05-106523 City of Federal Way Electrical Permit #: 05-106523-00-EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: PACIFIC INTERNATIONAL BANK
Project Address: 31827 PACIFIC HWY S Suite B Parcel Number: 082104 9126
Project Description: Install 200-amp panel and wire for HVAC for tenant space.
Owner Applicant Contractor
HARSCH INVESTMENT PROPERTIES LLC EVERGREEN ELECTRICAL SERVICES INC EVERGREEN ELECTRICAL SERVICES INC
HARSCH INVESTMENT PROPERTIES LLC 15103 60TH AVE W EVERGES039KF 5/6/07
1121 SW SALMON ST EDMONDS WA 98026 15103 60TH AVE W
PORTLAND OR 97205 EDMONDS WA 98026
Additional Permit Information
Electrical Fixtures
Service/Feeder: 101-200 amps-Cc 1
CONDITIONS:
•
PERMIT EXPIRES Sunday, June 25, 2006
Permit Issued on Tuesday, December 27, 2005 ,
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the will be in acc -nce lith the laws, rules and regulations of the State of Washington
4. th- J ity of Federal Way.
Owner or agent: ' Date:is7/O.3
THIS CARD IS TO REMAIN ON-SIVE
CITY OF Community Development Inspection Record
;Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106523-00-EL r
Owner: HARSCH INVESTMENT PROPERTIES L
Address: 31827 PACIFIC HWY S Suite B
FEDERAL WAY, WA 98003-5409
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) tij Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date B3� Date a v.dy_ab
•
O Rough Electrical(4225) ❑ Ceiling Cover(4020) /4
Final-Electrical(4055)
Approved Approved Approved
By- • ' Date By Date •• By Q! �7 Date ,
❑ Under-slab groundwork(4295) ;'
Approved
By • . Date • . .
12127/200514: 56 4257
EIVECJ EVERGREEN ELEC SVCS PAGE 01
CPTas 411A'. Y Lam /2 5- 1 •. / ,-3
. rederal Way DEC 2 7 ZoPERM IT MF SF CO M• L DE EN FF
. 1 COMMUNITY nevElo' 7n'sit:�vlcss SF ; •�
,•3530 PIR57 WAY 30UTH•PO BOX 9718
FEDERAL WAY,WA 98063-9718 CITY OF F r u 4 C AT I 0 N
753TO
.661.411,5•PAN293-661.4129 BUIL T. 4,2 / 7 / c.. `
y^U:..,,,,,,,-edcnil con:
The oliouit 'tared ormation-an Inca •lets • - •Iication will not be acee•ted. Please •rint le• bi in in or •e.
CJ PROPERTY INFORMATION
SITE ADDRESS 3/p ii �t� e_ 444/ • ,..co 1 �ram/ tiSUITE/UNIT ft
ASSESSOR'S TAX/PARCEL* . t, „$ ,,,L,00 - / 4 LOT SIZE tsf)
LEGAL DESCRIPTION (e.g Acme Estates, Lot 1) _
(An.ch reporn'e pog.for 41014 legal clesc.tpeon)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING 0 MECHANICAL
❑ DEMOLITION )(ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work in/eluded on jl-i permit only)
I $ add UO• ... /?o .2p- . . s_ :.b G.a,. - .. /-
PROJECT NAME (Name of.Business or Owner Gast Name) £ 4 /4"v t 611‘e
PEOPLE INFORMATION
PROPERTY NAME/
.s C L ` \ i f e z� PRIMARY PHONE -
OWNER ,•J �/ ( I
M IL O ADDRESS CITY,STATE,ZIP ......,_,
- .,,..
