02-102108City of Federal Way
Community Development Services
33530 1 st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Electrical Permit #:02 -102108 - 00 - EL
Inspection request line: 253.835.3050
Project Name: 7-11
Project Address: 31006 PACIFIC S Parcel Number: 785360 0210
Project Description: ELE - Wire 2 replaced rooftop units, add 1 outlet if required.
Owner
Applicant
Contractor
THE SOUTHLAND CORP
K E PETERSEN ELECTRIC INC
K E PETERSEN ELECTRIC INC
2828 N HASKELL AVE
23124 25TH AVE W
23124 25TH AVE W
DALLAS TX
LYNNWOOD WA 98036
LYNNWOOD WA 98036
75204-2909
(425) 775-1199
Electrical Fixtures
Circuits - Commercial 3
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: > L f .4�-Ak- Date: _ _ s/z / / bZ
,� -- 2. Zt - o z F/ti "VL 7'1 -IVR o v672), —�
C
CONSTRUCTION PERMIT APPLICATION
uV R EC E V QAPPLICATION NUMBER:
PPLICATION NUMBER:
M Vis, 2 l /00PPLICATION NUMBER:—
**The following, f9ci5W iiip�g�tWk-Y please print (in ink) or type**
Please note: Electrical, Fire Preventio�pp��, ���� ms annd Engineering T*'�Y g' g permits may require a separate application.
SITE ADDRESS: 3 / D O �,� G j'C I�u S 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): _ ��i 2 eeelt c.sw/ /pmm ]C �cs� (/,4
yw _
PROJECT NAME:— 7
PEOPLE•• •
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME: DAYTIME PHONE: -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, 21Pf
NAME:// r L
G` , L , AP— / e --f �.c/f e -t 0�/ • L
DAYTIME PHONE:
(�%?5_ ) 77r - l/ lel
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):EVENING
2512 y z s` t� ,4-v� I./L ►..�, � fy ggo3y
PHONE:
(�,G ) `6 - /y2 j
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
2 15
CONTRACTORS REGISTRATION NUMBER:
(ropy d % E 1
EXPIRATION DATE:
card fid)
NAME: DAYTIME PHONE:
a •S {— ( ) -
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT 11TENANT OTHER ( DESCRIBE):t/= f
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: Rc i EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: -e— PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 11 HIGHLINE 11 PRIVATE (SEPTIC)
I
**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 UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
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)
VACUUM BREAKER(S)
WASH MACHINE OUTLET
WATER CLOSET(S)
JTSCLAIMER/SIGNATURE BLC
WATER HEATER(S)
❑ ELECTRIC ❑ GAS
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: S C- DATE: E/Az Z&?==
❑ 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
www.cbppffedMlway.com