02-100290 i
,
City Community Developmmentens Services Federal
Way
CommunityElectrical Permit #:02 - 100290 - 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: BURCH
Project Address: 31527 41ST SW Parcel Number: 873198 2650
Project Description: ELE-Repipe the underground feeder
Owner Applicant Contractor
Claude E&Katy L Burch CHIN'S ELECTRIC CHIN'S ELECTRIC
31527 41ST AVE SW 33530 13TH PL SW 33530 13TH PL SW
FEDERAL WAY WA FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
98023-2116 (253)405-3348
Electrical Fixtures
Description Quantity Description 'Quantity Description Quantity
Mast or Meter Repair-Residential/MI 1
PERMIT EXPIRES July 21,2002,IF NO WORK IS STARTED.
Permit issued on January 22,2002
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.
----2 ---72
Owner or agent: Date: ' 2Z
! --3`J — 0 2- c R v'L C.c. P4-r c',t-L Ortss -- p
Crvio, 5--c k A-51 2-01-1 62DuA4 `R011j
:°' G_ CONSTRUCT ION PERMIT APPLICATION
uV ED,. .. '.: - --,'`e,_',.
APPLICATION NUMBER:
_ _ - / 6-1T---D-,2,4
APPLICATION NUMBER: • -
-.JAN 2 2 `,)ft APPLICATION NUMBER: - -
**The following is required information—Please print(in ink)or type**
iNL vv,-.1.
Please note: Electrical,Fire ditei!it nWframs and Engineering permits may require a separate application.
- - •-■ PROPERTY INFORMATION ' " -
SITE ADDRESS: J/127 IP 1944 cS w ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
-_ : -. .;; -, . _ -;- . -- , ■. PROJECT INFORMATION - .
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION_
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION Provide etail descriptio �s�'L.ej
popl,
...14
PROJECT NAME:
' - - ■ PEOPLE INFORMATION .
PROPERTY OWNER: NAME: �,����^y / DAYTIME PHONE:
It MAILING A DRESS( ET AD RESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: i) Lc DAYTIME PHONE• I
/l6.12;4_4: (2S? ) Yam 33 y?
M N ADDRESS(STREET ADDRESS; ,STATE,ZIP): EVENING PHONE:
3535-0 /3- / Lr ,$ �J - ( )
CITY OF FEDERAL WAY BUS[NE S LICENSE NUM ER:Q � - � O �� �� � FAX NUMBER:
SC ( `) '-
ONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME' /!� '/ DAYTIME PHONE:
( / /iv-S vt /'/ v1_MAILINNG Add DRESS(STREET ADDR 5;CITY, ,ZIP): EVENING PHONE:
S /9"-6 frs -- i9 A-71.2 ( ) I
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 ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 111 LAKEHAVEN ❑ HIGHLINE 111 PRIVATE(SEPTIC)
•
**NEW RESIDENTIAL CONSTRUCTION ONLY** ..
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
•
• ■ PRO3ECT 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 HEATEij(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GASH
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 I
further agree to hold harmless the City of Federal Way as to any daim(induding costs,expenses,and attorneys'fees incurred in the I
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 d as a part of this application.
NAME/TITLE: -7--1
-1-- v iiiii) v/ /c , Z..7-"(21 DATE: 7Z?-78 2_
❑ PROPERTY OWNER (((!!!❑ APPLICANT CONTRACTOR
.FOR OFFICE USE ONLY: 1
=°❑:NEW=:==Y f-❑ ADDITION ❑ ALTERATION - - _0_REP%1IR -- 0-TENANTIMPROVEMENT
'CENSUS CODE: __ _ -_-- - LOLSIZE ' ' _ - -
ONING,DE:SIGNATION: BUILDING SHELL ONLY? 0 YES 0 NO
COMP_PLN`DESIGNATION BASIC PLAN?_ ❑ YES 0 NO
-SECTION_;.-:=, TOWNSHIP RANGE NEW ADDRESS REQUIRED? - ❑ YES 0 NO
-PLATTED.LOT? ❑ YES ❑ NO CHANGE OF USE? - ❑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.citvofederalway.com