02-100669 City of Federal Way
Community Development Services Electrical Permit #:02 - 100669 - 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
110
Project Name: MOSS
Project Address: 144 S 308TH Parcel Number: 339210 0150
Project Description: ELE-Altered 200 amp service new panel meter box and grounding
•
Owner Applicant Contractor
Lorna G Bolin QUICK WIRE ELECTRIC QUICK WIRE ELECTRIC
144 S 308TH ST 29715 55TH AVE S 29715 55TH AVE S
FEDERAL WAY WA AUBURN WA 98001 AUBURN WA 98001
98003-4022 (253)887-9650
Electrical Fixtures
"Description" : " Quantity =" " Description . Quantity Description "., -,": rv:a Quantity
Low Voltage-Other Residential 1
4111
PERMIT EXPIRES August 11,2002,IF NO WORK IS STARTED.
Permit issued on February 12,2002
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 / i Date:
— ►1F_ 4 7.. F��n� r i G o
•
(/
7
6(.6—
3c CONSTRUCTION PERMIT APPLICATION
uV c RECEIVED APPLICATION NUMBER: 0 2-- / 0 0 _a to f- CO.
APPLICATION NUMBER: - -
APPLICATION NUMBER: - -
FEB 1 2 2002
**The following is required information-Please print(in ink)or type**
Please note: Electri�i j� yF�ns and Engineering permits may require a separate application.
'.-1 - . = - - • ' t-' ' -U ■ PROPERTY INFORMATION ' - -
SITE ADDRESS: , D 1 th,S? ASSESSOR'S TAX/PARCEL#: -
` ,
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
.-, .;.z -. ■ PRO]ECT INFORMATION -
TYPE OF PROJECT(This application): ,❑,., BUI�ING CI PLUMBING El MECHANICAL CI DEMOLITION.
UYfLECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
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PROJECT DESCRIPTION(Provide detailed description): _A_/,.� G
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-,tJ - '.c, ,77 4, ei.-6-/ Ge---+,,,
PROJECT NAME: 7-72 .5 S
- - ,.- ■ PEOPLE INFORMATION -
PROPERTY OWNER: NAME: - DAYTIME PHONE:
e,, 4-- /7 i' S'S X3.3) g3?- 2—S5
MAIU! /gpRESS(STREET
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CONTRACTOR: NA v7C / DAYTIME PHONE:
f G,L! /,14 ���7%e�- :753) g27- ;sd
UN ADDRESS(STREET ADDRES CITY,ST ZIP): EVENING PHONE:
, 2f7/5 ' ,9b/g-5 'LU�,1 l'Imo/( ) ;'4-'
CITY FE RAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
( ) - I
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: DAYTIME PHONE:
( )
M MAILING ADDRESS(STREET ADDRESS,CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ 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 Cl NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
• - ■ PROJECT FLOOR AREAS -
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
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)
DISHWASHERS) 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.( )
INTERCEPTOR(S) SUMP(S)
• • V IC DISCLAIMER/SIGNATURE BLOCK -
I certify under penalty of perjury tha 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 dty,induding its officers and employees,upon the accuracy
of the information supplied to the dty as a part of this application.
,/NAME/TITLE: iy'� " DATE:
❑ PROPERTY OWNER ❑ APPLICANT E,€6NTRACTOR
-FOR OFFICE USE ONLY: I
'D'NEW ti❑ ADDITION ❑ ALTERATION D REPAIR -- ❑TENANT-IMPROVEMENT
*CENSUS CODE: _ --- LOT SIZE: - - - -
ZONING_DESIGNATION: BUILDING SHELL ONLY? 0 YES 0 NO
-COMP-PLAN-DESIGNATION BASIC PLAN?"' ❑ YES ❑NO -
SECTION: _- TOWNSHIP RANGE _NEW ADDRESS REQUIRED? ❑ YES ❑ NO
-PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? 0 YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.cityoftederalway.com