05-106525 1.1
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City of Federal Way Electrical Permit #: 05-106525-00-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
4
Project Name: SOUTH SOUND ORAL MEDICINE
Project Address: 34709 9TH AVE S Suite B300 Parcel Number: 926480 0015
Project Description: Low voltage security and fire alarm systems.
Owner Applicant Contractor
CCD ENTERPRISES LYNSEN ELECTRONICS LYNSEN ELECTRONICS
1601 5TH AVE SUITE 1703 PO BOX 9537 LYNSEECO99JH(4/8/07)
SEATTLE WA 98101 SEATTLE WA 98109 PO BOX 9537
SEATTLE WA 98109
Additional Permit Information
Electrical Fixtures
Low Voltage Fire Alarm-Comma 900
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 u - will be in accordance with the laws, rules and regulations of the State of Washington
and the City ederal Way.
Owner or agent: '/ Date: (a-7.."?6
THIS CARD IS TO REMAIN ON-SITE ""
CITY OF fA Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-106525-00-EL ?
Owner: CCD ENTERPRISES
Address: 34709 9TH AVE S Suite B300
FEDERAL WAY, WA 98003
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) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ '' Rough Electrical(4225) - 0 Ceiling Cover(4020) t;, ° Final-Electrical(4055 ,'
Approved Approved Approved
1
By Date •By ; ' Dater . ! , By :- Date.l_��;'.d, '
` � r
❑ Under-slab groundwork(4295) ?LI ' - . I
Approved
By Date i 3't
RECEIVED
°,A DEC 2 7 2005 0 oZ i
Federal Way PERMIT —� - - =�
cJoueUMrIDEVELorusNr=ERE Y OF FEDER SF MF CO M OK DE EN FP
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FEDERAL WAY,WA 94063-9714 ,
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253www.ci07•FAX 4wau.co 4609 �_
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The ollowi • is •uired in ormation-an Inco 'fete , •'lication will not be acce• • • Please •rint le• •1 n i or
■ PROPERTY INFORMATION
SITE ADDRESS 31-1 7 Oct 9+k A-ti e S QQ
6
q SUITE/UNIT i l�3 'a
ASSESSOR'S TAX/PARCEL# 1 2- (o 4 d - d a LOT SIZE(sj)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(AOedt lege/ate gege jee lengthy legal desatgetent
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION )(ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed descript' n of work included on this permit o/d
-rt.. Lbw ti k e, c c _ 4 S)(s1-
1 o k,...1-1 O 1 3 — o�D vL J 1 — S t t1 r_1 t \ �C •• ( I � v....\- ) ,�. C.
I
`'C -J1MvCec� f' 2 ST , ( mu F ( 2a f'�Kc (.t r
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PROJECT NAME(Name of Business or Owner Last Name S0(,( (r) UV al a JC -
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER C' �p t ( )
-
MAILING ADDRESS ` CITY,STATEZIP
1 GU 5 - A-.-e S.„1L i7.0: c c cCc. R'�S(C( _
CONTRACTOR COMPANY NAME t-y e... �t t•C f 7_?,&1--/pPLICANT NAME OFFICE PHONE
MAILING ADDR CITY,L—c&ir-1\1/4-,
ATE,ZIP P'' `` CELL PHONE
1112 Ott' c- Aie N S ev=t-H-,c Oa ( ). 3 I - 710 P
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE - FAX NUMBER
a a-9. -L a Q 1 !�- tZ /3 ( 12�PI>g131,, $' -7fl
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
Ly nuc e Cod. 2 / /
APPLICANT COMPANY NAME
ODw
APPLICANT NAME OFFICE PHONE
5.211'1 to cls �'QQC4bc ( ) -
MAILING Ab DRESS CITY,STATE,ZIP — CELL PHONE
RELATIONSHIP TO PROJECT ( )
FAX NUMBER
0 Architect ❑Tenant 0 Agent 0 Other(Describe) ( )
CONTACT NAME r� PRIMARY PHONE E-MAIL ADDRESS
L a(i` o n.pa( (a•0(o) 3'31 - ,„_,7
l toI
LENDER :r, ; -• :::, !•,,,e r 1,:r,-,.7(„!;Y•1-,- s; NAME
,-,,i, r,-,, q:!.,-,rt-4, .,,f,,-- -,,•( ,.C,-4.}.,,t,Z,
MAILING ADDRESS art,STATE,ZIP
. • DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
u+D
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ (40(15-0(40(15-0C
SPRINKLERED BUILDING? ❑ YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES a NO
WATER SERVICE PROVIDER a LAKEHAVEN 0 HIGHLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) •
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST • 9pv
SECOND 1
THIRD
•FOURTH •
ADDITIONAL FLOO• (DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be ; tailed or relo••ted as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
•
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS H•!DS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGE MISC(Describe)
• COMPRESSORS FURNACES GAS WATER • •.TERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(. b/Shower Combo) SHOWERS WATER CLOSETS(Tones MISC(Describe)
DISHWAS. RS SINKS DRINKING FOUNTAINS
GAS • OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sink.) VACUUM BREAKERS ELECTRIC WATER HEATERS
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 o city,including its officers and e . .yees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE DATE )2 —2.7—O
(Signature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent contractor 0 Architect 0 Other
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application