09-101090 CITY OP \EC T - t V I V / 0
Federal Way 1 —
COMMUA77'y DEVELOPMENT SERVICES
RMIT SF MF CO ME PL DE EN FP
3332E FE8DnEi A41Y, H 980 63-97 89718 MAR 2 APPLICATION TD
253-835-2607.FAX 253-835-2609 �+ / /
uww.catirotfederohuatco e J \( O!
The following is required in Ffo n n'
l,.(J'`Q mpTete application will not be accepted. Please print legibly(in ink)or type.
t- PROPERTY INFORMATION
SITE ADDRESS 6 1
�-5 a 1 SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# _ __ LOT SIZE Of)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate pax for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION 'ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
4 PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
1 1'. A I r ` l .ILO
&IIRIMISIMPIIIM ' 11'.. .f I i_ (1l t:0— .i i - / (,
1— kin Ie
PROJECT NAME(Name of Business or Owner Last Name) , - WO t✓I Lf C// (fr brO4t) IL-
/ PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER ( ) -
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME ,APPLICANT NAME OFFICE PHONE
►rte l�avt G / r � ln� 7i LoYC-to X7 8 3
1e��4n c. 1 n i
MAILING ADDRESS Q
0 S)-0 6r„A i ' .STATE,ZIP ' R V 67� CBLL PHON 2. -/^�7■CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER :* • • TION DATE FAX NUMBER lG (i
;/o-Zz -30 ,._ i ., r .R, I / o5 (0753) -17C - 1177
CONTRACTOR'S REGISTRATION NUMBER `� / EXPIRATION DATE E-MAIL ADD F_4Q
-�r1h�� 1yr�►b`► 5Yl�°.I Il ), adL::C� `�I(�/3y1�` teyrj Sin �`�
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
l�ni ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
❑ Architect ❑ Tenant ❑Agent ❑ Other ( ) -
PROJECT NAME Q (r PRIMARY PHONE E-MAIL ADDRESS
CONTACT � � ) -
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP 1 PHONE
( ) _
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
all •
PROJECT FLOOR AREAS.
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
=ST= PROPOSED TOTAL TOTAL 117270109r TOTAL PROPOSED sr TOTAL Sr
NUMBER OF FLOORS
"NEW HOMES ONLY NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
U FLXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITHAPPLICATIOIV)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(comm...,q
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower combo3 LAVS paths.Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS lraa.
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my
knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local,state,or federal laws regulating construction or environmental laws.
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, 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 placation..//// ,�r, IRO C�SIGNATURE: / •1^;,> a . 4 v (2 DATE 6/85 0
Agent
and/or Authorized A
Property Owner / B
❑NEW ❑ADDITION o ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO o YES o-NO
BASIC PLAN?
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? ❑YES a NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Pennit Application
City of Federal Way
6 ° f0' r 1,`' 6 .Electrical
Community Development Services Permit #: 09-101090-00-EL
P.O.Box 9718 n` tv ti"
.
Federal Way,WA 98063-9718 k =°"' Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q ( 1
Project Name: T-MOBILE ALDERBROOK
Project Address: 33003 20TH PL SW Parcel Number: 010455 0010
Project Description: Add (1)20 amp circuit to a T-mobile cellular shed.
Owner Applicant Contractor
TAME CONTORAVDIS CHRISTINE DILORETO SINE WAVE ELECTRIC INC
EVELYN CONTORAVDIS SINE WAVE ELECTRIC,INC SINEWWE922JQ(4/18/10)
33003 20TH PL SW 10820 E 150TH ST 10820 150TH ST E
FEDERAL WAY WA 98023-6477 PUYALLUP WA 98374 PUYALLUP WA 98374
; o ,:;.f>,"*".-fe K 4 'i;ft d''a § , ya p
Is Use Educational or Institutional? No Service greater than 1000 Amps? No
/,. g ,' .lei r ;,'-' s \, 3 'y y. s n, 'yk, $ ,r"
,.« ..,� . . lat n.YS ..-,,
Circuits Commercial 1
PERMIT EXPIRES Tuesday, March 23, 2010
Permit Issued on Monday, March 23, 2009
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
d the •ity of Federal Way.
' '. . '3
Owner or agent: i2u') tt-i;;--Le... (r - 7 t'4-4. Date: ' " / 2`tdi
FIAU0
D'1
,-10
1
A .• filL
THIS CARD IS TO MAIN ON-SITS'
CITY OF Community Develop ent Inspection Record
1 Federal way
IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 09-101090-00-EL
Owner: TAME CONTORAVDIS
Address: 33003 20TH PL SW
FEDERAL WAY, WA 98023-6477
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.
❑ UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
❑ Final-Electrical(4055)
Approved
/� Date 3�z
For inspector reference only
0 Rough Electrical ❑ FINAL-Electrical
Approved Approved
By Date By Date