02-100549 City of Federal Way
Community Development Services Electrical Permit #:02 - 100549 - 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: QUEST DIAGNOSTICS
Project Address: 34616 11TH S 3 Parcel Number: 215470 0070
Project Description: ELE-Altering a circuit
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Owner Applicant Contractor
TORQUAY ASSOCIATES S&E ELECTRIC INC. S&E ELECTRIC INC.
34616 11TH PL S S&E ELECTRIC INC. S&E ELECTRIC INC.
FEDERAL WAY WA 3904 S CENTER ST 3904 S CENTER ST
98003-8705 TACOMA WA 98409 (253)272-5813
Electrical Fixtures
Description Quantity Description (Quantity) Description "_,Quantity
Circuits- Commercial 1
i.--1%. • pc�
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PERMIT EXPIRES August 4,2002,IF NO WORK IS STARTED.
Permit issued on February 5,2002
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: Date: /5/0 2,
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ariVr G RECEIVED CONSTRUCTION AAPERMIT APPLICATION
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APPLICATION NUMBER: d, - ( 0 05g-9 -
FEB 0 5 2002 APPLICATION NUMBER: - -
• CITY OF F�ENDG nEPLTWAY APPLICATION NUMBER: - -
8U11 *The following is required information—Please print(in ink)or type**
Please note: Electrical, Fire Prevention stems and Engineering permits may require a separate application. ,
= - - /J, ' - - I PROPERTY INFORMATION • - -
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SITE ADDRESS: 34461 /9`[Ctg- a'(' ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- , *'-'t., -1-•-; • _ -;:-. - , :- . 0 PRO]ECTINFORMATION - - -
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
Nigi ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): OI-4-eh ect C i r C l,t.,I4
PROJECT NAME: i L/& /7 Pi" 0 7/C-5.
- P PEOPLE INFORMATION •
0
PROPERTY OWNER: NAME: DAYTIME PHONE:
'/9/(,651- t2rn '�1OcS-1/G•AS ',,/ ( ) -
MAILING` �!J/ V(STREETSS // O/ �`G ZIP):�'G i+ � ii- cie-420- G000f/ W A . 7 O Oo 3
CONTRACTOR: NAME: ` DAYTIME PHONE-
S E E e l ec--1-r ic/ T,.(G. (as3 ) D')).... S813
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
39o4 So 0.. en -4-er S4- ( )
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
0 CD_ - 1 5 .47 - Q Q ( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) S 6 L E I * -l. S Q Q (At / /
APPLICANT: NAME DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS,CITY,STATE,ZIP)- EVENING PHONE:
F ( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT XCONTRACTOR
1 "DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ I
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO r
l
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 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: 0 ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) 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,induding the undersigned,and filed against the City of
Federal Way,but only whey- such daim arises out of the r• "ance of the dty,induding its officers and employees,upon the accuracy
of the information suppli.. o the .• as a .art -this jication.
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NAME/TITLE: e r .�/ i/T — DATE:
❑ PROPERTY OW ER ❑ APPLICANT XCONTRACTOR
-FOR OFFICE USE ONLY:
*j 7.-40/7 ='=x:-❑ADDITION 0 ALTERATION D REPAIR - ❑TENANT IMPROVEMENT -
'CENSUSCODE: - _ LOT SIZE:
ZONING DESIGNATION: BUILDING SHELLONLY? 0 YES ❑ NO
1 -COMP=PLA(N DESIGNATION BASIC PLAN?== ❑ YES 0 NO -
SECTION. _, TOWNSHIP RANGE NEW ADDRESS REQUIRED? 0 YES ❑ NO
PLATTED LOT? 0 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.cityoffederalway.com