02-102480 k
Cm of Federal Way
Community
Electrical Permit #:02 - 102480 - 00 - EL
Cttanunity Development Services
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: TWIN LAKES GOLF&COUNTRY CLUB
Project Address: 3583 SW 320TH Parcel Number: 179021 7660
Project Description: ELE-Electrical for new sign
Owner Applicant Contractor
TWIN LAKES GOLF COURSE&COUNTRY I DUANE'S ELECTRIC DUANE'S ELECTRIC
BOB STANGROOM,GEN MGR 10210 45TH ST E 10210 45TH ST E
3583 SW 320TH ST EDGEWOOD,WA EDGEWOOD,WA
FEDERAL WAY WA 98023 98372 (253)848-7596
Electrical Fixtures
Description . ,. -.Q1,10it z r'a 4Description ' `jQuantity Description fQuantityj
Sign
PERMIT EXPIRES December 10,2002,IF NO WORK IS STARTED.
Permit issued on June 13,2002
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 Feder. ,v
/�Owner or agent: ,;__� — � , Date: C.-- / — fD 2
e(C-------
arLc, G CONSTRUCTION PERMIT APPLICATION
lamErzF-rL RECEIVED APPLICATION NUMBER: _OZ- L .0Z' $D -err)
uVF-iY
JUN 1r�` APPLICATION NUMBER: -APPLICATION NUMBER: - -
**TheToflREeig ktd, iMormation-Please print(in ink)or type**
U' DEPT.
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
- I7 PROPERTY INFORMATION
SITE ADDRESS: 3 5 3 5-4t/ 3.20 A S /, ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- - -- • M PROTECT INFORMATION - -
TYPE OF PROJECT(This application): ❑ B ILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
eklitLECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): /AJ S7 // /4--4DQd .4 ,09 4_T d,
Ai ec. ) S'1,..,,J •
•
PROJECT NAME:
ill PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
T '(a /z�c Go /4' )c.- Co u AI 7? c/ct r3 ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
3 S'8' 3 S c_<_.) 3 2 v 74 S 7. {.4/e,/Cc.I Zeiiir
CONTRACTOR: NAME: f DAYTIME PHONE:
P (t/ 2 S Lt t� G (25-3)SfrB 7S- c
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
/d ,2 fO -- v.s-7z, 5-7—---- ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:/ d 9 FAX NUMBER:
-e/22-7
9
�� 1d a..0 !/Iv •t - L 2 2 2, - - - (s)O qa e/2/2/
EXPIRATION DATE:
(copy of card required) D ,U 4 Ne-F C Z B 6 ? / /y /,2e02.
APPLICANT: NAME:
DAYTIME PHONE:
PGca.ve C-0..'",/n ;e ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
/d 02 / a _YS 7-4 S/"--d GsCcSeavoop ( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT 0 OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑APPLICANT ❑ CONTRACTOR
Pi DETAILED BUILDING INFORMATION
EXISTING USE: EXIST' • :UI • G ASSESSED/APPRAISED VALU, - •N
PROPOSED U.E: PROPOSE• VALUATION FOR IMPR• MENTS: $ I'_
SPRINKL •ED BUILDING? ❑ YES ❑ NO FIR:SUPPRESSION SY' EM PROPOSED/REQUI•• D:❑ Y - 0 NO
WATE: SERVICE PROVIDER. 0 EHAVEN 0 HIGHLINE 0 TACO ❑ PRIVATE(WELL)
S ER SERVICE PROVIDER: / LAKEHAVEN ❑ HIGHUNE I . •. ATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRIC•
■ PRO3ECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PRO••SED SQ.FT TOTAL
BASEME
FIRST
SECO, D
THI•D
FO RTH
0 HER •LOORS(DESCRIBE)
BECK
ARAG:
OW M•NY FLOORS?
TOTAL:
Ind• •to number of each type of fixture
•
MECHANICAL
AIR H•NDLING UNIT(S) APORATIVE COOLER(S) GAS OG(S) REFRIG.SYSTEM(S)
BBQ(S F•N(S) HOO.I(S) WOOD' OVE(S)
BOILE•(S) REPLACE INSERT(S) RAN e (S) MISC. )
COMPR SOR(S) URNACE(S)
DUCT(S GAS PIPE OUTLET(S) H •T SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB( ) LAVATORY(S) URINAL(S) W TER HEATER(S)
DISHWASH,R(S) RAIN WATER SYS. VACUUM BREAKER ) ❑ ELECT• C ❑ GAS
DRINKING F 1 UNTAIN(S) SHOWER(S) WASH MACHINE 0 ET
GAS PIPE 0 ET(S) SINKS) WATER CLOSET(S) MISC.( )
INTERCEPTOR -) SUMP(S)
►�� "DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury th• 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 daim(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANT 0 CONTRACTOR
FOR'OFFICE USE ONLY:d
iVE')i- _>I❑ADDITION S ;❑ALTERATION:_, . .❑-REP.AIR"::s � .❑JENANT IMPROVEMENT " :i";,
ZOKING SIGNATXON = r_ ' fBUIi.DING--SHELL ONLY?E ❑
ECO7L,ANVESIGNATIUIV {'F= BA5XC
• �SECTIOIV�*�-'•'._`-TUIM1INStIIP;���'"�RAN6E _, _, -- ;NEW ADUitESS REQUIRED?��.,'_ � ❑: �=_,
` U ATTER LOT?: ❑"YES_ -, -IVO =- :CHANGE OF USE?_.` ❑,YES s❑.NO.' -: s:,- "
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtvoffederaiway.com