01-104321 r
City of Federal Way Electrical Permit #:01 - 104321 - 00 - EL
Community Development Services
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: DASH POINT VILLAGE
Project Address: 1612 SW DASH PT 1141 Parcel Number: 122013 9074
Project Description: ELE-Install new T-stats&wiring
Owner Applicant Contractor
DASH POINT VILLAGE SYSTEM HEATING&A/C CO.,INC SYSTEM HEATING&A/C CO.,INC
1640 SW DASH POINT RD 9410 DELRIDGE WAY SW 9410 DELRIDGE WAY SW
FEDERAL WAY WA 98023 SEATTLE WA 98106 SEATTLE WA 98106
(206)762-4249
Electrical Fixtures
De,,,s iptirpp uantity Aficripiron 4Q40..* ;d i Description ' 4Quantity
Thermostat 1
PERMIT EXPIRES May 7,2002,IF NO WORK IS STARTED.
Permit issued on November 8,2001
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: ��,�4_ Date: 1//9'/c7
9
X53- (06 ( -
� I a� CONSTRUC I ION PERMIT P PLICATION
APPLICATION NUMBER: C L - 1 ( I -
\>\> Rv FAX APPLICATION NUMBER: -
_ _
----'`E!‘/En APPLICATION NUMBER: - — —
**The following is required information-Please print(in ink)or type** 9,9 /o p pa- o0
Please not . VCtQdal,An
'Prevention Systems and Engineering permits may require a separate application.
/ W `PROPERTY INFORMATION
SITE ADDRESS: % 61 sic/ Dassii pO i h/ eCIASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
r : , PROJECT INFORMATION .
TYPE OF PROJECT(This application): ❑ BUILDING 0 PLUMBING ❑ MECHANICAL ❑ DEMOLITION
Jgr ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): t1/1 Ste�/ 74-574. 7" V- ter/,e_
PROJECT NAME: D 667 07,A,t" // /Jf i CJ
=: • PZ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHONE:
S Yst€,0 //ea t i h5 14. C, (w6) 76d - 11-9
MAILING ADDRESS
ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
EVENING PHONE:
9q-10 NeQSce/syJ /,/ Sem / i ' 981o6 (
CITY OF BUSINESS
NUMBER: NUMBER:
j t- -
9C6)763 -69ci6—
(copy ofCONTRACTORS�uired )REGISTRATION NUMBER:l 5 telt t ` T BO EXPIRATION;AT / 0,3--
APPLICANT: NAME: DAYTIME PHONE:
J i f7 E cc%s tom- ( ) $ /44
MAILING
� ILADDRESSRE (STREET ADDRESS;QTY,STATE,/,ZIP):See/
j / EVENING PHONE: �j/
RELATIONSHIP
efr 'dye &/'Q-- S�4 .�t°4.77/& W(Z 7`' /96 ( ) s/` /0i
✓ FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
74::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 ❑ HIGHIINE ❑ 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:
Indicate number of each type of fixture -
k MECHANICAL
AIR HANDLING UNI(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) UMP(S)
01. DISCLAIMER/SIGNATURE BLOCK - -
I certify under penalty of perjury tha 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 dty as a part of this application.
NAME/TITLE: J a tin eS ICG (es- DATE: L r
( " g—c2
❑ PROPERTY OWNER APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:.-
:NE-14-17.-1-k__:,-:D ADDITION
-❑ALTERATION .` ❑REPAIR' TENANT IMPROVEMENT
CENSUSCODE: LOTSIZE ,
• ZONING DESIGNATION BUILDING SHELL ONLY? x.❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑YES - ❑ NO
SECTION -TOWNSHIP RANGE NEW ADDRESS REQUIRED? JO YES NO
;PLATTED LOT? ❑.YES ❑'NO CHANGE OF USE? ' ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY scum•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129