01-104499 +� a
City of Federal Way +
Community Development Services Electrical Permit #:01 - 104499 - 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: DOLLARWISE
Address: 3455 S 344TH'Suite204 Parcel Number: 222104 9006
Project Description: ELE-Add(7)VAV's to existing system.
Owner Applicant Contractor
BEDFORD PROPERTY INVESTOR CROSS ELECTRIC*MIKE ISAKSON* CROSS ELECTRIC*MIKE ISAKSON*
3725SKST 3725SKST
TACOMA WA 98418 TACOMA WA 98418
(253)472-6648
Electrical Fixtures
Description = Quantity Description [Quantity Description _IQuantity
Thermostat 7
PERMIT EXPIRES May 25,2002,IF NO WORK IS STARTED.
Permit issued on November 26,2001
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: / ,. < �,_.�. %1 • (—( _ . Date: /1 - �2 L G
Dk C._e,/,z 1 Gov
.
:°' G RECEIVED. CONSTRUCT t ION PERMIT APPLICATION
ElEIETKPEL�� FAY - APPLICATION NUMBER: Q - 1 /± - (,--
Nf PV 2 6 2001 `
APPLICATION NUMBER: _ _ - _
OffY OF FEDERAL WAY 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.
■ PROPERTYINFORMATION -
SITE ADDRESS: , '' ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
t♦•PROTECT INFORMATION -
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION
,ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
PROJECT NAME: 1
PEOPLE INFORMATION •
PROPERTY OWNER: NAME: DAYTIME PHONE:
t )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
r ) -
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
)
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) f l /
APPLICANT: NAME: DAYTIME Pl/HONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING
NING PHONE:
)
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
' - 1♦::DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
•
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** •
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS •
FLOOR EXISTING S• 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 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 city s a part of this application.
I;
NAME/TITLE: .74 �, �� / / 1- DATE: 1 i — r
❑ PROPERTY OWNER b APPLICANT ja,CONTRACTOR
•
•
FOR OFFICE USEONLY:
`.o NEW :'0 ADDITION s ❑:ALTERATION ❑;REPAIR` ..: TENANT IMPROVEMENT
CENSUSFCODE'; ;LOT SIZE .,.
ZONING ESIGNATION_ ,x ._ BUILDING SHELL,ONLY? • ❑ YES ❑ NO
-cOMPPkLAN DESIGNATION _ BASIC°PLAN? ,.. ❑YES . . ❑ NO:
SECTION ,x TOWNSHIP RANGE - .' NEW ADDRESS.REQUIRED? ❑ YES ❑,NO
SLATTED LOT?:! ❑YES. ❑'NO CHANGE'I OF,USE? ❑YES ❑ NO
r
• COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129