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01-102988 City 1f Federal Way• CoRsttunity Development Services Mechanical Permit #:01 - 102988 - 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: EDMISTON j J ' Project Address: 32314 11TH/SW Parcel Number: 926493 0210 Project Description: MECH-Changeout gas hot water heater in existing residence. Owner Applicant Contractor Ronnel M&Nancy A Edmiston Ronnel M&Nancy A Edmiston Ronnel M&Nancy A Edmiston 32314 11TH AVE SW 32314 11TH AVE SW 32314 11TH AVE SW FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA 98023-5554 98023-5554 (253)874-5532 Mechanical Valuation 675 Over the Counter Permit Yes PERMIT EXPIRES January 26,2002,IF NO WORK IS STARTED. Permit issued on July 30,2001 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 iWay. Owner or agent: /{ i aacc -sre Date: r � /7-1A CEIVED :°f = CONSTRUCTION PERMIT APPLICATION ELIVV En".�lIL- JUI 3 ® `�©®l APPLICATION NUMBER: <DC -61�1-d F - , - ` Y APPLICATION NUMBER: o0`tCIT OF FEDERAL WAY BUILDING DEPT. APPLICATION NUMBER: � - - �, **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: 3,9319 /P 4o 5'W ASSESSOR'S TAX/PARCEL #: - 40AL,2440 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ■ PRO3ECT INFORMATION TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIIPTIOON�N(Provide detailed description): t (9-t4 fza eza L PROJECT NAME: CV /SnTiti ■ PEOPLE INFORMATION PROPERTY OWNER: NAME:n DAYTIME PHONE: /lohLne / 14- Eo(1.14 t 0 IN (9- ) �7(( - C 3� MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): CONTRACTOR: NAME: DAYTIME PHONE: v1a;Y,cV ( ) MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: ( ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: ( ) CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) APPLICANT: NAME: DAYTIME PHONE: 1..?of L' `r ( ) MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: ( ) RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) 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 ❑ HIGHLINE ❑ PRIVATE(SEPTIC) 1 J l **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ 1J . ■ PROTECT 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) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC XGAS 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: 1� A- DATE: 7/30/0/ ❑ 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 mMMI mime nFVFI OPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000-FAX:253-661-4129 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 plus33.77 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) PROPOSED VALUATION: �� 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) Sub Total (Pane noel: Line(c)(11+(71+(31+(41+(51+(61+(71+(81+(91+(101 = (11)