02-1021581
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City Federal Way
Community Development Services Electrical Permit #:02 -102158 - 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: BUCHANAN
Project Address: 1904 SW 351ST Parcel Number: 795620 0170
Project Description: lr/ace rtteter base & mast like for like for existing residence do Ii
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Owner
Applicant
Contractor
David A & Patti A Buchanan
ELECTRO SERVE LLC
ELECTRO SERVE LLC
1904 SW 351ST ST
13547 SE 27TH PL SUITE 3-D
13547 SE 27TH PL SUITE 3-D
FEDERAL WAY WA 98023-6919
BELLEVUE WA 98005
BELLEVUE WA 98005
(425) 451-3358
Electrical Fixtures
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Mast or Meter Repair - Residential/M Service: - Residential
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: See AUDlicatin Date: Z71
G ar— t= t%,vm I APP"-'-
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ITTED
CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER:
PPLICATIONNUMBER:
MAY 2 4 ZM PPLICATION 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: \C� S
"� �/� ` ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION
TYPE OF PROJECT (This application): ❑ UILDING 11 PLUMBING 11 MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): �:2-- ,a Q
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
■ PEOPLE INFORMATION
NAME:DAYTIME PHONE:
-
�a Q t J, ," 373
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): _ _
NAME:
DAYTIME PHONE:
(STREET ADDRESS; CITY, STATE, ZIP): 2
MAILING Lt,--?
EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
C. { �-2-C- J l o `1
EXPIRATION DATE:
(CDPY of card required)
NAME:
MAILING ADDRESS (STREET ADDRESS; CITY, 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
EXISTING USE:
PROPOSED USE:
■ DETAILED BUILDING INFORMATION
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
SPRINKLERED BUILDING? ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
PROPOSED VALUATION FOR IMPROVEMENTS:
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN 11 HIGHLINE ❑ PRIVATE (SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROIECT 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)
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. ( )
INTERCEPTORS) SUMP(S)
]TSCLOIMER/SIGNATURE BLC
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: � -
o DATE: Z V-0
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.253-661-4000 • FAX: 2S3-661-4129
www.dNoffedM[way.com