENTION SYSTEM
(a) Base Fee:
(b) Additional Increment Fee:
E PLUMBING
Base Fee Number of Fixtures
$21.00 + { X $7.00/fixture} _ (8) Estirgated Permit Fee
Estimated Permit Fee
X .65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
Sub Total (Panenni: Line(s) (1)+(2)+(3)+(4)+(S)+(6)+(7)+(8)+(91+(10) _ (11)