01-103209 City of Federal Way
Community Development Services Mechanical Permit #:01 - 103209 - 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: ASHBY
Project Address: 606 S MARINE HILLS WAY Parcel Number: 515292 0030
Project Description: MECH-Replace existing heat pump and air handler in existing single family residence
Owner Applicant Contractor
Allen B&Anne H Ashby NORPAC HEATING&A/C INC NORPAC HEATING&A/C INC
606 S MARINE HILLS WAY 3414 A ST SE SUITE 102 3414 A ST SE SUITE 102
FEDERAL WAY WA AUBURN WA 98002 AUBURN WA 98002
98003-3663 (253)931-0608
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Mechanical Valuation 4000 Over the Counter Permit Yes
Mechanical Fixtures
1. Description ;z1Quantitvl Description (Quantity Description [Quantity
Air Handling Units 1
PERMIT EXPIRES February 11,2002,IF NO WORK IS STARTED.
Permit issued on August 15,2001
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 age''t: ' ` Date: (3 //C51(3-
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Y
_ RECEIVE' _ CONSTRUCTION PERMIT APPLICATION
o, APPLICATION NUMBER: 49 L - / 0 JZ Dgi -00:-44.,6-
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vv RI_ AUe 1 5 2601APPLICATION NUMBER: - -
CITY OF FEDERAL WAY APPLICATION NUMBER: - -
BUILDING DEPT
**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
1381(
SITE ADDRESS: I 0 / I A /I 61 .A II 1/�ASSESSOR'S TAX/PARCEL#: S 1 S Z9z- O O 3�
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
r • PROJECT INFORMATION .
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): , a' U_ A, ck, 0 1111_1 ■ a . I 'a i
PROJECT NAME: i vy
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: (253 )9G� OCJ 1 pI
i
DAYTIME PHONE:
Anw
e, As'*
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
foOCo S. MBArMe 4-1i-ti 0a4
CONTRACTOR: NAME: DAYTIME PHONE:
I\or Pao, HeA,4j v i �- 'old (� )431 - cog
MAILING ADDRESS(STREET ADDRESS; ,STATE,ZIP) EVENING PHONE:
11-1 114 A Si . SE •.i--to to-Z_ A u19LA rvi ( ) - 1
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
Cl 1 Q i g5 ( - OO (253 )g31 - C'/7
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) a Z i A U ,& 1 Z 3 U 5 / /
APPLICANT: NAME: DAYTIME PHONE:
Li 0ds04 H411sp8A-k_ ( )c3( -0-0 S-
2 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
,5l-IH A Si. ,S .4Q_ lO7 AWbc._Ar(^ ( ) -
RELATIONSHIP TO PROJECT: �.� FAX NUMBER:
❑ ARCHITECT CI TENANT .OTHER(DESCRIBE):'�.t1i C /'h OCIC (j,3 )03 I - Obi-1-1
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANTNTRACTOR
•
- ■ 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 ❑ HIGHUNE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: El LAKEHAVEN ❑ HIGHUNE 0 PRIVATE(SEPTIC)
r `
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR07ECT 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) 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 ❑ 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
cityy]as a part of this application. L / l
NAME/TITLF�Y /�/�� ,�� ,���'�{,� I<l k'g theYL( s1 DATE: O81c1/Q
❑ PROPERTY"OWNER APPLICANT COXTRACTOR
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? 0 YES 0 NO
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.$2 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: Nt O O D
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)
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