05-102870 City of Federal Way Mechanical Permit #: 05 - 102870 - 00 - ME
Community Development Services
PO Box 9718
Federal Way,WA 98063-9718
Ph (253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: JACKSON pet
Project Address: 33550 36THISW Parcel Number: 109960 0480
Project Description: Replace gas furnace.
Owner Applicant Contractor
Anna D Jackson ALL SEASONS,INC ALL SEASONS,INC.
33550 36TH AVE SW 5001 N 28TH ST 5001 N 28TH ST
FEDERAL WAY WA TACOMA WA 98407 TACOMA WA 98407
98023-2904 (253)278-9344
Mechanical Valuation 2456 Over the Counter Permit Yes
Mechanical Fixtures
Description Quantity Description Quantity Description �[uantity'I
Furnaces 1
ri
PERMIT EXPIRES December 14,2005.
Permit issued on June 17,2005
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 Iaws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: 6. (7" ��
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record_
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-102870-00-ME
Owner: ANNA D JACKSON
Address: 33550 36TH AVE SW
FEDERAL WAY, WA 98023-2904
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
0 Mechanical Rough-in (4165) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By 1 Date to. g..
&-D----E
RECEIVEb CONSTRUCTION PERMIT APPLICAT
CITY OF -' APPLICATION NUMBER: 05- L 601 lry-
Federal Way JUN 1 7 2005 APPLICATION NUMBER: - -
CITY OF PEL hAL WAY kPPLICATION NUMBER: -
isqun**The following rreireea rOrmation-Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
- _•: ' "''. _ - -_-- •■ ,PROPERTY INFORMATION , - •• .
SITE ADDRESS: 33-5% 3Z-f1" SA./ ASSESSOR'S TAX/PARCEL #: ( 019. 96 - 001M-0
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- - ' . -- ■ PROTECT INFORMATION - -. ' _ _
TYPE OF PROJECT(This application): o BUILDING o PLUMBING . ECHANICAL a DEMOLITION
o ELECTRICAL a ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): , _ .-e---. L� a
PROJECT NAME: CAIS./r/ 0---
" - -■ PEOPLE INFORMATION • - - - -
PROPERTY OWNER: NAME: DAYTIME
S I 2-53)
e� PHONE:
MING ADDRESS(STREET AD(RE S;CITY,STATE,ZIP): I ( 2-3) '3S -y763
3)552 3,6•' l/9-•1/�SG(?
CONTRACTOR: NAME: I DAYTIME PHONE:
�
MAILINGS ADDRESS(STREET7ADDRESS; ATE.ZIP i EVENING PHONE' -
t�!/ (/l/ 9--Y �" l ( l
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - (zs3) "9 - ` /y 3
CONTRACTOR'S REGISTRATION, NUMBER: EXPIRATION DATE:
(copy f
py of card required) // //Xe -4C/ 0...7a.0- / 77 / 0_
APPLICANT: ( NAME: /� DAYTIME PHONE
k ( 4L/ $et5 4$/ 7 (2-57) 2_73 - 939 if
MAILIN ADDRESS(STREET ADDRESS;CITY,SaU,ZIP): EVENING PHONE'
RELATIONSHIP PROJECT: 2� �/ 7-,,r G 4,4 F.,90 7 I (AX NUMBER.
0 ARCHITECT ❑ TENANT 0 OTHER( DESCRIBE): (2 S3) ?7r - ?i ye
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER a APPLICANT ❑ CONTRACTOR
- - - ■ DETAILED BUILDING INFORMATION - .
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? a YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES o NO
WATER SERVICE PROVIDER: a LAKEHAVEN a HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: a LAKEHAVEN 0 HIGHLINE o PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PRO]ECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) I FURNACE(S) 75k Craig
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) - URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC a GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
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 daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the Information supplied to the .- as a part% this •pplication.
• /
NAME/TITLE: / � DATE: C(/ 7 64'5
❑ PROPERTY OWNER ❑APPLICANT 4fed -TRACTOR
.FOR-OFFICE"USE ONLY:*I
�p� 1EV11 p'`�ADDITIOIV Y a ALTERATION T;o REPAIR' O TENANT.IMPROVEMENT
CENSUS CODE 3 +- LOT SIZE: x � r _ -. n - .-
�ZONINGTDESIGNATION,; ;= BUILDIN'G'SHELL'ONLY?. o YES ==a NO
COMP PIAN OESIGNAfION _-.. -zw _ '-•" -s Y =
. _�,� ,w, ����__ �.BASICPLAN?-- �❑AYES b'NO,
`SECTION`i -%=- TOWNSHIP_ ".t RANGE=I? NE*ADDRESS REQUIRED? : -T❑YES E •:rj NO' ' Y
^Pail-EO LOTi.;513 YES 'NO ; -'614ANkE OF USE?== ," ;.-o YES' _NO n, ;,;`
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.cityoffederalway.com
Construction Permit Fee,Calculation Sheet
•
*******PLEASE NOTE: ALL FEES MUST BE VERIFIED BY CITY STAFF PRIOR TO ACCEPTANCE OF PAYMENT.
4
CHECKS FOR INCORRECT AMOUNTS WILL NOT BE ACCEPTED!*******
Building,mechanical,and tire prevention system fees are based on the following schedule.
