01-102375 !City of Federal Way Mechanical Permit #:01 - 102375 - 00 - ME
Community Development Services
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: POWERS
Project Address: 2507 SW 323RD 51- Parcel Number: 873180 1050
Project Description: HVAC-Electric to gas furnace changeout
Owner Applicant Contractor
Leo A Powers ADVANCED FILTER AND MECHANICAL ADVANCED FILTER AND MECHANICAL
2507 SW 323RD ST 418 VALLEY AVE NE 418 VALLEY AVE NE
FEDERAL WAY WA PUYALLUP WA 98372 PUYALLUP WA 98372
98023-2520 (253)770-2440
Mechanical Valuation 3468 Over the Counter Permit Yes
Mechanical Fixtures
_ , Quanta ' : �iD'scri{#ion' ds. iQua'htitj
Descrl p..tion - �Q fitl � �. es�cri•tion x .��%j,
Furnaces I 1
PERMIT EXPIRES December 11,2001,IF NO WORK IS STARTED.
Permit issued on June 14,2001
I hereby certify that the above information is correct an at theynstruction on the above described property and
the occupancy and the yge will be in accordance wi laws, les and regulations of the State of Washington and
the City of Federal Way. i
Owner or agent: /�/ 4. b?' Date:
Mechanical rough-in: Date:
Gas pipe: Date:
At----(/FINAL MECHANICAL: Date: V7/,/1
ig
CIT•C.F CONSTRUCTION PERMIT APPLICATION
� APPLICATION NUMBER: o_t - 1 O S -Q
APPLICATION NUMBER: - -
,itw APPLICATION NUMBER: - -
Vii►i dgL l c*towing is required information—Please print(in ink)or type**
Please note: Electrical, Fire Preventi•n S stems and Engineering permits may require a separate application.
F' PROPERTY INFORMATION
SITE ADDRESS: J 0-7 5 c,7 •c `Z- ark- ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
14 PRO]ECT INFORMATION
TYPE OF PROJECT(This application): ❑ B LDING ❑ PLUMBING KMECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGIN�EERINGp`❑ FIRE PREVENTION SYSTEM
}
PROJECT DESCRIPTION(Provide detailed description): 771------.1.3 C>p�\\-2S. 't 12-•<-<12-•<-< e c} 1
PROJECT NAME: L e -4 c ) -11,, -C tan� -.
Pal PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
L,e__,E) -4r- — Q Z (7-.5 ) 5,.x7 - /oa 3
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
1�Co 7 3 c_a: 32:s Czaz, c,-k---
CONTRACTOR: NAME: DAYTIME PHONE:
PfS>3 s 4- 62 (X15 )770 - ayt(O
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
y r u.�k.� -ilv-L_ Q-- -0_ .,.J 1D ( ) -
CITY OF FEDERAL WAY BUSINESS UCE MBER: FAX NUMBER:
- - ( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) Pi-Ai�$)F-Y\Z_Ly 2_i _ / /
APPLICANT' NAME: DAYTIME PHONE:
/ c24€--) (j ( )
MAILING RESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
kv ..-y� 'tJ .-cam ( )
RELATIONSHIP TO ROJECT: `J FAX NUMBER: I
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): (r ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
ki DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ -
c ,
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS 3 ita.&-`
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
Pik
. •
**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:
11111111111111111.11111111111111111102=1111111.1111111111111111.1.11111111111
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) O
DUCT(S) / GAS PIPE OUTLET(S) g HEAT SOURCE: ❑ ELECTRIC 7-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)
-•:1 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 defen such claim) inch may-pe made by any person,including the undersigned,and filed against the City of
Federal Way,but o where'such clai arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the informatie sup lied o the ci
as part of this pplication.
NAME TITLE: //�i%
Ay/ � /1;:),„0,LDATE: / Y 0/
❑ PROPERTY OWNER ❑ APPLICANT ❑ 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
rnwnnm Inir�v n r-vri nPMFNT SFRVICFS•TTSln F1RCT WAY cnnTH.P!l RnW Q71R.FFIIFRAI WAY WA 9Rf)6 -971R•76 -ff,1-4nnn•FAY- 7C7-(.(1-4179
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 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)
1111111111.11111111111111111111111.11111111111
PROPOSED VALUATION: ' <3;f
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)
ciihTotal rn,.,..n„,'i' line(c)(11+(7)+/11+(41+(c1+(F,1+(71+(R1+(91+(1(11 = (111