01-103718 City of Federal Way
Community Development Ser(ices Electrical Permit #:01 - 103718 - 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: CHINA HOUSE MONGOLIAN GRILL
Project Address: 31448 PACIFIC S Parcel Number: 092104 9113
Project Description: ELE-Provide electrical for(3) rooftop HVAC units.
Owner Applicant Contractor
CHINA HOUSE MONGOLIAN GRILL ALLIED MARINE CORPORATION ALLIED MARINE CORPORATION
31448 PACIFIC HWY S 5905 15TH ST E 5905 15TH ST E
FEDERAL WAY WA 98003 FIFE WA 98424 FIFE WA 98424
(253)926-2000
Electrical Fixtures
Description !Quantity Description Quantity Description (Quantity
Circuits- Commercial 3
PERMIT EXPIRES March 23,2002,IF NO WORK IS STARTED.
Permit issued on September 24,2001
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 the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: /7/- 2Date: cSt-p%4ol84� GYJj.
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.76om_ CONSTRUCTION PERMITtAPPLICATION
VV F-fY `' 2 � APPLICATION NUMBER: DI - 1 O 3 7( - E —
APPLICATION NUMBER: _ - -
Cil!Y Ur-r -,:r:L 41/1-11' APPLICATION NUMBER: -
BUILDING DEPT. — — — — — — — — —
**The following is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
3 1 ' -c7- liw�+1 $
SITE ADDRESS: / %4 CvC 7-707,/ 64----44- .J ASSESSOR'S TAX/PARCEL#: Q g 2. LQ It - 9 i 1 3
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑, BUILD G ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
L�'ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): to, `%('6 f Q I C- or 3 ,4c_ N,•/
ecY
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PROJECT NAME:
- ■ PEOPLE INFORMATION
PROPERTY OWNER: ""NAME: DAYTIME PHONE:
/)40.JG-c,C dil GrsLC (o2s3 )S3.9 -L/05-0
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
3/y Y5 P 1-z y s
CONTRACTOR: *I. NAME: DAYTIME PHONE:
. Te:'0 /n st rwe-- C74:31/'€924 -✓ (Z 3 ) ? - a 000
MAI ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
53o5 /$- =MY Of Of FEDERAL WAY BUSINESS LICENSE NUMBER: , . FAX NUMBER:
&VP/ 78 /J cL" — — — — — -of )(�53 ) 5. tae 2
CONTRACTORS REGISTRATION NUMBER: ' EXPIRATION DATE:
(copy of card required) �-J L_ L 2- r_ , C Q O 3 O CZ% /f7-S / o Z
APPLICANT: NAME: DAYTIME PHONE:
htA/7- �,e'yL.Ens ( c ) 7.u, -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): p EVENING PHONE:
JrZIG� F, f f"C i tjJi 7O/02 Y ( )
( RELATIONSHIP TO PROJECT: FAX NUMBER:
El ARCHITECT ❑ TENANT El OTHER(DESCRIBE): ( ) -
�, �O��-- E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER El APPLICANT L -CNTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN El HIGHLINE El PRIVATE(SEPTIC)
•
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROSECT 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: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ 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 the d s a part of this application.
NAME/TITLE: DATE: ?k 21 I '24x)/
❑ PROPERTY OWNER ❑ APPLICANT TRACTOR
it
FOR OFFICE USE ONLY:..,
o NEWT ;El ADDITION ❑ ALTERATION ❑:REPAIR .TENANT°IMPROVEMENT
CENSUSI.CODE:: LOT SIZE ,
ZONING DESIGNATION-, BUILDING SHELL ONLY? :❑ YES ❑ NO
COMP.PLAN DESIGNATION BASIC°PLAN? . . ❑YES ❑.NO •
SECTION TOWNSHIP RANGE - NEW;ADDRESS REQUIRED? ❑'YES ❑.NO
,PLATTED LOT? ',. ❑YES ❑ NO CHANGE OF USE?. ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•-33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129