00-105408City 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: VICTOR
Electrical Permit #:00 - 105408 - 00 - EL
Inspection request line: 253.661.4140
(3:30pm cut-off for next day inspections)
Project Address: 31315 22ND SW Parcel Number: 178980 0035
Project Description: ELE - Replace bent electrical service mast - 100 amps
Owner
Applicant
Contractor
GARY VICTOR
NONE
BILLINGS ELECTRIC
31315 22ND AVE SW
FEDERAL WAY WA
PO BOX 681
98023
NONE
SUMNER WA 98390
Electrical Fixtures
Description Quanti
Mast or Meter Repair - Residential/M 1
PERMIT EXPIRES April 30, 2001, IF NO WORK IS STARTED.
Permit issued on November 1, 2000
I hcreby 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 age Date:
�.•� G CONSTRUCTION PERMIT APPLICATION
wn f337t- PLICATION NUMBER: C)
PLICATION NUMBER: - VPPLICATION NUMBER: - _
**The following is required information - Please print (in ink) or type**
v+;v
Please note: Electrical, Fire Prev"on Svst dfi find Engineering permits may require a separate application.
ADDRESS: <-- Zz 444LO- J • ASSESSOR'S TAX/PARCEL #: _ _ _ _ _ - _ _ _ _
.L DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): XeS a
OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENNGINEERING❑ FIRE PREVENTION SYSTEM
ECT DESCRIPTION (Provide detailed description):
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR'
DAPI IMt MUM:
VS3 ) 8"71/ -
MAILING ADD (STREET ADDRESS; CITY, STATE, ZIP):
-3/ ?l.S, ---`2 /'0Ko �•Ky YL''� 7�"oL�
NAME:
L/. -v cr
DAYTIME PHONE:
(Zs & .3-lvo8'o
NG ADDRESS (STREET ADDRESS; CrrY, STATE, ZIP):
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
— — — — — — — —
FAX NUMBER:
CONTRACTORS REGISTRATION NUM8M
ADle /P 4 �
EXPIRATION WE:
// 1D / Oe
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
RELATIONSHIP TO PROTECT: FAX NUMBER'
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT:/\ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
DETAILED DING 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 ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
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)
BBQ(S) FAN(S)
BOILERS) FIREPLACEINSERT(S)
COMPRESSOR(S) FURNACE(S)
DUCTS) GAS PIPE OUTLET(S)
PLUMBING
GAS LOG(S) REFRIG. SYSTEM(S)
HOOD(S) WOODSTOVE(S)
RANGE(S) MISC.
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
BATHTUB(S). LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC a GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC.
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
ther, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
ther agree to hold harmless the City of Federal Way as to any daim (including costs, expenses, and attorneys' fees incurred in the
restigation and defense of such daim), which may be made by any person, including the undersigned, and filed against the City of
deral Way, but only where such daim arises out of the reliance of the city, including its officers and employees, upon the accuracy
the information supplied to the city as a part of this application.
Mf:1 rn F• /�� ® DATE:
❑ APPLICANT CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 335M FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063'9718.253-661-1000 • FAX: 253-661-4129