02-104817City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Mechanical Permit #: 02 -10-x'817 - 00 - ME
Project Name: SMITH Q\
Project Address: 32634 51SAW
Project Description: MECH - Gas furnace changeout in existing residence.
Inspection request line: 253.835.3050
Parcel Number: 189832 0320
Owner
Applicant
Contractor
Kathleen M Smith
COLUMBIA HEATING
COLUMBIA HEATING
32634 51ST PL SW
13114 SE 258TH
13114 SE 258TH
FEDERAL WAY WA
KENT WA 98031
KENT WA 98031
98023-1944
(253) 631-6544
Mechanical Valuation..........................................1350
Mechanical Fixtures
Furnaces
PERMIT EXPIRES April 28, 2003, IF NO WORK IS STARTED.
Permit issued on October 30, 2002
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:
R
Cr" Of �
RECEIVED
L . OCT 3 4 2002
CITY OF FEDERAL WAY
BUILDING DEPT.
CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: -(/-
APPLICATION NUMBER: - -
-- ------ --
APPLICATION NUMB FR: -
**The following is required information -Please print (in ink) or•type**
Please note: Electrical, Fre Prevention Systems and Engineering permits may require a separate application:
SITE ADDRESS: �y S �� ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ - _ _ _
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
MA
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING 1KIMECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME:DAYTIME PHONE:
AILING ADD (STREET ADDRESS; CITY, STATE, ZIP):
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; C(TY, STATE, ZIP):
EVENING PHONE:
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LICENSE NLO48M
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
'" ww" C-0 /_ "'Ir/ i--, _ c _
/ 10
DAYTIME PHONE:
MAILING AD (STREET ADDRESS; CITY, STATE, ZIP): EEVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( ) -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE:
PROPOSED USE:
■ DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
PROPOSED VALUATION FOR IMPROVEMENTS:
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** '
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
Mill!
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)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate number of each type of fixture
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)
,jiSCLAIMER/SIGNATURE BLC
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 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 as a part of this application.
NAME/TITLE: DATE:
/U4�c-�U
❑ PROPERTY OWNER ❑ APPLICA CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES . 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL. WAY, WA 98063-9718 • 253.661-4000 • FAX: 253-661-4129
www.ctvofedmlway.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.
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 53.50 for eadb additional
S100:OOor fraction thereof, to and including
$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
51,000:00 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 $11.00 for each addtional$1.000.A0or
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 58.00 for each additional51,000.00
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 56.00 for each
additional S1.000.COor 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 $5.50 for each
additional S1,000.D0or 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 54.00 foreach
additional SI,000.00or fraction thereof.
Bold number is the base fee for the specified increment
ltalicized underfined number Is the fee per additional spedFed
Increment
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: (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee: (1)
Estimated Plan Review Fee: (2)
Estimated FW Fre Department Surcharge: (3)
(COMMERCIAL ONLY)
8 MECHANICAL
PROPOSED VALUATION: S_C�
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5)
0 FIRE PREVENTION SYSTEM
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number: (a) Base Fee:
(b) Additional Increment Fee:
Estimated Permit Fee: (6)
Estimated Plan Review Fee: (7)
Base Fee Number d fbdu es
$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 (Paye one): Line(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10) _ (11)