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01-101192 City of Federal Way Community Development Services Mechanical Permit #:01 - 101192 - 00 - ME 33530 1st Way S Federal Way,WA 98003-6210 Plr 253 661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: JOHNSON Project Address: 1820 S 285TH UnitC 63at s . Zg5 tt: pj It) Parcel Number: 327614 0030 Project Description: MEC-Install(1)pellet stove in existing dwelling unit. Owner Applicant Contractor Dean 0 Johnson Dean 0 Johnson Dean 0 Johnson 17431 AMBAUM BLVD S#C8 17431 AMBAUM BLVD S#C8 17431 AMBAUM BLVD S#C8 SEATTLE WA SEATTLE WA SEATTLE WA 98148-1733 98148-1733 ? 1.2:7 71-o - 26t Mechanical Valuation 2117 Over the Counter Permit Yes Mechanical Fixtures Description Quantity Description iQuantity Description Cliaritity Woodstoves 1 PERMIT EXPIRES September 24,2001,IF NO WORK IS STARTED. Permit issued on March 28,2001 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: Date: -: ecdk, ,A_& ( (,/z 6 - cpleoeiveo CRYOf = CONSTRUCTION PERMIT APPLICATION VV fZY APPLICATION NUMBER: (D C - ( O ( (�'Z- IANg APPLICATION NUMBER: - 0.014°DEPT' APPLICATION NUMBER: - i **The following is 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: ;gay S ASSESSOR'S TAX/PARCEL #: L -D 650 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ■ PROJECT INFORMATION . TYPE OF PROJECT(This application): ❑ BUILDING U PLUMBING U MECHANICAL ❑ DEMOLITION U ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): 1Q(e7°' 52& - 'PROJECT NAME: '■ PEOPLE INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE: VE44' -3"oN#s'�✓ ( & b)3,3 - 3 efi0 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): (-75! s a as-cg- /ED, froL-- w19 k/ (j4 ci i?o G CONTRACTOR: NAM��E::��+ PP�� DAYTIME PHONE: MAILING ADDRESS(STRE6701Ef (MO) ADDRESS; ,ZIP (Vf y7 - 86/Z 8113 OpgT" i 4 444,'i 2a3 '8 ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: CO CTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) APPLICANT: NAME: DAYTIME PHONE: `�. peel."/ -�a�}�.$ r'/ ( � )X35`3- 3�ZU MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: I °`'' s yr L_ k -C ce.;Ocv,1/ gs©a3 (20)9-e( -l3i RELATIONSHIP TO PRO)ECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) - I E-MAIL ADDRESS: • CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY 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 U HIGHLINE ❑ PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ _ ■ PROJECT FLOOR AREAS iI 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) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC Cl GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ 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 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: 42 7b/ ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR 1 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 (YIMMtwrry nFVFI nPMFNT SFRVICFS•33530 FIRST WAY Sill TH•P n ROY 9718•FFDFRAL WAY.WA 98063-9718•253-661-4000•FAX- 753-F,61-4179 ,' 6 . 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$100.00 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 additional$1,000.00 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 additional$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 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$1,000.00 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 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$1,000.00 or fraction thereof. Bold number is the base fee for th,specified increment Italicized,underlined number is the aer 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) PROPOSED VALUATION: i/J 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 $21.00+{ X$7.00/fixture}= (8)Estimated Permit Fee Estimated Permit Fee X .65 = (9) Estimated Plan Review Fee Miscellaneous Fixture Charge:(10) Sllh Total (Paneonel: Line(s)(11+(21+(31+(41+(51+(Fl+(71+(81+(91+(101 = (11)