03-105272 •
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City of Federal Way
Community Development Services Electrical Permit #:03 - 105272 - 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: LA WEIGHT LOSS
Project Address: 31835 PACIFIC S UnitE&F Parcel Number: 082104 9196
Project Description: Install 200-amp,3-phase sub panel from existing service to run HVAC and lighting.
Owner Applicant Contractor
HARSCH INVESTMENT PROPERTIES LLC D.RIDDING ELECTRIC D.RIDDING ELECTRIC
HARSCH INVESTMENT PROPERTIES LLC D.RIDDING ELECTRIC D.RIDDING ELECTRIC
1121 SW SALMON ST 19630 N DANVERS RD 19630 N DANVERS RD
PORTLAND OR 97205 LYNWOOD WA 98036 (425)778-1064
Electrical Fixtures
ii sc pfi . __ * ,, ` l gi#11$i __, C amity' : WMOTOIT an0
Alt.Serv./Feeder up to 200 amps-Coin 1
PERMIT EXPIRES May 29,2004.
Permit issued on December 1,2003
I hereby certify that the above informationis correct and that the construction on the above described property and
the occupancy and the use wil ,.- in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: / Date: w3 'd i' 03
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RECEIVED CONSTRUCTION PERMIT APPLICATION
CITY OF 111".—""%,..../ APPLICATION NUMBER: 03- I 05-2.72,-on
Federal Way DEC 0 1 2003 APPLICATION NUMBER: -CITY OF FEDERAL WAY 'APPLICATION NUMBER: - -
"The following�Vegluire iinnforrm'ation—Please print(in ink)or type"
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
_
I PROPERTY INFORMATION
SITE ADDRESS: ✓I 0 35 P, C. //ivy SASSESSOR'S/TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
. • PROJECT INFORMATION
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING ❑ MECHANICAL o DEMOLITION
X ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
�1
PROJECT DESCRIPTION(Provide detailed description): 200 4/7/P 3 P// Si gpQ 'EL- F/20,11
�XlST/ G Se4v/CE'. MAC .4.vo 04f/rw4 .
PROJECT NAME: L-/I. WE/o7 Loss -SA/EU PE/2or 87--
•-PEOPLE INFORMATION
PROPERTY OWNER: NAME: ; DAYTIME PHONE'
4144.S'Cy ZNv''fr 6a? f'RD.PEter/Er
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHONE:
).
Pion /iv (-'T/2/c ' ( qzj-) 17S - /0‘�
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): I. EVENING PHONE:
f= I 16 3 o N - 0/¢-Nvr'tc /2Li C-w ay IVA ( can 721 -
I 1 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: ( FAX NUMBER:
n
CONTRACTORS REGISTRATION NUMBER:
IEXPIRATION DATE:
(copy of card required) 1) LD f / .6 13 _ 0 I Zl O✓
APPLICANT: NAME: I DAYTIME PHONE:
I
1 ( )
- I MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT:
j FAX NUMBER:
0 ARCHITECT ❑ TENANT MOTHER(DESCRIBE): eo r✓(4-C,aL ; ( )E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
I{r : ■ 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:❑ YES ❑ NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE o TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT 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 Value of Mechanical Work: $
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: ❑ ELECTRIC a GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC a 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 dty,induding its officers and employees,upon the accuracy
of the information supper.% to the as a part of this application.
NAME/TITLE: l DATE: IZ•a/•03
❑ PROPERTY OWNER o APPLICANT y CONTRACTOR
•FOR;OFFICE.USE ONLY
.�: NEW „p;ADDITION�...::�RAL-TERATION� .REPAIRS �:` L]:TENANTIMPROVEMENT�� ,�.��>r''
;CENSUSCODE ' !LOT-SIZE::
`ZONING DESIGNATION jBUILDING SHELI ONLY?0 YES NO S
COMP PLAN DESIGNATION ` yw
SECTION+ TOWNSHIP RANGE ANEW ADDRESS REQUIRED? ❑YES ❑NO
~PLATTED LOT? _ a YES v;IVO 'CHANGE OF USE? ,�, ' '❑YES'"Th IVO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000.FAX:253-661-4129
www.dtvoffederalway.com