01-103446 City of Federal Way ..
Community Development Services Mechanical Permit #:01 - 103446 - 00 - ME
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: QUON
Project Address: 1216 SW 346TH 5t Parcel Number: 666490 0030
Project Description: HVAC-Replacing gas water heater
Owner Applicant Contractor
Clement T F&Muriel L Quon ACTION WATER HEATERS ONLY INC ACTION WATER HEATERS ONLY INC
808 CONSTITUTION DR ACTION WATER HEATERS ONLY INC ACTION WATER HEATERS ONLY INC
FOSTER CITY CA 12704 NE 124TH ST SUITE 43 12704 NE 124TH ST SUITE 43
94404-1802 KIRKLAND WA 98034 (425)820-8848
Mechanical Valuation 1818 Over the Counter Permit Yes
PERMIT EXPIRES February 27,2002,IF NO WORK IS STARTED.
Permit issued on August 31,2001
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:,//" t � �� Date: 'F/' ; /U(
7/2 6 /1/ 14
a
Mechanical rough-in: Date:
Gas pipe: Date:
FINAL MECHANICAL: Date: /O///°Y
. •
t
Lai;Of
`— REGENE05FPAR ,5-- CONSTRUCTION PERMIT APPLICATION
VV L COMMUNITY'�E LOFME200� APPLICATION NUMBER: 6 L - Lu 3 q - _
COMMUMIYDE ELOPMDENBT7EP RT MNT APPLICATION NUMBER: - -
a''(; 1 1 APPLICATION NUMBER: - -
*Ne collo s 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: I2 1 t..e Su) 3 '(g K 3--V. ASSESSOR'S TAX/PARCEL #:64 ,0-V O
i�
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- - ■ PROJECT INFORMATION . . - . . .-
TYPE OF PROJECT(This application): ❑ BUILDING u PLU :BINE N P•9EC;IANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): (?-{i14 c. e lti41 (.c_J r 14,,L,---
PROJECT
4c rPROJECT NAME: LW 1 ) e0.e ,/ MC IJ
- - - ■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
G�2w—ew1- a QOb.. r.1 Q o fr. (zs3 ) ei.-( - Co<1
MAILING ADDRESS(STREET ADDRESS;CITY,STAT ZIP):
) 2.1(0 w 3 c-f(Q--L S 4-. 1'. Le.- 1 1•04-7 10c—. ?iv 2 3
CONTRACTOR: NAM : I q ' I DAYTIME PHONE:
vt►uh l c�a.•�{r 1t-CejerS cowl (�lzc) 2,- fs�CSic�
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): ( EVENING PHONE:
127 Dy J )1: )2. 9 \.. Sulo,_ y3 Kien( 14A /k031( ( ) -
CITY OF FEDE L WAY BUSINESS LICENSE NUMBER: _ FAX NUMBER:
II -9S--logj t, -oo-"t3 - -- - -- - ( Y2-c ) 8to - ?.814,
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION HATE:
(copy of card required) A L A- 1 a h) g Q S D_ - 12 / 311 /2-4)0)
APPLICANT: NAME: DAYTIME PHONE:
Ac4 1,...)4-c,- }-}-�.A-mss Ov k (4h5) S20 -ggy
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,1ZIP): ��// / J EVENING PHONE:
)170‘( ME-
To E- 72-09- s-\- •`"y� ki, �A..4(ECT: 1 WA_1 9io3y ( ) -
FAX NUMBER:
❑ ARCHITECT ❑ TENANT [A-OTHER(DESCRIBE):( TQt.4oa. ( ) -
V
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: PERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
' - _ ■ DETAILED BUILDING 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 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** .
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■-PROJECT FLOOR AREAS - -
FLOOR EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
-THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
'FIXTURES _
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) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)AT�
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC R AS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
• -r= ;' ■ •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 defe - • s+€h - -'m),which may be made by any person,including the undersigned,and filed against the City of
Federal Way, , •nly where such m arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the inf• ation supplied • e city as a part of this application.
NAME/TITLE: , DATE: s
Cl PROPERTY OWNER ❑ APPLICANT [YJ 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
r'nnMn1i rnrrry nr-.rr nnn1rnrr crr'nr'rc. FIP'T WAY gni mni.P n Rr1X 071 R•rrnFPAl WAY WA 98061-9718•251 661-4000•FAX• 751-F6l-4179
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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$3.27 for each additional S100.00 or fraction thereof,to and including$2,000.00
(3)52,001.00 to$25,000.00 (3)$71.46 for the first$2,000.00 plus 51500 for each additional 51.000.00 or fraction thereof,to and including
$25,000.00
(4)$25,001.00 to 550,000.00 (4)$403.61 for the first$25,000.00 plus$10.82 for each additional51,000.00or 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 S7.50 for each additional$1,000.00 or fraction thereof,to and including
$100,000.00.
(6)$100,001.00 to$500,000.00 (6)$1,025.55 for the first$100,000.00 plus$6.00 for each additional SI 000.0Q or fraction thereof,to and including
$500,000.00
(7)$500,001.00 to 51,000,000.00 (7)$3,337.23 for the fist$500,000.00 plus 55.09 for each additional$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 additional 51.000.0004-fraction thereof.
Bold number is the base fee for the specified increment
Italicized,underlined number is the fee per additional specified 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**
. =.- ■.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)
1111.17
111131:2711.111111111111111.1111111111111111111111111111111111111M
PROPOSED VALUATION: /5 70 7
FEE FACTOR FROM TABLE A: Number: ' (a) Base Fee: CrZY`25(b)Additional Increment Fee: `11 C41 a 45. I b
Estimated Permit Fee: (4)
Estimated Plan Review Fee: (5) if 7 d '3 4' C91 '35/
_- .-.., _.- _ . - ■ 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 - -- - -
$21.00 +{ X$7.00/fixture) = (8)Estimated Permit Fee
Estimated Permit Fee
X .65 = (9) Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
Sub Total (Paieone): Line(s) (1)+(2)±(3)i-(4)+-(5)+(6)+(7)+-(8)F(9)+(10) = (11)