00-106031City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Pb: 253.661.4000 Fax: 253.661.4129
Project Name: ADELAIDE ELEMENTARY SCHOOL
Electrical Permit #:00 -106031 - 00 - EL
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspections)
Project Address: 1635 SW 304TH Parcel Number: 122103 9084
Project Description: ELECTRICAL - Add two parking lot light poles to front parking lot
Owner
Applicant
Contractor
FEDERAL WAY PUBLIC SCHOOL
NONE
SHEPPARD & NELSON ELECTRIC
31405 18TH AVE S
FEDERAL WAY WA
SHEPPARD & NELSON ELECTRIC
98003-5433
NONE
PO BOX 3630
Electrical Fixtures
Description , ' Quanti
Circuits - Commercial 2
Description Quantity
PERMIT EXPIRES June 13, 2001, IF NO WORK IS STARTED.
Permit issued on December 15, 2000
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. / L
Owner or agent: Date:
,)_ - Z 7 -Com / 10' A 17r—i J__'_'T
G_ CONSTRUCTION PERMIT APPLICATION
PPLICATION NUMBER:
PPLICATION NUMBER:
,Ott rJ APPLICATION NUMBER:
Y
**The folio"
IlOo�"�#ired information -Please print (in ink) or type**
Please note: Electricaolr9l49ention Systems and Engineering permits may require a separate application.
PROPERTY•. •
SITE ADDRESS: 1 �9 IJ S V)' .j O Lir ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ _ - _ _ _ _
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGIINEEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): }� jI WL Vl� d/-19 4,9,- ��!/Ci
• A-P'LCL t' I
■ PEOPLE INFORMATION
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME: DAYTIME PHONE:
LCY akoo beoiTp
MAILING ADDRESSISTREET ADD ; CITY, STATE, ZIP):
NAME: -ey":q J90G� (� l ^�C- L �I
Eta.,-,DAaZ&7d-
YTIME PHONE:
7333
MAI G ADDRE�ST'RE FT �ADDRESS; CITY, STATE, ZIP)- �
�
EVENING � ONE: -
CITY OF FEDE WAY BUSINESS LICENSE NUMBER:
L! `C_I _ -
FAX NUMBER:
c�o��g7� -X90
CONTRACTORS REGISTRATION NUMBER: L / E �l/ F
55-�?yam _ -
EXPIRA�N DATE: 731161
NAME:
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT -a CONTRACTOR
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: 0 LAKEHAVEN ❑ HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
AIR HANDLING UNIT(S) FAN(S) HOOD(S) WOODSTOVE(S)
BBQ(S) FIREPLACE INSERT(S)
RANGE(S) MISC.
_ BOILER(S) FURNACE(S) COMPRESSOR(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
DUCT(S) GAS PIPE OUTLET(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 MISC.
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S)
INTERCEPTORS) SUMP(S)
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 whichth and anti application y incurred in the
further agree to hold harmless the City of Federal Way as to any dal m (Including costs, Pe
Investigation and defense of such claim), which may be made by any person, including the undersigned, and filed again the accuracy
against the City of
Federal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upo
of the information supplied to the dty as a part of this application. )
��/ , DATE: L�--OO
NAME/TITLE: l �7G0'�'JD l- ��`'z�l
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718.253-661-4000 • FAX: 253-661-4129
No