00-105723I
Ciiy of Federal Way
Applicant
Electrical Permit #: 00 -105723 - 00 - EL
Commmnity Development Services
NONE
INDEPENDENT ELECTRICAL CONTRACTO
33530 1st Way S
Federal Way, WA 98003-6210
Inspection request line: 253.661.4140
Ph: 253.661.4000 Fax: 253.661.4129
(3:30pm cut-off for next day inspections)
Project Name: SCHOFIELD CHIROPRACTIC CENTER
Project Address: 2260 S 320TH SuiteA-3 Parcel Number: 242320 0050
Project Description: ELE - Intall (8) circuits for tenant improvement.
Owner
Applicant
Contractor
NONE
NONE
INDEPENDENT ELECTRICAL CONTRACTO
8612 S 228TH
NONE
NONE
KENT WA 98031
Electrical Fixtures
Description Qtaritt °Description Quanti Description Quantity
Circuits - Commercial
PERMIT EXPIRES May 20, 2001, IF NO WORK IS STARTED.
Permit issued on November 21, 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:
//-3e. or) 0 At) iS's c'�� (9"'?�
a"aF � CONSTRUCTION PERMIT APPLICATION
�� AY�L- APPLICATION NUMBER:
PPLICATION NUMBER: - -
APPLICATION NUMBER: - -
**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.
PROPERTY•. •
SITE ADDRESS: x 5 ,; A_3 3x '5� 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 ❑ ENGINEERING El FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): 1.1 �d ; v.4 G e-,ne,ro
P �i C �� ✓moo 1 X Q cJ
PROJECT NAME: �y4 �1 e In J d r0.0 I i L. I o' i C_
PEOPLE•• •
PROPERTY OWNER:
CONTRACTOR:
NAME: DAYTIME PHONE:
Isc-lha � L e- [A ck'k �o � � �rI ( -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
NAME::
DAYTIME PHONE:
f
MAILING ADDRESS ( ET ADDRESS; CITY, STATE, ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
APPLICANT: I NAME:
CITY, STATE,
32
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
■ DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS:
5'3) 5"2,� - S(
EVENING PHONE:
c �
FAX NUMBER:
(,s3 ) 5)a -53
F -MAIL ADDRESS:
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
**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
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S)
BBQ(S) FAN(S) HOOD(S)
BOILERS) FIREPLACEINSERT(S) RANGE(S)
COMPRESSOR(S) FURNACE(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
GAS PIPE OUTLET(S)
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
REFRIG.SYSTEM(S)
WOODSTOVE(S)
MISC. ( )
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MM.( )
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.
❑ PROPERTY OWNER ❑ APPLICANT )X CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129