04-100007 •
it
City of Federal Way
Community Development Services Electrical Permit #:04 - 100007 - 00 - EL
33530 I st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253 661.4129 /----------, Inspection request line: 253.835.3050
Project Name: STOUT
Project Address: 2410 SW 317TH st Parcel Number: 193840 0240
Project Description: Add four circuits to serve a 487.5 sqft bedroom/bathroom addition.
Owner Applicant Contractor
Michael R Stout &Mary E Stout Michael R Stout Michael R Stout
2410 SW 317TH ST 2410 SW 317TH ST 2410 SW 317TH ST
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-2202 98023-2202
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits-Residential 4
• PERMIT EXPIRES June 30,2004.
Permit issued on January 2,2004
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:j712/_69
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RECEIVED _ CONSTRUCTION PERMIT APPLICATION
CITY OF —.rm.,�
APPLICATION NUMBER: o - L Q000 2 - Ca
Federal Way DEC 3 0 2003 APPLICATION NUMBER: -
APPLICATION NUMBER: - -
CITY OF FEDERAL WAY
**The follow4Q4614keraEl ormation—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
SITE ADDRESS: '�i3O `) ) ?V14" 3r ASSESSOR'S TAX/PARCEL #: A q 3 g Y 0 - Oa:2-1 T
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): I d'} a LA , �J
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■ PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING o MECHANICAL a DEMOLITION
a ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
i
PROJECT DESCRIPTION(Provide detailed description): U ,;,(-)r\ - - be.cc'c,1 bo,-\n poo 0,
act a V:oY) titi1. "),5s
PROJECT NAME:
- • PEOPLE INFORMATION
PROPERTY OWNER: NAME: `` DAYTIME PHONE
'�(�\C�0.e\ NACk '�` cvock - cou t j (33) 8\5 -a&d'-1
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
ai-k\o )L0 . \--1-,\•\ .1- - r- 6.eA0\.\ 1.x.1 w FiDa3
CONTRACTOR: I NAME: DAYTIME PHONE
Of -\ Aid MCILA ,\ 4-koo - ; (a5 t5 8 -°k2�a)
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE•
aLk) S� 3 n�vi 3A- �-e..kkc \ 301 C oa ( te 2 3 - q Al(
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX
- ( )
CONTRACTORS REGISTRATION NUMBER:
IXPIRATION DATE:
(ropy of card required) / /
APPLICANT: NAME: I DAYTIME PHONE*
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: i FAX NUMBER:
0 ARCHITECT ❑TENANT a OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 51 PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: I (,..(.30
6 EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
I
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ c
SPRINKLERED BUILDING? ❑YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES a NO
WATER SERVICE PROVIDER: 4 LAKEHAVEN o HIGHLINE a TACOMA a PRIVATE(WELL) •
SEWER SERVICE PROVIDER: ty LAKEHAVEN ❑ HIGHLINE ❑ 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 ❑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
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 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 • this application.
NAME/TITLE: g.. e,t ��� � / DATE:
❑PROPERTY OWNER o PLICANT 0 CONTRACTOR
i•-ir-43R-DFuicEmsE'oNLYIA =" .- #NAN'I'3MPROYEMENTMt=v:-
CCENSUS CODE.€ tLOTSIZE:iot'
ZONING'DESIGNATION "
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t,COMPPLAIV' ESIGNIITIOIV
_ _ - -�' �`,�?.�-����`�� BASIC•PLAN7� ri'.YES ,��[i.NO_ -.--„ _.:��, ,
SECTION TOWNSHIP '`;. RANGE;. r f1EW`/1DDRESS REQUIRED? � =YES G0 NO •
LATTE<i LOT?F YES k ;❑NO S. : CFiAN6EOF USE?:= == rj YES''r :NO . •
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
ywaw.dtyoffederalway,com