07-104603Is
City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical Permit #: 07 -104603 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: DOMINO'S PIZZA
Project Address: 1426 S 324TH ST Suite A108 r Parcel Number: 150050 0080
a L.
Project Description: Installation of IN communication cable
Owner
Applicant
Contractor
HARSCH INVESTMENT PROPERTIES
DIAMOND COMMUNICATION
DIAMOND COMMUNICATION
851 SW 6TH AVE SUITE 550
24830 SE 224TH ST
DIAMOCI9880J (9/11/08)
PORTLAND OR 97204
MAPLE VALLEY WA 98038
24830 SE 224TH ST
MAPLE VALLEY WA 98038
Additional Permit -;Information
Electrical Fixturbs
Low Voltage - Other Commercial.. 1,000
PERMIT EXPIRES Thursday, August 14, 2008
Permit Issued on Monday, August 20, 2007
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:2 --0%
FINALED
I
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 07 -104603 -00 -EL
Owner: HARSCH INVESTMENT PROPERTIES
Address: 1426 S 324TH ST Suite A108
FEDERAL WAY, WA 98003-8444
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order
as possible (read left to right, top to bottom). Please schedule
inspections as appropriate. Work must not
be covered until it is approved. Check with your
inspector if
you are unsure about any of the inspections or the
inspection sequence. On-going inspections
are logged on the back of this card.
❑
Slab/Concrete Floor (4255)
❑
Ditch cover (4030)
❑
Pool Bonding (4195)
Approved to place concrete
Approved
Approved
By
Date
By
Date
By
Date
❑
❑
Temporary Power (4275)
Service (4235)
❑
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
14 By
Date
By
Date
❑
❑
Rough Electrical (4225)
Ceiling Cover (4020)
❑
Final - Electrical (4055)
Approved
Approved
Approved
By
Date` 'Y''�P 7
By
Date -111B
G Date
❑
UFER Ground (4295)
Approved
By
Date
For rector reference only _
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
In
vEQ
My. A � Federal Wa 2 -LO � (F- `�
Way �u�] PSE RM IT SF MF CO ME L L DE EN FP
COMMUNITY DEVELOPMENT SERVICES
33325 8TM AVENUE SOUIH • PO BOX 9718
FEDERAL WAY, WA 98063-9718 m
253-835-2607• FAX 253-835-2609
u wu_cihnd(edrrahnau.eom
The following is required information - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS I q4 LGA- ) • �� S� SUITE/UNIT #
ASSESSOR'S TAS/PARCEL # 16 O CL� D - J _o Q 2 0 LOT SIZE (Sp
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Aaach separate page,(or left legal descN uwv
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this Permit onlu)
T—1 n St c-
PROJECT NAME (Name of Business or Owner Last Namel (yyn i Y-) 0 ` , U� Z Z ck
PEOPLE•• •
PROPERTY
OWNER
CONTRACTOR
COPY of card required
with yKp application
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME PRIMARY PHONE
( ) -
MAILING ADDRESS CITY. STATE, ZIP E-MAIL ADDRESS
COMPANY NAME �o
APPLICANT NAME
OFFICE PHONE
but- ul-A CG MvYt�u���CL�iU�tS lw
CITY. STATE, ZIP
(tf25 )�/3-(rcu'�
MAILING ADDRESS /
D C i , t& X LC'
CITY, STATE, ZIP
i 6 C-'( L � 1 (? ftp 2.5
CELL PHONE
( ) -
CITY OF FEDERAL, WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
cr5 7
CONTRACTOR'S REGISTRATION NUMBER
EXPIRAT70N DATE
E-MAIL ADDRESS
�s W m c7 c r c��
`��� � /c� �
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY. STATE, ZIP
/CELL PHONE
l ) —
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant o Agent ❑ Other
FAX NUMBER
( ) -
NAME PRIMARY PHONE E-MAIL ADDRESS
V�' CU q3,' < 1 :1
NAME
Per RCW 19.27.095:
Lender irtformation is required (f project value exceeds $5,000
MAILING ADDRESS
CITY. STATE, ZIP
PHONE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER o LAKEHAVEN o HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER o LAKRHAVEN o HIGHLINE o PRIVATE (SEPTIC)
l
I
PROJECT'
AREA DESCRIPTION
AREAS
RAINWATER SYST
VACUUM BREAKERS
EXISTING
FT.
PROPOSED
S . FT.
TOTAL
SQ. FT.
BASEMENT
SUMPS
BUILDING SHELL ONLY? ❑ YES ❑ NO
BASIC PLAN?
FIRST
❑ NO
ZONING DESIGNATION
SECOND
❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
THIRD
❑ YES
❑ NO
PLATTED LOT? ❑ YES ❑ NO
ADDITIONAL FLOORS (DESCRIBE)
❑ YES
❑ NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
raoeos®
ror�
7orwce�wosr
rorwcrxorosmsr
rorwcsr
•`NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of future to be installed or relocated as part of this project. Do not include existing fbtures to remain.
Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS HOODS (commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
BATHTUBS (or Tub/Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
LAVS (Bathroom Sinks)
URINALS MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
SHOWERS
WATER CLOSETS rrouet)
SINKS
WASHING MACHINES
SUMPS
BUILDING SHELL ONLY? ❑ YES ❑ NO
I cert(jy under penalty of perjury that the irtformation furnished by me is true and correct to the best of mg 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,}iled against the City of Federal Way, but only where such claim
arises out of the reliance of the city luding its =he accuracy gf the irtformation supplied to the city a part of
this application.NAME/TITLE?DATE l
(Signature) (Wile)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent -)6- Contractor ❑ Architect ❑ Other
FOR OFFICE USE ONLY
❑ NEW ❑ ADDITION
❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
BASIC PLAN?
❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP/SEPA/SU?
❑ YES
❑ NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
❑ NO
Bulletin #100 - April 2, 2007
Page 2 of 4
k\Handouts\Pennit Application