01-104078City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph:253,661,4000 Fax:253.661,4129
Plumbing Permit #:01 - 16.4078 - 00 - PL
Inspection request line: 253.835.3050
Project Name: COOPER , \
Project Address: 34824 14'I AW Parcel Number: 542242 0380
Project Description: PLUMB - Electric hot water heater changeout in existing residence.
Owner
Applicant
Contractor
Charles C & Judy M Cooper
ACTION WATER HEATERS ONLY INC
ACTION WATER HEATERS ONLY INC
34824 14TH PL SW
12704 NE 124TH ST SUITE 43
12704 NE 124TH ST SUITE 43
FEDERAL WAY WA 98023-7020
KIRKLAND WA 98034
KIRKLAND WA 98034
(425) 820-8848
Plumbing Fixtures
Descri tion Quanta Description Quantity Description guantit
Water Heaters 1
PERMIT EXPIRES April 21, 2002, IF NO WORK IS STARTED.
Permit issued on October 23, 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:
crtr�--- RECEIVED BY
or
_ Cp�e•l •Ir„ OPN1E14T❑Fh pPIR' f-"'t--ONSTRUCTION PERMIT APPLICATION
1?V � RECEIVIM:EwO 200t PPLICATION NUMBER: (� _ - _ (�-7S - _ I �-
CdMMUN TY nF-VELOPMENT DEPARTMENT APPLICATION NUMBER: -
OCT 15 2001 APPLICATION NUS
"The following is required information — Please Niniti errlFC} ,rTAp� TOFPARTMF.NT~
Please note: Electrical, Fire Prevention Systernprd,nd Engineering permits maQPT i?e3 20D-Ite application.
PROPERTY
u r` �} INFORMATION
SITE ADDRESS: 344 ��"� `f� , v ASSESSOR'S TAX/PARCEL #:.JC
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING PLUMB ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): ` A C V I�
PROJECT NAME:
;` ■ PEOPLE INFORMATION
CONTRACTOR:
APPLICANT:
IVHI"IC: ` ,
Vl .
I
MAILING �00.�57$ (STREET ADa3�
NAME: '
MAILING ADDRESS(ST
-7 j
CITY Of FEDERAL WAY
CONTRACTOR'S REGISI
(Copy of card required)
NAh4E
C�,ISTATE, ZIP);
,� 0L- 5
• ADDRESS; plY, A7E:
CNESS LJCENSE NUMBER:
NUMBER:
F ct7 di-, W Q4-e r k)z
MAILING ADDRESS (STREET ADDRESS; CITY, STkTF, ZIP):
IF k Oo� �-
vs--e -
RELKnONSHIP To ❑ PROJECT:
ARCHITECT ❑ TENANT 2fOTHER ( DESCRIBE):l llyl��_
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT XCONTRACTOR
,.., c �._' : ; _. ■ DETAILED BUILDING INFORMATION
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED VALUATION FOR IMPROVEMENTS: S�
DAYTIME PHONE:
(ZS3)93$-
DAYTIME PIIOlf(N�Z: ����
(41F)L(f - UV
EVENING PHONE:
(
FAX NUMBER:
(OAST' ?-L6- 7&N L
EXPIRATION DATE:
f_ 31 io �
DAYTIME PHONE:
EVENING PHONE:
(
FAX NUMBER:
E-MAIL ADDRESS:
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
'=:. ■ PROJECT FLOORAREAS .
FLOOR
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
GARAGE
HOW MANY FLOORS?
TOTAL:
• Y•��.` , .4 ry ■ �f FJit"1UREQ " - .. , �.: ;I F - ^� 1:' - - -
AIR HANDLING UNITS)
BBQ(S)
BOILER(S)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINK(S)
SUMP(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S)
FAN(S)
FIREPLACE INSERT(S)
FURNACE(S)
GAS PIP-E'0T1TLTe 1(5i-----�
PLUMBING
URINALS) � I WATER HEATER(S)
VACUUM BREAKER(S) (ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. { )
GAS LOG(S) REFRIG. SYSTEM(S)
HOOD(S) WOODSTOVE(S)
RANGE(S) MISC. ( }
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
'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
nas�a part of this application.
NAME/TITLE: 1 _ DATE: a
❑ PROPERTY OWNER ❑ APPLICANT l.L_ 0NTRACT0R
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE:
LOT SIZE:
ZONING DESIGNATION!
OUILDING 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
I—"- nnn,rnrr "n"T(-F-c . -111�-10 1:I01T U/AY MIm4 . o n nnv n71n . FmFRAI WAY WA QR7r,7-971R • ?,7-C)CIAOAO . PAY- 75-1_Fr1-417Q
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 1500.00
(1) $24.25
(2) $501.00 to $2,000.00
(2) $24.25 for the first $500.00 plus
fraction thereof, to and including 42,000.00
(3) $2,001,00 to $25,000.00
(3) $71.46 for the first $2,000.00 plus f15.00 (w i?xh alkllfirxw13L0LYLCdO
or fraction thereof, to and including
$25,000,00
(1) $25,001.00 to $50,000.00
(1) $403.61 for the first $25,000.00 plus 510.8 kreaeh adknnr t i1,000.0D
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 57.59Ifar.eiXh. i&lUbn,3[SLQG(2A7or
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 56.QQ for each �A'j22A
tl0A7.U0 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 S5.09f0P each dW.Lh2v 9
f1.000.000r 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 S3.91 foreach addiNonal
$1,000,0 or fraction thereof.
Bold number is the base fee for the specified increment
Italicized 9r1 rlirrtd number iS�hg £�a�di[ftglWOL��ACrPmCrrt
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 439 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 **
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:
Estimated Permit Fee: (4)
(a) Base Fee:
(b) Additional Increment Fee:
Estimated Plan Review Fee:
- .. ■ FIRE PREVENTION SVSFEM :>z�• ;r.ry�, k_ ..-..::., _
PROPOSED VALUATION:
FEE FACTOR FROM TABLE A: Number:
Estimated Permit Fee:
Estimated Plan Review Fee: (7
Base Fee Numt r of Fixtures
$21.00 + { I X $7.00/fixture} _
Estimated Permit Fee
X .6S =
(a) Base Fee:
(b) Additional Increment Fee;
/ T D O (8) Estimated Permit
(9) Estimated Plan Review Fee
Miscellaneous Fixture Charge: (10)
Sub Total (Par,eone): Line(s)O)+(2)+(3)-r(4)+(S)+(6)+(7)+(a)+(9)+(10) = (11)