00-106108City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name:
Project Address
BLANCO
1705 SW 331ST
Project Description: ELE - Low voltage security system
Electrical Permit #:00 -106108 - 00 - EL
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspections)
Parcel Number: 010457 0200
Owner
Applicant
Contractor
ART BLANCO
NONE
SECURITYLINK FROM AMERITECH
1705 SW 331ST PL
FEDERAL WAY WA
3033 16TH AVE W
ONE
SEATTLE WA 98119
Electrical Fixtures
Description Quanti
Low Voltage Burgler Alarm - Residen 1�
Description Quantit
PERMIT EXPIRES June 18, 2001, IF NO WORK IS STARTED.
Permit issued on December 20, 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.
Owner or agent: Date: l a - c� D -DO
C"0 G CONSTRUCTION PERMIT APPLICATION
PPLICATION NUMBER: O—
PPLICATION NUMBER: - -
Z'53/ C � - q l M DEC 2 0 20M PPLICATION NUMBER: _ _ - — — - — — — - — —
**The following is required information — Please print (in ink) or type**
%;i i Y OF I EUERAL WAY
Please note: Electrical, Fire Prevel3}1&09Vf 4D"1rBd Engineering permits may require a separate application,
PROPERTY•. •
SITE ADDRESS: .1-76r, S 331 si Pl- ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): LSecljrJ �v,S�jsi^e p^
PROJECT NAME:
CONTRACTOR:
■ PEOPLE INFORMATION
NAME: DAYTIME PHONE:
A ri 9? (okr•LTi (a53) $3` - A7oLr
MAILING ADDRESS; CITY, STATE, ZIP):
/7[)5 5Q.'3314 - PL Fah,[ 0a-1 6)a- -
NAME
DAYTIME�)
I
-4L+3
MAILING ADDRESS (STR ET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
� ad
_I
( )
`IA U
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
APPLICANT' NAME: DAYTIME PHONE:
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 ❑ 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: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
F�\
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT 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
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACEINSERT(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) SINKS) WATER CLOSET(S) MISC.(
INTERCEPTORS) SUMP(S)
1 ■ 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 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 of
Federal Way, 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 application.
NAME/TITLE:.- � 7C1 �G.1r1 12r .J 1 DATE: _ o2ZQPd Z -w-
❑ PROPERTY'OVW,(UJNUUER ❑ APPLICANT IP CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129