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00-105262City of Federal Way Applicant Electrical Permit M 00 -105262 - 00 - EL t..ortvnunity Development Services CERTIFIED ELECTRICAL SERVICE CERTIFIED ELECTRICAL SERVICE 33530 1 st Way S CERTIFIED ELECTRICAL SERVICE Inspection request line: 253.661.4140 Federal Way, WA 98003-6210 29622 41 ST PL SW CERTIFIED ELECTRICAL SERVICE Ph: 253.661.4000 Fax: 253.661.4129 (3:30pm cut-off for next day inspections) Project Name: OWSLY Project Address: 1115 SW 300TH Parcel Number: 515320 0487 () Project Description: ELECTRICAL - Install new 200 -amp service for single family residence 1NGL.� otr. �T (1, ir u • ` Owner Applicant Contractor Lisa K Owsley CERTIFIED ELECTRICAL SERVICE CERTIFIED ELECTRICAL SERVICE 1115 SW 300TH ST CERTIFIED ELECTRICAL SERVICE FEDERAL WAY WA 29622 41 ST PL SW CERTIFIED ELECTRICAL SERVICE 98023-8219 AUBURN WA 98001 29622 41 ST PL SW 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: I U t- oso Vkf,0 ® CONSTRUCTION PERMIT APPLICATION S P� r� APPLICATION NUMBER: D_D_ ofd ODEP�APPLICATION NUMBER GSC BV��,p%N 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: 1 l is J- C,-! 3 0 U *L J-7- ASSESSOR'S TAX/PARCEL #: LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION • W"ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): 0 L n,/'-jLQ L1 r7Pu1 -- %ao a±r— 6C Prh 0a Jeryr (p PROJECTZ:6112 (( cuefujil 4- 191A 00rive T A0.7 22 -ea PEOPLE INFORMATION PROPERTY OWNER: CONTRACTOR: APPLICANT: NAME: DAYTIME PHONE: O (, it y� l.�.c 3 ) S29 -206 a MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): 11 /S il- (Ij 3004 JIT NAME: DAYTIME PHONE: CEr'! /f-rQ lec / / (-Ds3 ) 9<i/ - O'OPGl MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: P © 0 P ZE'96 /WW F' ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: ra- CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: CQ Y 6- /2� NAME: ft DAYTIME PHONE: a ( ) - MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: ( ) RELATIONSHIP TO PROJECT: I FAX NUMBER: ❑ ❑ El - ARCHITECT TENANT OTHER( DESCRIBE): ( ) E-MAIL ADDRESS: 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: $ ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: ❑ YES ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) ❑ 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 UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILERS) FIREPLACE INSERT(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) DISHWASHERS) 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) •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: d4trl 1 0 t?( ?WI3 DATE: ❑ PROPERTY OWNER ❑ APPLICANT J rCONTRACTOR COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129