09-103368 OP • Eleetricil
City of Federal Way Permit #: 09-103368-00-EL
Community Development Services
P.O Box 9718
Federal Way,WA 98063-9718 FILE
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: KLEIN
Project Address: 125 SW 292ND ST Parcel Number: 119600 1020
Project Description: Replace 125A electrical box in fire damaged garage
Owner Applicant Contractor
GARY R KLEIN GARY R KLEIN GARY R KLEIN
125 SW 292ND ST 125 SW 292ND ST 125 SW 292ND ST
FEDERAL WAY WA 98023-3501 FEDERAL WAY WA 98023-3501 FEDERAL WAY WA 98023-3501
Additional Permit Information
Is Use Educational or Institutional? No
x
Electrical Fixtures
Alt. Serv.%Feeder: 0 to 200 amps(F 1
PERMIT EXPIRES Tuesday, August 31, 2010
Permit Issued on Monday, August 31, 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
angi the City of Federal Way.
Owner or agent: Date: 0—
tC7/Z0/4r)41
THIS CARD IS TO MAIN ON-SITE
Construction I ection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050 .
PERMIT #: 09-103368-00-EL Address: 125 SW 292ND ST
Owner: GARY R KLEIN FEDERAL WAY, WA 98023-3501
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.
El UFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding (4195) 0 Temporary Power(4275) El Service (4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) El Rough Electrical (4225) El Ceiling Cover(4020)
Approved Approved Approved
ByC—4 Daten Cie'. cl By � ! Date 6(v,..E'.amici By Date
.
O Final-Electrical (4055)
Approved
ByC' _" Date 1 Es,_26'4'I
❑ Rough Electrical 111 Final ElectricalCI Right of Way
Approved Approved Approved
By Date By Date By Date
0 _ i038"
fig'', *PERMIT F CO M EL DE EN FP
Federal Way r
I6,
COMMUNITY DEVELOPMENT SERVICES APPLICATION / - /
253-835-2607•FAX 253-835-2609
www.cittioffederalwail.com
,, � e .,.. /'. ., t{ph 3ac'
SITE ADDRESS
x
SUITE/UNIT# ZONING ASSESSOR'S TAX/PARCEL# ,
zws
5
NAME OF PROJECT �'�
(Tenant or Homeowner Name) i, :•N' C.: p t,{ L, I ;®�
0 BUILDING 0 PLUMBING 0 MECHANICAL CO1"
TYPE OF PERMIT ❑ DEMOLITION 6 "ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION r v�
C p let t_ e{ 2 S trill e!e' ! `
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only 56") f;,,,,e 1I�d / - 1
NAME PRIMARY PHONE
PROPERTY OWNER i i____ - . 1"`. (,)?..53 )7V-r -77-4--e:
MAILING ADDRESS,CITY,STATE,ZIP ,r E-MAIL
OWNER IS ALSO: 0 CONTRACTOR G APPLICANT ❑ PROJECT CONTACT
NAME PRIMARY PHONE e
(
CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP FAX
(
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT ( ) —
MAILING ADDRESS,CITY,STATE,ZIP FAX
(
PROJECT CONTACT NAME PRIMARY PHONE
(The individual to receive and ( ) -
respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX
concerning this application) ( ) -
ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL
(
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required for projects with
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE
(RCW 19.27.095)
(
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the
best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that 1 will comply
with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmentalharmlelaws.
I further agree to hold ss the City of Federal Way as to any claim(includcosts,expenses,an
in the investigation and defense of such claim), which may be made by any person, includinging d attorneys'fees incurred
the undersigned, and filed against the
city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a p• • is application.
�,
SIGNATURE: ��� �• DATE 3/ Y
PRINT NAME:_-• 4 FL g L1
Bulletin#100—4/17/2009 Page 1 of 4 k:\flandouts\Permit Application
1. 4`t AL 6
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
BASEMENT -------
FIRST FLOOR(or Mobile Home)
SECOND FLOOR — — — --
COVERED ENTRY — -----' —
DECK
GARAGE ❑ CARPORT C]
OTHER(describe)
EXISTDfO PROPOSED TOTAL
Area Totals
**NEW HOMES,ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
NEW BUILDING
ADDITION
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Group(s) Type Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—4/17/2009 Page 2 of 4 k:\Handouts\Permit Application