02-102778 e a
City raf Fe'ileral Way
C�Ommwlity Development Services Electrical Permit #:02 - 102778 - 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: VADAI
Project Address: 35349 11TH SW Parcel Number: 502860 1710
Project Description: ELE-Hook up of hot up
Owner Applicant Contractor
Leslie L&Glenda L Stokes TCM ELECTRIC TCM ELECTRIC
35349 11TH CT SW TCM ELECTRIC TCM ELECTRIC
FEDERAL WAY WA 31034 55TH AVE S 31034 55TH AVE S
98023-6956 AUBURN WA 98001 (253)333-1190
Electrical Fixtures
Description': Quantit% Quantity "Description 'x :Quantity
Hot Tub 1
PERMIT EXPIRES December 29,2002,IF NO WORK IS STARTED.
Permit issued on July 2,2002
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 W
Owner or agent: Date: ? ��
- �' Z (A9R-L& c-7 1/S GAS R-/ri'-C'+✓, - ��
RECEIVED
(-7\s, ..-. L CONSTRUCTION PERMIT APPLICATION
-IY JUL 0 2 2002 APPLICATION NUMBER: .0a- 102 7755--00
APPLICATION NUMBER: - -
C CITY OF FEDERAL WAY APPLICATION NUMBER: -BUILDING DEPT. -
**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.
�■ PROPERTY INFORMATION
SITE ADDRESS:--73a-ii-1" / " I ' 0-004-513 ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
= • • PROTECT INFORMATION
TYPE OF PROJECT(This application): UILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION
ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): rO\CV4-1 A0a� - ,- -b T
PROJECT NAME: V/l(/la
■ PEOPLE INFORMATION r
PROPERTY OWNER: NAME: v c DAYTIME PHONE:
l ck.t C— It .b ‘, Cccs c c t ( ) -
MAILING ADDRESS(STREET ADDESS;CITY,STATE,ZIP):
3S3&FC — I I � SIA)
CONTRACTOR: NAME: DAYTIME
� ��3 - �� ��
SLA-_.,k'-.___.k 6163))
MAILING ADDRESS(STREET ADDRESS;CITY STATE,ZIP): EVENING PHONE:
3 I O34f-- Ss'f il . 5, Pt-A0 tit . 95e01 I ( I ) it - fe
CITY OF FEDERAL WAY BUSINESS UCENSEINUMBER: � - � � � D c� � � FAX NUMBER:
CONTRACTOR'S REGISTRATIO.,Nl1„MBER: Q'() (� EXPIRATIONJ` DATE:
(copy of card required) Z C m k 3 3 .0 / /
APPLICANT: NAME: �L / `" 1 DAYTIME PHONE: -
to
MAILING ADDRESS(STREET(STREETADDRESS;CITY,STATE, IP): �A_ q EVENING PHONE:
3 ID 3 'l S `\ -PI&I)c)t. /1/ (d,53)333 - 1 t ,0
RELATIONSHIP TO PROJECT: FAX NUMBERy�
❑ ARCHITECT 0 TENANT OTHER(DESCRIBE): ) 33 3 - I t77��
V
' E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY O ER ❑ APPLICANT A CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
I
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROSECT 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)
BOILER(S) FIREPLACE INSERT(S) 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)
DISHWASHER(S) RAIN WATER 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)
' - ■ -DISCLAIMER/SIGNATURE BLOCK
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 daim(induding costs,expenses,and attorneys'fees incurred in the
Investigation and defense of such daim),which may be made by any person,including 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 informatio�upplied to the city as a part of this application.
NAME/TITLE: `_�/Iy flA 401k�_ 1 01,_0, „I' DATE: / --C).:2---,
€ ❑ PROPERTY OWNER 0 APPLICANT kONTRACTOR
t _ EOR£OF ICE-USEONLY: 4
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COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063.9718•253-661-4000•FAX:253-661-4129
www.Gtvoffederalway.00m
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