02-100088 •
a
City on Federal Way
Community Development Services Electrical Permit #:02 - 100088 - 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: QFC#867
Project Address: 31217 PACIFIC S Parcel Number: 082104 9186
Project Description: ELE-Remove(2)checkstands,relocate(1)checkstand to south end,Install(4)u-scan units and 1 teller
desk wire for new chicken warmer,wire new cust.service booth
Owner Applicant Contractor
QFC#867 SPARTAN ELECTRIC SRVC INC SPARTAN ELECTRIC SRVC INC
31217 PACIFIC HWY S 6263 ELLIS AVE S 6263 ELLIS AVE S
FEDERAL WAY WA 98003 SEATTLE WA 98108 SEATTLE WA 98108
(206)763-1144
Electrical Fixtures
Description , ',. 'Quantity Description . 1Quantityr - Description , Quantity
Low Voltage-Other Commercial 7
PERMIT EXPIRES July 6,2002,IF NO WORK IS STARTED.
Permit issued on January 7,2002
•I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use 4 I be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: / _ / Date: /?/0"
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:°c CONSTRUCTION PERMIT APPLICATION
�� i�EI�L APPLICATION NUMBER: 0Z-- L Q V fl
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.
. = ■ =PROPERTY INFORMATION : _-
SITE
SITE ADDRESS: 3 1Z i C ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
'�. /• PROTECT INFORMATION :-
TYPE OF PROJECT(This application): ❑ BUILDING 0 PLUMBING El MECHANICAL 0 DEMOLITION
JELECTRICAL El ENGINEERING
_❑/ FIRE
LPREVENTION SYSTEM
4.040
PROJECT DESCRIPTION(Provide detailed description): c/� Com) (:.kcc45+q s re-f0 Ccc+ C )
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PROJECT NAME: F. C— - d ‘P7
_ ■ PEOPLE INFORMATION : - . _ •
PROPERTY OWNER: NAME:
DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHONE:
144i v. E/ecfr (C- (2.6 ) 763 - I/
MAI G ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
&267 WO' ,9-c e- S - Sem-/re ' 4177�t01 ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - (2.496' ) 762- s 7/9
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION
,/►
(copy of card required) 5 /9' f 7` S a 2- O O /DATE: /
APPLICANT: NAME: fr_) /J.^(L r! DAYTIME PHONE:
1/�^,"
E � � / 1
r J`
MAILING ADO.
g{sTRE ET 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 El 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 El.NO
WATER SERVICE PROVIDER: El LAKEHAVEN ❑ HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
•
■ PRO]ECT 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 UNITS) 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.( )
INTERCEPTOR(S) SUMP(S)
= - -■ DISCLAIMER/SIGNATURE BLOCK r " - • - • = - - •
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 where s daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied e city as a p.rt of this application.
NAMEMTLE: DATE: /Oa_
❑ PROPERTY OWNER ❑ APPLICANT :1 ONTRACTOR
•
•
1FOROFFICE USE-ONLY: _
'O NEW -AD
❑ DITION ❑'ALTERATION -TENANT IMPROVEMENT
-CENSUStODE:' -`_ _- - LOT SIZE:`R; '.. -"• -
gONING ESIGNATION - - >_ - BUILDING SHELL ONLY? ❑YES - 0 NO - ,
uCOMP3PLANbESIGNATION' BASIC PLAN? :.,=❑;YES" ❑ NO•
ECTION` ;TOWNSHIP . RANGE - < - NEW ADDRESS REQUIRED? -❑ YES -[LNO
;PLATTED LOT? ❑XES -❑ NO CCHANGEOF_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