02-102172r
City of Federal Way
Conmiunity Development Services Electrical Permit #: 02 -102172 - 00 - EL
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: BELMOR MOBILE HOME PARK SPACES 58 & 59
Project Address: 2101 S 324TH Parcel Number: 162104 9037
Project Description: ELE - Replace meter pedestal for mobile homes - SPACES 58 & 59
Owner
Applicant
Contractor
BELMOR HOLDINGS LTD
SHEPPARD & NELSON ELECTRIC
SHEPPARD & NELSON ELECTRIC
1571 BELLEVUE AVE W SUITE 210
PO BOX 3630
PO BOX 3630
VANCOUVER CN
KENT WA 98032-0210
KENT WA 98032-0210
(206) 878-7333
Electrical Fixtures
90,00111106 r" ..a t'
Service or Feeder - Manu./ M.H. Park 2
Descri tion r Qtaan r
PERMIT EXPIRES November 19, 2002, IF NO WORK IS STARTED.
Permit issued on May 23, 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.
Owner or agent: Cpp A nn1:3L...L! _. Date: Lo f,
4-2P Py (---7 �11-& -
il
h
` �°' oL CONSTRUCTION PERMIT APPLICATION
uV f� PPUCATION NUMBER: 0-
RECENEU APPUCATION NUMBER:
APPLICATION NUMBER:
**The following is iliiqulref lhfdrMation - Please print (in ink) or type**
Please note: Electrical, Fire Prev
eCt" 6y5ALE9Vppgering permits may require a separate application.
SITE ADDRESS: , �' 39-Y ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): Q L&G �� rn-P�4- -P-U— !7::e—CS
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME: �
'/ G /Z
Z DAYTIME PHONE: -
MAILING ADDRESS (STREET ADDRESS, 'ATE, ZIP):
3l d� S Y t=- —j, 4 5'x'003
NAME:
�1- - L s
-e ��`.
DAYTIME PHONE:
SSS
-73 33
MAIUNG ADD (STREET ADDRESS; CITY, STATE, ZIP):
(EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMB
CONTRACTORS REGISTRATION NUMBER:
Loopy acaid ted) L-� P
P
EXPIRATION DATE:
U / 3
/ 3
FVUNG ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): E
VENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUM
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ACONTRACTOR I
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: S;
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 11 LAKEHAVEN 11 HIG14LINE ❑ 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
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) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAINWATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLETS) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
']TCr1 ATWO1CMNATIIRF Al r
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 claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the Informaions led to the city as a art of this application.
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ PPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063.9718 •253-661-4000 • FAX: 253-661-4129
www.y_QlfcAcralway.c&m