02-100621 City toity Development Services
Way
CommunElectrical Permit #:02 - 100621 - 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: DODSON
Project Address: 28607 21ST S Parcel Number: 422200 0140
Project Description: ELE-Install 200 amp panel&2 circuits to kitchen
Owner Applicant Contractor
Joel A&Linda B Dodson FULLER ELECTRIC FULLER ELECTRIC
28607 21ST AVE S FULLER ELECTRIC FULLER ELECTRIC
FEDERAL WAY WA 37107 12TH AVE S 37107 12TH AVE S
98003-3339 FEDERAL WAY WA 98003 (253)661-7181
Electrical Fixtures
Description Quantity Description Quantity ' Description 1Quantity
Low Voltage-Other Residential N 3
PERMIT EXPIRES August 7,2002,IF NO WORK IS STARTED.
Permit issued on February 8,2002
•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: GL/ L ✓\ Date: 2`P-0
2- L2-co-2- S-e-te..►'c,-c FcLth I oK —1 -S.
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c` D ....z..._,-7.:-_-0---a
sof G CONSTRUCTION PERMIT APPLICATION
uv FEY EtZFTL
APPLICATION NUMBER: Q 2.- 4, 4z L - do
APPLICATION NUMBER: - - - - - -
APPLICATION NUMBER: -. -
**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.
6o-7 Q ■ PROPERTY INFORMATION
SITE ADDRESS: �.fI a/ S �/lR- So ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
/-{ous e_
• PROTECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL 0 DEMOLITION
( ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
-LAS AZ./ 2045 tram., ttne/
2 c;c ?is fo k .}crl en
PROJECT NAME: 1)OdSO4 1.
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
Joel Dodson ( 253) 639 -Y'36.3
MAILING ADDRESS(STREET ADDRESS;QTY,STATE,ZIP):
2?T O al St A e So
CONTRACTOR: NAME: DAYTIME PHONE:
F.-/ e!' 5/e cir,'L e . (153 ) Ola/ =2/11
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
3-7/0 ? iz-eA ,9-ve So ( 253 ) 661 7/57
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER:
- ( 253 ) 66/ - 6,56
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) E l I e. e ( o 2, 2 3 k / / 2 boy
APPLICANT: NAME: DAYTIME PHONE:
?may FJ/e. -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
37/07 /21-2- Ave So ( )
I RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER ❑APPLICANT .fkCONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ 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 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) _ SUMP(S)
1'i DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury th.t 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(inducting 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.
- Z DATE: 0
NAME/TITLE: `1 a
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
FFOROF,FICE.USE•ONLY:r 4
itia#M ---❑`i1DDIRON 0 ALTERATION `_❑ttEPAiR = . :_❑TENANTIMPROVEMENT
1_CENSUSCODE: LOT SIZE:'•,""
1ZONI GVESIGNATION ;_-_ BUILDING SHELL ONLY? ❑ YES --❑ NO
COMP,, 1NbESIGNATION • BASIC PLAN' tom $ES""- ❑ NO' -
ECTION ,z`=TOWNSHIP -- -:RANGE • NEW ADDRESS REQUIRED? -.❑ YES =❑:NO
PLATTED`LOT?`_ ❑-YES: :❑ NO - _ ' CHANGE-OF-USE?- =. . 0 YES • 0 NO , =
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129