02-101032` City of Federal Way
G%nunity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: TERIYAKI HOUSE #3
Project Address: 1608 SW DASH POINT
Project Description: ELE - Install (1) thermostat.
Electrical Permit #:02 - 101032 - 00 - EL
Inspection request line: 253.835.3050
Parcel Number: 122103 9074
Owner
Applicant
Contractor
AUDREY/SYDNEY IRMAS CHARITABLE F(
SYSTEM HEATING & A/C CO., INC
SYSTEM HEATING & A/C CO., INC
20206 72ND AVE S
9410 DELRIDGE WAY SW
9410 DELRIDGE WAY SW
KENT WA 98032-2322
SEATTLE WA 98106
SEATTLE WA 98106
(206)762-4249
Electrical Fixtures
Thetnostat I
PERMIT EXPIRES September 4, 2002, IF NO WORK IS STARTED.
Permit issued on March 8, 2002
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: 3--
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LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROIECT INFORMATION
TYPE OF PROJECT (This application):❑ UILDING ❑PLUMBING 11 MECHANICAL El DEMOLITION
OLECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
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NAME: j� �J �DAYTIME PHONE: l�
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MAILING ADDRESS ET ADDRESS; QTY, STATE, ZIP):
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NAME
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DAYTIME PHONE:
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MAILING AO RESS (STREET ADDRESS;
QTY, STATE,
EVENING PHONE:
-
CITY OF FEDERAL WAY BUSINESS LIQ:NS MBER: 00 _
FAX NUMBER:
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7-u 6) 7 V3 - G9C1
CONTRACTORS REGISTRATION NUMBER
EXPIRATION DATE:
c�PY
13-T
/ /
0( card req—ed)
NAME .�
MAILING ADDRESS (STREET ADDRESS; QTY, STATE, ZIP):
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
EXISTING USE:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $.
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? N YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** '
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT..
PROPOSED . Fr.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNITS)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEMS)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINAL(S) WATER HEATER(S)
RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINKS) WATER CLOSET(S) MISC. ( )
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:
❑ PROPER OWNER
❑ APPLICANT CONTRACTOR
DATE: 3 (9 Vy
COMMUNITY DEVELOPMENT SERVICES - 33S30 FIRST WAY SOUTH - PO BOX 9718 - FEDERAL WAY, WA 98063-9718 - 253-661-4000 - FAX: 253-661-4129