05-102006 City of Federal Way Electrical Permit #: 05 - 102006 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: DEVONSHIRE LOT 22
Project Address: 36119 10TH SW Parcel Number: 202100 0220
Cr
Project Description: T-stat wiring
Owner Applicant Contractor
NORRIS HOMES INC AIR SUPPLY SYSTEMS INC AIR SUPPLY SYSTEMS INC
10516 172ND CT SE P.O.BOX 331 P.O.BOX 331
RENTON WA 98059 BUCKLEY WA 98321 BUCKLEY WA 98321
(360)829-5384
Electrical Fixtures
Description Quantity Description !Quantity Description Quantity
Thermostat 1
PERMIT EXPIRES October 29,2005.
Permit issued on May 2,2005
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 acc with the laws,rules and regulations of the State of Washington and
the City oZWa
ederal y.
Owner ent: / `��G�`✓ Date: O Z v s/
THIS CARD IS TO REMAIN ON-SITE
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-102006-00-EL
Owner: NORRIS HOMES INC
Address: 36119 10TH CT SW
FEDERAL WAY, WA 98023
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.
O Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
[l Rough Electrical (4225) ❑ Ceiling Cover(4020) I.4 Final-Electrical(4055)
Approved Approved Approved
By 0_ ,..r Date 5 ,m,..,,e. By Date By kir' Date I 0
❑ Under-slab groundwork(4295)
Approved
By Date
I
APR-28-2005 01 :37 PM Air SuPPI9 Systems 360 829 3584 P. 04
• f x V&O RECE1VFD 0 '5T- _0 360 _&
CFederal Way PERM ITr
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957435.407.FAX 957475.1401 Ift
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M PROPERTY INFORMATION
BITE ADDRESS 7 LP) 113 10 k CT $WFed way qtraa 3 suns/vier# . _
ASSESSOR'S TAX/PARCEL Z. 0 2• / O O - 0 2 Z- O LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates, Lot 1)
!AIWA+W.fe INK Pff#0.101y IV.I/.IMNbN
MI PROJECT INFORMATION
TYPE OF PERMIT O BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION Z ELNCTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
PROJECT NAME(Name of Business or Owner Last Name) Po r r I S 4044e$ e V or 5 ,`ire De
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER A/O r'rt s orvte C2oc0 )49.-7 5 - Kim.
MAILING ADDRESS CITY,STATE,ZIP
,205 3 fat,ixi, Dia rt1cecer I s wA q oq o
CONTRACTORZi MPA A APPLICANT NANE OFFICE PHONE
Su((QQ 11 Clads In 5 -. ei o)8a9 -53SI
LINO ADDR ,STATE,ZIP CELL PHONE
$ir-
OB 23I �y �i� 9'd'3ai ?53)33 . - zzzy
-ant or IEDARAL WAY BUSINESS LICENSE NUMBER EXPIRATION D FE ' FAX NUMBER
D - p -1 0 g D L-a )Z ' 3/ / OS ( ) -
CONTRACTOR'S REGISTRATION NUMBER(copy of cud rebleed with cult applicatiOal EXPIRATION DATE
ALgSV 5J9D � BL 0/ / /3 "200-7
APPLICANT COMPANY NAME APPLICANT NAME OFFICR PHONE
cltite a S Corn's-e 76-- ( ) -
MAILINO ADDRESS CITY,STATE,ZIP CELL MIME
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
in Architect o Tenant 0 Agcnt V Qther(Describe) _Qin Mc, 0- ( )
CONTACT PRIMARYt N6 [E.MAILAZIDRESS
ME
U,rK 11c1,c41. (� C'5[c�) � - 5 3 8
LENDER r,:.~ ;, NAfle
MAILINO ADDRESS CITY.STATE,ZIP
• TiETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE f VALUE OP PROPOSED WORK e
SPR NICLERED BUILDING? (3 YES p NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES D NO
WATER SERVICE PROVIDER o LAICEHAVEN 0 RzOSILINE a TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAWERRAVEN o RIG LINE a PRIVATE(SEPTIC( 1
+r �
: • ' PROJECT TLOOR AREAS _ ^_T - -" - - -
AREA DESCRIPTION EXISTING •.PT. PROPOSED -•.FT.
111111611111
BASEMENT .
FIRST
SECOND
THIRD
1a
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT r�i st"a,uo.aow+m
ro:a.>: inns
HOW MANY FLOORS?
"NSW HOMES ONLY" NUMBER OF BEDROOMS
ESTIMATED SELLING PRICE $ - —•—
FIXTURES tIRES
fixtures to remain.
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing f
1NNC1fA1VlCAL .
Value of Mechanical Work Rr.FR1C.SYSTEMS
EVAPORATIVE COOLERS GAS LOGS WO RIG.SYSTEMS AIR HANDLING UNITS ., FANS HOODSic—arii
MISC(Describe)
ES
BOAS FIREPLACE INSERTS RANGES .--�
�- COMPRESSORSORe FURNACES O�WATER HEATERS
DUCTS GAS PIPE OUTLETS
pLVDtRING WATER CLOSETS tf.ukA1 - MISC(Describe)
DIS BATHTUB-1 N*Tuh/ •`••Coml.' SHOWERS DRINKING FOUNTAINS
tT NS
DISHWASHERS SINKS f RAINWATER CYST
CAS PIPE OUTLETS SUMPS RAINWATER
WASHING MACHINES URINALS HOSEEmetlIB WATER HEATERS —.
VACUUM BREAKERS
- DISCLAIMER/SIGNATURE BLOCK{ __ _- . - - - ---
-
" ----
and further,that I
. - u that the information furnished by rue is true and correct to the best
isymade. T knowledge,anti agree to hold
l eeroris d underbypenally of perjury for which the permit application
expenses and attorneys'fees incurred to the investigation and defense of
antaauthorized City
the Federalaof the above premises to perform the work ofFederal Way.but only wherensuch*seclaim
suchclai the City omy bem deWb a yo arson,including thy claim e undersign d,and filed against the Cityart
suis el whre may a fade byit any P u n the accuracy of the information supplied to the city as a p
of
arises out of the reliance of the city,including its officers and employees, lro
this application.
I�1�iW� DATi% Lk-2,,a--OS
NAME/TITLE _ - triol
yContractor D Architect 0 Other_________..—_______
thers _ _
t RELATIONSHIP TO PROJECT a Owner D Agent (J`_ .—
:1FOR-t)FF•ICE•'USE9 '.Y. --- oTENANI IMPROVEMENT
O NEW a ADDITION o ALTS'..'. ION o REPAIR. o S o NO
1 9U>ZLDING SHELL ONLY? o YES ONO BASIC PLAN?CHANGE OF,USE? a YES a NO
ZONING DESIGNATION Up/SEPA/$U? o YES a NO
t NI iii ADDRESS REQUIRED? o YS 0 NO DEMO PERMIT REQUIRED? b YES O NO
PLATTED LOT? o YES 0 NO
P
'
•
Page 2 oro {c�Handouts-Reviscdlltetmit Application
Bulletin 0100-March 30,2004 1
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