05-100679 •
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City of Federal Way Electrical Permit #: 05 - 100679 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
4 Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: DEVONSHIRE LOT 24
Project Address: 36120 10TH SMV C SW Parcel Number: 202100 0240
Project Description: Install low-voltage T-stat wiring.
Owner Applicant Contractor
NORRIS HOMES INC MIDLAND MECHANICAL*JEAN-PAUL ME MIDLAND MECHANICAL*JEAN-PAUL ME
10516 172ND CT SE MIDLAND MECHANICAL MIDLAND MECHANICAL
RENTON WA 98059 11212 SE 179TH ST 11212 SE 179TH ST
RENTON WA 98055 (425)228-4715
Electrical Fixtures
Description Quantity Description Quantity Description (Quantity
Thermostat 1
PERMIT EXPIRES August 13,2005.
Permit issued on February 14,2005
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 ordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: ' Date:
2 oa o,
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-100679-00-EL
Owner: NORRIS HOMES INC
Address: 36120 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
Rough Electrical(4225) 0 Ceiling Cover(4020) �[ Final-Electrical(4055)
Approved Approved Approved
By 3 Date 3 a,. o5 j By Date By 2,titr Date1,
❑ Under-slab groundwork(4295)
Approved
By Date
GfY /Cf 2 - Lo O V 7 1
Federal Way RECEIVE..., PERMIT SF MF CO ME OWL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
333258TM AVENUE SOUi7f•PO BOX 9718
APPLICATION
FEDERAL WA F.WA 98063-9718 A p p LI C AT I O N /
253-835-2607•FAX 253-835-2609 /
www.cituo/federalwaucom FEB 1 4 2005
The ollowi • is re•_ ,_ d in ormation-an Inco •fete • ••lication will not be acce•ted. Please •rint le•ibl (in or • .
IN PROPERTY INFORMATION
SITE ADDRESS 36^( ? [ u T.
`' _s v✓ F e,2.--..., ( /1/-q y /< SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ _ LOT SIZE(sl
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) 1i 'f 1 �/
(Attach separate page for lengthy legal descnplon)
•■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
1 —
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
- -7-1 "4:1-1 ii I-16=4-‘..' i-:S 1-A 7 s-+-' : h
c
PROJECT NAME(Name of Business or Owner Last Name) f7G VJ.15'j,,:'►"f..
PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
/‘ �i .�/ yy,'
OWNER MAILING�RESS ` l , � /�(.� 5 CITY,STATE,ZIP �`l� 1�—/, - _/�V�i
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
(' u::llc-tvtf itlfe(-11t t iehc I J •. I, vLl:CI'___^{./- (117S-) Z' -17/5
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
1 t ?( ? >>= (7 > i f2=„ .-, w,, 9 Xo. 3 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
— — -B L / / ('/=..i)'41.) .-//'`f- ,..16'
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/vii D r_ 4 m I- -7 — / l
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS c, CfITTY,STATE,ZIP — CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑Tenant ❑Agent ❑ Other(Describe) ) 13TJ -Ljsi` c
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
LENDER �� • rider- o t aE NAME
, ,t' d
,,� ', -. tie ete • 5,
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
•
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES a NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE ❑TACOMA ❑ PRIVATE(WELL) t
SEWER SERVICE PROVIDER ❑LAKEHAVEN a HUGHLINE a PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT. -
-BASEMENT
FIRST •
SECOND
THIRD
FOURTH .•
ADDITIONAL FLOORS(DESCRIBE) •
DECK(COVERED?)
GARAGE 0 CARPORT 0
=ratio PROPOSED TOTAL TOTAL riasruni Sr y TOTAL PROPOSED SF TOTAL Sr
NUMBER OF FLOORS
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offudure to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECIIAMCAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/shoa<rCombo) SHOWERS WATER CLOSETS(roil.) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom sinks) 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 of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application. ^
NAME/TITLE ‘ 7
DATE C
(Signature) (Title)
RELATIONSHIP"PO PROJECT ❑ Owner o Agent 0 Contractor ❑ Architect ❑ Other
• o • � �
(
,� A DI IONA s ALTERATION a.REPAIR TENANT,IMPROVEMENT 4"�
I ►'� .HELL NLY?� a ES o N0 fi' BASIC PLAN? �a. < Trci NO_
F
o YES
• •• •ESIGNATIUN CHANGE IEt * x i NOS
CRESS ,•UIFtED? , ES a NOS,. UP/SEPA/SU? q �
51-...177x • , .YES MO ,x ..,.. DEMO.,PERMIT •UIRED? "A-444:1 .. .
)
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application