02-102110City of Federal Way
Electrical Permit #: 02 -102110 - 00 - EL
Commmity Development Services
WINCO FOODS #43
K E PETERSEN ELECTRIC INC
33530 1st Way S
106 SW CAMPUS DR
23124 25TH AVE W
Federal Way, WA 98003-6210
FEDERAL WAY WA 98005
Inspection request line: 2553.8355.30550
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: WINCO FOODS
Project Address: 106 SW CAMPUS Parcel Number: 415920 0710
Project Description: ELE - Change out refrigerated cases, approx 10 circuits.
Owner
Applicant
Contractor
WINCO FOODS #43
K E PETERSEN ELECTRIC INC
K E PETERSEN ELECTRIC INC
106 SW CAMPUS DR
23124 25TH AVE W
23124 25TH AVE W
FEDERAL WAY WA 98005
LYNNWOOD WA 98036
LYNNWOOD WA 98036
(425) 775-1199
Electrical Fixtures
76) l;sci7ptlon „„ a Qan ' = iecri' tion". Quariti'
Circuits - Commercial 10
PERMIT EXPIRES November '17, 2002, IF NO WORK IS STARTED.
Permit issued on May 21, 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: Date: (,2
4'91,1Zo-c i^l]f- s/ C oiv,-?)CA/'I- Y/
r �
RECEIVED CONSTRUCTION PERMIT APPLICATION
N) F[y PPLICATION NUMBER:
MAY 2 1 2002 APPLICATION NUMBER:
CITY OF FEDERAL WAY
APPLICATION NUMBER: _ _ _ _ _
**The fbL1d fs RQ64red information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: elt •1911 5 ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
J4 ELECTRICAL f/❑ ENGINEERIN/G� ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): Chu., ye re/a"I,g &-J-011 Cu S'RS
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PROJECT NAME:
PEOPLE•• •
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME: 1 / /• DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, IIP):
/ DG 5 ),/ t.,,�
NAME:
�e ie"
MAILING
(11 s PHONE:
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,L
7r -
1117 Y
MAILING ADDRESS (STREET ADDRESS; CITY,
STATE, ZIP): /
EVENING PHONE:
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23/2-/ 2 A
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(264) `i -j -
1 -1125
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
—— — — — —— -
(yes) 77S//,ff
CONTRACTORS REGISTRATION NUMBER:
(cvy of caro required)
1( E o T E ! y S T )D
EXPIRATION DATE:
L
/// 3/ / 0'&. -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT. �/ /4 FAX
NUMBER -ARCHITECT TENANT OTHER ( DESCRIBE): E/e-1 ed� /'-•( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE: Gro C',O-S 57`0+e EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:%g,— e- PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: 11 LAKEHAVEN 11 HIGHLINE 11 PRIVATE (SEPTIC)
❑ NO
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
■ PR03ECT FLOOR AREAS I
FLOOR
EXISTING SQ. FT.
PROPOSED . FT.
TOTAL
BASEMENT _
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
• r
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOADSTOVE(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) RAINWATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTORS) SUMP(S)
1TgC!LATMER/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 s a part of this application.
NAME/TITLE: �L Li DATE:
❑ PROPERTY OWNER ❑ APPLICANT .4 CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.253-661-4000 • FAX: 253-661-4129
www.cttpffedmlway.com