00-105730City of Federal Way
Commmiity Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name:
Project Address:
76 GAS STATION
2100 SW 356TH
Electrical Permit #:00 - 105730 - 00 - EL
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspections)
Project Description: ELE - New canopy perimeter lighting using existing circuits
Parcel Number: 252103 9036
Owner
Applicant
Contractor
TOSCO CORPORATION
NONE
FUEL SYSTEMS ELETRIC INC
4829 120TH PL SE
NONE
EVERETT WA 98208
Electrical Fixtures
Description Q40
Circuits - Commercial 4
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: ��� /�e� Date:
a" (W G eACONSTRUCTION
DAYTIME
(l z� ) PHONE:
_�-o v - 1'76 CJ
MAILING DRESS (STREET ADDRESS; , STATE, ;P): ��D /
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PERMIT
APPLICATION
FAX NUMBER:
('1zS) 333 -,2
*x
EXPIRATION ATE: /
APPLICATION NUMBER:
_7 3
PPLICATION NUMBER:
APPLICATION
-
-
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.
SITE ADDRESS: F/00 '94
ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING
- ELECTRICAL
PROJECT DESCRIPTION (Provide detailed description):%
a,':p-jh,:9-- T'1-7
❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
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■ PEOPLE INFORMATION
PROPERTY OWNER:
CONTRACTOR:
NAME:DAYTIME PHONE:
Gly o C� 76 ( )
MAILING ADDRESS (STREET ADDRESS; C5STATE, ZIP):
NAME: l —
S s I�/ -5 � " l
DAYTIME
(l z� ) PHONE:
_�-o v - 1'76 CJ
MAILING DRESS (STREET ADDRESS; , STATE, ;P): ��D /
l Zl Se2 I A%
EVENING PHONE: I
(�S") 3r6 - 5 S7
CTTY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
q- L s2 7 3 6-Z-00
FAX NUMBER:
('1zS) 333 -,2
CONTRACTOR'S REGISTRATION NUMBER:t--"' 4 � � 5 � -f Q L 6 D Z
EXPIRATION ATE: /
APPLICANT: NAME: DAYTIME PHONE:
( )
MAILING ADDRESS (STREET ADDRESS; CRY, 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 0 HIGHLINE 0 PRIVATE (SEPTIC)
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**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) FIREPLACE INSERTS) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINALS) 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.( )
INTERCEPTOR(S) SUMP(S)
■ 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 daim), which may be made by any person, including the undersigned, and filed against the City of
Federal Way, but only where such daim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information supplieO to the city as a part of this application.
NAME/TITLE: 1 Lam%% / RATE.
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❑ PROPERTY OWNER ❑ APPLICANT lv CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063.9718.253.661-4000 • FAX: 253-661-1129