CONTRACTOR COMPAtvy NAME APP !CANT NAME OFFICE PHONE
ri v, (W( ) 7ya--Yv-o
!LINO ADD ESS CITY,ST ,ZIP CELL PHONE
1003 4,1-4 Ave, J. (Lai-) 773 - OIS,
CITY OP PEt ERAL WAY BUSINESS LICEN$e NUMBER EXPIRATION DATE FAX NUMBER
I -1 �Z 3 2 o_ L / / l o -' (47/12(15:11:7!)N
4 7•y.? - 23 yam/
CONTRACTOR'$REGISTRATION NUMBER(copy of card requital wltL Sac*'weed/043)
Y 1; g 6 , S Q , q .k. F EX1IRATION D%TC
APPLICANT COMPANY Nq`J T►"`^�
APPLICANT NAME "
OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP ( j ^
CELL PHONE
RELATIONSHIP TO PROJECT
to Architect 0 Tenar>t 0 Agent 0 Other(Describe) FAX NvM)
( 1
CONTACT —NAME PRIMARY PHONE
�y E-MAIL ADDRESS
LENDER Pyr itC �' , - P • iu." e..uS 1.2"A-
7-0.09.5:.. ii a itt'0,; ;
rsgittrad if Prttleci valve 4it.0414 it>�+ "''', .
MAILING ADDRESS CITY,STATE,ZIP
I)ETAALED BUILDING INFORMATION
EXISTING USE IVPROPOSED USE
.,
,EXISTING ASSESSED/APPRAISED VALUE $ _ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? C YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER :7 LAKEJIA • O HIGELINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEH - N ❑ RIGHLINE 0 PRIVATE(SEPTIC)
12/27/2005 14:56 4257422394 EVERGREEN ELEC SVCS PAGE 02
PROJECT FLOOR AREAS
—� AREA DEBCRIPTI017
1.-----
EXISTING SQ.FT. SQ. 11 T• `DOTAL
BASEMENT
FIRST -
SECOND -
.341-6
THIRD
FOURTH -
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?) - -
GARAGE/CARPORT
HOW MANY FLOORS? j
1{1S{�pppt i,1, i'f• .t1(11 SrhS{t 'N' l!.1ir 1'. £ 7.711;.:4$1=7:1'7'.
.....71 ;.,.:,
I E)1', r ri(1 .la ,1 1,,`�hli r ,•Lis "�i 1SHtt jUmtyIC?, '.,1 1`,I�a�l' „ F��„),„ „ {',.,,,,...,..;.
1 ill 1 /1 W. ' ' i' '11l'': ,>I4 j',i •.4 1'`1 : '2.'41:48,1 . l I li )!)l 't.
"NEW HOMES ONLY" NUMBER OP BEDROOMS .,,.
ESTIMAT % SELLING PRICE $
FIXTUP1 S
Indicate number of each type of fiat - • be Installed or reloc. ed as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $
AiR HANDLING UNITS EVA:oRATIVE .•OLERB
GAS LOGS
BBQS F. ,$ REFRIG.SYSTEMS
BOILERS HOODS(Cotaaurdai( WOODSTOVES
IRI%PLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAP WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS ioxrub/shower••=b.) SHOWERS WATER ►:-ETSu e�
DISHWASHERS SINKS �o MISC(Describe)
DRINKING FO AINg
GAS PIPE OUTL 50
SUMPS RAINWATER SYST
WASHING M- NES
URINALS HOSE Bl$B5
LAYS to .. eialcqVACUUM BREAKERS
i7.yt."P12IC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCH
I certify under penalty of perjury that the information furnished by nes is true and correct to the best of my knowledge, and further, that I
am authorised 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
such claim), which may be made by any person, including the undersigned,and led incourred FederalIthe Way,buonlyinvestigation and defense of
m
arises out of the reliance of the tear,including its officers and employee*, against thefCity fo -tion but to the where such claim
this application. o mP Jtses,upon the accuracy of the wvrmation supplied etty as a part of
NAME/TITLE /4LA/
(Sian,, ) '/ DATE /.?7 [�
�► (Title)
RELATIONSHIP TO pROJpC� ❑ Owner 0 Agent Contractor o Architect 0 Other
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Bulletin#100-March 30,2004 Page 2 of 4 k\Handouts-Revised\Pemnit Application