02-102228City of Federal Way
,Common'.-2+�Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: SPRING VALLEY MONTESSORI
Project Address: 36605 PACIFIC S
Electrical Permit #:02 -102228 - 00 - EL
Project Description: ELE - Install new 200amp service and (5) new circuits.
Inspection request line 253.835.3050
Parcel Number: 292104 9074
Owner
Applicant
Contractor
George R Credit Justus
FULLER ELECTRIC
FULLER ELECTRIC
36475 PACIFIC HWY S
FULLER ELECTRIC
FULLER ELECTRIC
FEDERAL WAY WA
37107 12TH AVE S
37107 12TH AVE S
98003
FEDERAL WAY WA 98003
(253) 661-7181
Electrical Fixtures
` Description scrp llrrF, , z my Qiarit'r
Alt. Serv./Feeder up to 200 amps - Co 1 Circuits Commercial 5
PERMIT EXPIRES November 25, 2002, IF NO WORK IS STARTED.
Permit issued on May 29, 2002
• 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.
AtA�-
Owner or agent: 1'! Date:
CP
'7- 2 -0 Z -
g - 101 6z.
0
1 PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
..ELECTRICAL ❑ ENGINEERING El FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): TAs /1 a w o2 O oGC'.
and S neo C., -c -';4-S
PROJECT NAME: .-eri r, s? Ua.��e� . I% ol,T e sJO/`r
PEOPLE•• •
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME: DAYTIME PHONE:
/Y►0-CYe/e,`he- Tars j4X,,,
MAILING ADDRESS (SERE ADDRESS; QTY, STATE,IIP):
36901
NAME:
Fu ler c /e -Ar: c
DAYTIME PHONE:
(�s3) 161
-71V
c' n c .
MAILING ADDRESS (STREET ADDRESS; QTY, STATE, ZIP):
?/ o:) -k' ue- So
EVENING PHONE:
(153) 66/-7/V
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
ede1-� c,� c,� A — - — — — —
— - _ _
FAX NUMBER:
(x573) 66�
- b ys�
CONTRACTORS REGISTRATION NUM
EXPIRATION DA
�%2
/ ay
(�ofcard �� F CL i Q
2 7 d /�
o//
NAME: P
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
37/0-2 /2.4-C At So Fe.,-Ienlj i�/ay ?X003
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): �ec�^. C-1
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT X CONTRACTOR
EXISTING USE:
PROPOSED USE:
■ DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
SPRINKLERED BUILDING? ❑ YES ❑ NO
PROPOSED VALUATION FOR IMPROVEMENTS: $
DAYTIME PHONE:
0-53) GC/ -7/6'�
EVENING PHONE: /
( 2S3)
FAX NUMBER:
(2s3) 6 C/-J�5's6
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 11 PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL'
AIR HANDLING UNITS)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S)
RAIN WATER SYS.
SHOWER(S)
SINKS)
SUMP(S)
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
■ 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 a rt of this application.
�AME/TITLE• DATE:
❑
PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 •253-661-4000 • FAX: 253-661-4129