01-103865 City Federal Way
Community Development Services
Electrical Permit #:01 - 103865 - 00 - EL
munit
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: IZZA TIME
Project Address: 2 0 SW 336TH 5i- U.n i f ftParcel Number: 132103 9096
Project Description: E -Electrical for TI for new pizza restaurant
Owner Applicant Contractor
Leon&Barbara Gardner POE ELETRICAL INC. POE ELETRICAL INC.
5108 MONTA VISTA DR PO BOX 44169 PO BOX 44169
SUMNER WA 12903 62ND AVE E PUYALLUP 12903 62ND AVE E PUYALLUP
98390 TACOMA WA 98444 (253)606-1682
Electrical Fixtures
iet pescriptipnw `r;1Quantitj '-'7'''"'="-, Description % ; .AQuantl .:14:-',1-t-Description .,{Quantity
Alt.Serv./Feeder up to 200 amps-Col 1
PERMIT EXPIRES April 1,2002,IF NO WORK IS STARTED.
Permit issued on October 3,2001
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: Date: /G''__.7-c'`j
/G % Cad--2—fe-��,e. 7b""/6 r- w(// d 1..4,r/
l/ - a - -e-/ q/J /
:oe GCONSTRUCTION PERMIT APPLICATION
uv9çFFnJRECEVEDF-� APPLICATION NUMBER: O1-- .10,32)65 - EL
APPLICATION NUMBER: — _ - -
OCT 0 3 2001 APPLICATION NUMBER: _ _ ; _ _
*�Ttle(f ilp iimgigy{ifed information—Please print(in ink)or type**
Please note: Electrical-Fereeaon.S stems and Engineering permits may require a separate application.
■ 'PROPERTY INFORMATION
SITE ADDRESS: 2-s~60 . 3 3 6 g7S7- ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROTECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
kELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): % L , 4 o--v— �r `' G` "re_ r-
PROJECT NAME:
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
2
CONTRACTOR: N E: �— DAYTIME PHONE:
�t-ec . _L (.253)6010 -/148-z
MING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
Po �o-b� �'Y` '%�� � cis N �BYYy (zs3) s'3s-- yz
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: _
/ D 7 (p67 6-131' (25-3) 535/0f >
CONTRACTORS REGISTRATION NUMBER: / ,q EXPIRATION(� DATE:
�"/�
(copy of card required) J� 0 E. E /r 4.p ® J s 3a -I l QR
APPLICANT: NAME DAYTIME PHONE:
(zs•- ) (Q O&' -482.
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
D S o Sc VI{jCa? T� G :� t v«5 ref S8 9 ( s-3) 2C04
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): &7rL cow 71"-• (.23-3) S3S" /0/5"-
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? LI YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ 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
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 0 GA's
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 claim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part ofthis application.
NAME/TITLE: C O" r/, 5, DATE: /b -3 - c)
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
:.FOR.OFFICE.USE ONLY::r
O NEW; ,_Y:', 0 ADDITION ❑ ALTERATION ❑ REPAIR 0.TENANT IMPROVEMENT
CENSUSCODE: -LOT:SIZE:
ZONING DESIGNATION; "". , BUILDING SHELL ONLY? "..:❑YES 0 NO
COMP PLAN DESIGNATION BASIC PLANS YES` "❑ NO'
SECTION . _ .TOWNSHIP RANGE NEW ADDRESS REQUIRED? 0 YES 0-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