02-101984City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: ANDREWS
Project Address: 1264 SW 301ST
Project Description: ELE - Replace 100A subpanel
Electrical Permit #:02 -101984 - 00 - EL
Inspection request line: 253.835.3050
Parcel Number: 515320 0280
Owner
Applicant
Contractor
Hugh C Andrews
ELECTRO SERVE LLC
ELECTRO SERVE LLC
1264 SW 301 ST ST
13547 SE 27TH PL SUITE 3-D
13547 SE 27TH PL SUITE 3-D
FEDERAL WAY WA
BELLEVUE WA 98005
BELLEVUE WA 98005
98023-3413
(425) 451-3358
Electrical Fixtures
=tescri tion Qu -10
Service: - Residential 1
PERMIT EXPIRES November 10, 2002, IF NO WORK IS STARTED.
Permit issued on May 14, 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: 7 ���� Date: 57-
- �i V a'0�7
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ary (w
��IVED CONSTRUCTION PERMIT APPLICATION
uV �yAPPLICATION NUMBER: o
MAY 14 2002 PPUCA-HON NUMBER:
OF FEDERALWAY PPLICATION NUMBER:
4 ft*jpiQWAjjuired information — Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS:/ J y 3 c> c , ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
A ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Providedetailed description):
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
NAME:
z'e-&fr
DAYTIME PHONE:
( 9—ee) Ysry- I--0
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
/3 5-6 t -�'0)yo
EVENING PHONE:
y S -l'.&
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
EXPIRATION DATE:
(copy or card required) �, C, 1 L ri zsl
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NAME: DAYTIME PHONE:
o� � ��� T (9&-3 ).x�- -a ('.
MAILING ADDRESS (STREET ADDRESS; CrTf, STATE, ZIP): EVENING PHONE:
( J
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE: EXISTING BUILDING ASSESSED SED VALUATION
ROPOSED USE: LA"EN11
ROPOSED VA TION FOR IM OVEMENTS: #
PRINKLERED BUILDIN YES SUPPRESSION Sy
M PROPOSED
ATER SERVICE PR DER: ❑ LAKEH LINE❑TACOMA ❑ RIV WE
WER SERVI ROVIDER: ❑LAKEHIGHLINE ❑ PRIVATE (SEPTIC)
❑ YES ❑ NO
**NEW RESIDENTIAL CONSTRUCTION ONLY" I
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
FLOOR
EXISTING . FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIB
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HA
BBQ(S)
DUCT(S)
In tate number of each type of fixture
MECHANICAL
UNITS) EVA RATIVE COOLER(S) G
FANO
FIRE LACE INSERTS)
i) FURN CE(S)
GAS POPE OUTLET(S)
PLUMBING
LAVAT Y(S)
RAIN WATER SYS.
FOUNTAIN(S) SHOWEI
OUTLET(S) SINK(S)
5 LOG(S) RIG. S (S)
OD(S) WOODSTOVE(S)
NGE(S) MISC. ( )
HEAT SOURCE: ❑ ELECTRIC ❑ GAS
URINAL(S) WATER HEATER(S)
VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
WASH MACHINE OUTLET
WATER CLOSET(S) MISC. ( )
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.
NAMEITITLE:
❑ PROPERTY OWNER
❑ APPLICANT ❑ CONTRACTOR
DATE:
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063.9718.253-661-4000 • FAX: 22-661-4129
www.cboffedmlway.com