TABLE A
TOTAL VALUATION FEE FACTOR
(1)$1.00 to$500.00 (1)$30.00
(2)$501.00 to$2,000.00 (2)$30.00 for the first$500.00 plus 14.00 for each additional S100.00 or fraction thereof,to and including
$2,000.00
(3)$2,001.00 to$25,000.00
(3)$90.00 for the first;2,000.00 plus$18..00 for each additional$1.000.00 or fraction thereof,to and
including$25,000.00
(4)$25,001.00 to$50,000.00
(4)$504.00 for the first$25,000.00 plus 11300 for each additional$1.000.00 or fraction thereof,to and
Including$50,000.00
(5)$50,001.00 to$100,000.00
(5)$829.00 for the first$50,000.00 plus$9.00 for each additional$1.000.0O or fraction thereof,to and
including$100,000.00
(6)$100,001.00 to$500,000.00
(6)$1,279.00 for the first$100,000.00 plus$7.00 for each additional$1,000.00 or fraction thereof,to and
induding$500,000.00
(7)$500,001.00 to$1,000,000.00
(7)$4,079.00 for the fist$500,000.00 plus$6.00 for cadr additional$1.000.00 or fraction thereof,to and
induding$1,000,000.00
(8)$1,000,001.00 and up
(8)$7,079.00 for the first$1,000,000.00 plus$4,SO for each additional$1.000.00 or fraction thereof.
Bold number Is the base fee for the spedfed Increment
JXa//dzed underffned number Is the fee Der add!tfonat wedfed 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,commerdal 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**
syr^ ■ BUILDING
PROPOSED VALUATION: +J
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)
,O
PROPOSED VALUATION: 2--34,s(r
FEE FACTOR FROM TABLE A:Number: (a)Base Fee:
(b)Additional Increment Fee:
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5)
• ■ 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)
■ PLUMBING •
Base Fee Number of Fixtures
$26.00+{ X$9.00/fixture}= (8)Estimated Permit Fee
Estimated Permit Fee
X .65= (9)Estimated Plan Review Fee
Miscellaneous Fixture Charge:(10)
' 1
Sub Total (Page one): tine(s)(1)+(2)+(3)+(4)+(5)+(6)+(7)+(8)+(9)+(10)= (11)
• EL CTAICAL
TABLE B ,,
NEW RESIDENTIAL SERVICES MOBILE HOMES MISC EQUIPMENT/TEMP SERVICES
_Single Family _Service or feeder only . -.. $57 00 _#of Thermostats(First-$43 00,add'n-$13 00ca) '
(First 1300 f11-$85 50,Each add'n 500 ft2-527 50) _Service and feeder . ... . 593 00 _#of Low voltage fire or burglar alarms
Square Feet. First 2500 ft-$50.00.Each add'n 25(10 ft`-$13 00
Each outbuilding or garage- $35 50 MOBILE HOME/RV PARK Square Feet-
_
(Inspected with service) _#of service or feeders ` Pcr WAC 296-46-9 I 0(5)(b)(i&ii)
_Each outbuilding or garage....-_. . . ... .$57 00 (First service/feeder-$57.00,Add'n service/ _#of Signs(First sign-543 00,add'n sign
(Inspected separately) feeder-537 each) $20 00 each)
Swimming pool,hot tub,spa 585 50
1 _Yard Pole meter loops $57 0(
I i
NEW MULTI-FAMILY COMMERCIAL/INDUSTRIAL COMMERCIAL/INDUSTRIAL
(Includes three units or morel Altered Service or Feeders
Service Feeder Amps Service or Add'n 0 to 200.. --- -- 3 93 00
_Up to 200 amp . - 5 93.00. . ...$ 27 50 Feeder _201 -600....._ . ... .. . 216.50
_201 -400 amp 115.50.. ._.. .57.00 _0 to 100..... ._. ... 5 93 00 $ 57.00 _601 - 1000.... ... . 326 50
_ p _ _ 363 00
401 -600 ant 158.50 78.50 101 -200 115.50..........72.50 over 1000
_601-800 amp 202.50 108.50 _201-400................... 216.50 85.50 _#of circuits
_Over 800 amp ...........289.50............ 216.50 _401-600... . ...... ... 252.50 101.00 (1-5 circuits-$72.50:Add'n circuits,$6 eat
ALTERED SINGLE/MULTI FAMILY _601-800 326.50 138.00
(When inspected separately front the services.) _801-1000 399.00 166.50 TEMPORARY SERVICE
Service or Feeder _Over 1000 434.50 232.00 Residential/Multi-Family/Commerciai/Industrial
_0 to 200 amp $ 71.50 _Over 600 volts surcharge 72.50 _0-100 $ 57.00
_201 -600 amp 115.50 _Mast or meter repair 78.50 _101 -200 72.50
_over 600 amp-.. ..-.. 174.00 _201-400.......... ........... . .. 85 50
—Mast or meter repair . .. . . ..... .... . 43.00 _401 -60011S i 50
#of circuits _over 600... .. 125 00
(1-4 circuits-557.00,Add'n circuits$6 ea)
If a new or altered commercial service is 200 amps or greater,or a new or altered residential service is greater than 400 amps,a plan review is required Fee is 35%of
permit fee+$72 50 Add'I plan review for other submissions is$85.50/hr
FIXTURE DESCRIPTION(A) FIXTURE FEE FROM TABLE B(B) NUMBER OF UNITS fC) TOTAL(D)
I
1
I ! L
I i
TOTAL COLUMN(D):
Total Column(0)
Estimated Permit Fee: (12)
Estimated Permit Fee from tine 12
Estimated Plan Review Fee: $72.50+( X.35)= (13)
• ■ DEMOLITION - - . •
Estimated Permit Fee: (14)
Bond Amount:(15)
- - •- ■ ENGINEERING . - -.
Estimated Permit Fee: (16)
Bond Amount: (17)
- - ■ OTHER FEES - • -
Mitigation Fee: (18) (20) (22)
SBCC Surcharge: (19) (21) (23)
Total (Pages One&Two): Line(s)(11)+(12)+(13)+(14)+(15)+(16)+(17)+(18)+(19)+(20)+(21)+(22)+(23) = (24)
1
• Bulletin #100—December 23, 2002