03-101906 City of Federal Way
Community Development Services Electrical Permit #:03 - 101906 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253 661 4000 Fax 253.661.4129 Inspection request line: 253.835.3050
Project Name: ROSEWOOD LANE#1
Project Address: 621 SW 361ST 5iParcel Number: 743680 0010
Project Description: Installing new LN security system
Owner Applicant Contractor
NORRIS HOMES INC MATRIX HOME THEATER,INC.*RYAN WF MATRIX HOME THEATER,INC.*RYAN WE
10516 172ND CT SE 20100 130TH AVE SE 20100 130TH AVE SE
RENTON WA 98059 KENT WA 98031 KENT WA 98031
(206)372-4632
Electrical Fixtures
A-71.21t* _ -;t fit` 4 6 ;^ 4, o t 7Qlfla d
Low Voltage l3urgler Alarm-Residen 3730
PERMIT EXPIRES November 9,2003.
Permit issued on May 13,2003
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 t - laws,rules and regulations of the State of Washington and
the City of Federal Wa .
Owner or .: t:
� Date: .>/.3 _o f
sem-
-79 )
Rough-in inspection: -
Date
FINAL inspection:
Date
CONSTRUCTION PERMIT APPLICATION
CITY OF NIP"'"1•44....i RECEIVED APPLICATION NUMBER: 05- l o l f 0b- �L
Way Federal a�I APPLICATION NUMBER: - -
MAY 1.3 2003 'APPLICATION NUMBER: -
*"The[(f��ollloryowing is required informationory —Please print(in ink)or type*'
Please note: Electrical, Engineering permits may require a separate application.
Dttt�����/ UUUI ■'C.IPROPERTY INFORMATION
SITE ADDRESS: Z(- • 3(p 7s/ ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING o MECHANICAL o DEMOLITION
ELECTRICAL 0 ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
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PROJECT NAME: •/
• ■ PEOPLE INFORMATION:`.
PROPERTY OWNER: NA/
/�/J� S (4L]•(�/ i DAYTIME PHONE
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): I (L s— )793-/6.3'a
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CONTRACTOR: ( NAME: ,// DAYTIME PHONE:
r / t�,e--- % % � ' Z06 ).:322 X63 �-
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UNG
ADDRESS(STREETrREADDRESS;CITY,STATE.ZIP): I EVENING PHONE:
OF 40 l WAY BUSINESSLICENSE NUMBER: c ( )
FAX NUMBER:
- i )
CONTRACTOR'S REGISTRATION NUMBER: /� p �1 EXPIRATION DATE:
/
(copy of card required) n`71/ice / /1L Z 1� /Z i 0C-/ 0 QG
/ 7
APPLICANT: I NAME: DAYTIME PHONE
i t )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: j FAX NUMBER:
o ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ! ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER o APPLICANT *CONTRACTOR
■ DETAILED BUILDING INFORMATION •
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES ❑ NO
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE o TACOMA CJ PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PRO)ECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) 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 daim(induding costs,expenses,and attorneys'fees incurred In the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to thejcityIa part of this application.
NAME/ZYfLE. r DATE: ��7 L 0-:S
o PROP RTY OWNER o APPLICANT O-CONTRACTOR
-FOR OFFICE USE ONLY: "-
1 13 NEW 1 n ADDITION " ,ti ALTERATION ;❑-REPAIR " O TENANT IMPROVEMENT"' •
'CENSUS'CODE: .. -LOT
BUILDING.SHELL ONLY?. BYES t =❑ NO
COMPLA
PN'DESIGNATION .. :BASIC PLAN?Nd ❑YES ❑'NO =
SECTION ,x= ---:TOWNSHIP RANGE - ", 'NEW ADDRESS REQUIRED? -=v- '❑YES ~ a NO-
PLATTED LOT? `:'❑.YES- i:f NO CHANGEOF USE? ❑YES `=fl NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtyoffederalwav,com