04-100071 L
1' I. " a ~•
City or Federal Way
t ornmuni;PDevelopment Services Electrical Permit #:04 - 100071 - 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: YORK
Project Address: 4250 SW DASH POINT Rd Parcel Number: 112103 9056
Project Description: New 200amp service
Owner Applicant Contractor
CHRIS&SUZZANNE YORK TAYLOR ELECTRIC *TODD TAYL( TAYLOR ELECTRIC *TODD TAYL(
133 S 309TH ST 31029 164TH AVE SE 31029 164TH AVE SE
FEDERAL WAY WA AUBURN WA 98092 AUBURN WA 98092
\ (253)631-4404
Electrical Fixtures
Description Quantity Description IIQuantity Description Quantity
ervice: -Residential 2800
PERMIT EXPIRES July 7,2004.
Permit issued on January 9,2004
.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: Elliej/ Date: 7"- q - dCf
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` COMMUNITY DEVELOPMENT SERVICES
CITY Of FIRST WAY SOUTH•PO BOX 9718
Federal Way . PERMIT APPLICATIONAN 0 9 2004 DE ;;WAY,WA ,
NM'W.O(I IN]{'Colo
-029
CTY )1aIDEPT.RALW
p«oma«Use OoIy FW File Number: 0 i%�?11- -4 D 0 0 7 I_ - C� / /
The ollowi • is • fired in ormation-an inco •lete -;•lication will not be acce•ted. Please •rint le•ibl (in ink)or p
^� c IA PROPERTY INFORMATION
SITE ADDRESS: Li `J6 n�'� pc t r - , ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION(eg:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
SQUARE FOOTAGE OF LOT:
t
IS PROJECT INFORMATION
TYPE OF PERMIT(This application): ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed- li 1. cription of work included on this permit only)
(*.Ai° ' 1` !p-1' €�✓ �✓Uw lams-
/ 206 . cep-Ce
PROJECT NAME Name 0 Business/Owner Last N. •
IA PEOPLE INFORMATION
PROPERTY NAME: Jf PRIMARY PHONE:
\ �
OWNER: )
-
MAILING DD (STREET ADDRESS;): CITY,STATE,ZIP
CONTRACTOR: NAME pp T7 .q( COMPANY
��`I4 I 0 r (/v�� '�'C 1 OFFICE PHONE:
MAILING ADDRESS(STREET ADDRESS�:� ` CITY,STALE,ZIP t` (�`1 C CELL PHONE: - y 4 0 L-(
3io zci “Dc-16- 4A. 4-w. (ZcJ)z6(- - ?k71
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER: -
I-
-
/ ( ) -EXPIRATION DATE:
—7 /8
CONTRACTOR'S REGISTRATION NUMBER: A / 0 f
(copy of card required with each application)" .� 1 Q 'Z '..4.4.
LENDER: NAME: DAYTIME PHONE:
(If P.op<se4 V,1.<..$5,0001 ( ) -
MAILING ADDRESS(STREET .-CITY,STAT ,ZIP
—
APPLICANT: NAME: f COMPANY OFFICE PHONE:
Sime As 0'&n4f ( ) -
MAIUNG ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 Architect 0 Tenant 0 Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: 0 Property Owner 0 Contractor ❑ Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION
EXISTING USE: PRO:•SED USE: 4
a:{�STING ASSESSED/ • • • .ED VALUE $ UE OF PROPOSED WORK:
SP• , i FRED BUILDING? ❑YES a NO IRE SUPP• D,•.ION SYSTEM PROPOSED/REQUIRED: ❑YES 0 NO
WATE• SERVICE PRO 'i'ER 0 LAKEHAVEN a HI :i t 0 TACOMA a PRIVATE(WELL)
SEWER ERVICE . 'OVIDER: 0 LAKEHAVEN a HIGHLINE a PRIVATE(SEPTIC) •
■ PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
(
ADDITIONAL FLOORS(DESC: :E)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? a, . ,TOTALEXSTING ' ,'TOTAL ';Toru twsnryG n►�to,irrosm,,•'
"NEW HOMES ONLY" NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
a FIXTURES
•
Indicate number of each type of fixture that is to be ins ..ed or relo.•ted as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS •SDSc i q WOODSTOVES
BOILERS FIREPLACE INSERTS ES MISC(Describe)
COMPRESSORS FURNACES GAS TER HEATERS
_DUCTS GAS PIPE OUTLETS _
PLUMBING
BATH .:S(or Tub/Shower Combo) SHOWERS WATER CLOSETS go- MISC(Describe)
DI ' ASHERS SINKS DRINKING FOUNTAINS
'AS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom VACUUM BREAKERS ELECTRIC WATER HEATERS
•
!� DISCLAIMER/SIGNATURE BLOCK
11
I cert(fy under penalty of perjury ' 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 claim(including costs, expenses,and
attorneys'fees incurred in the investigation and defense of such claim), which may be made by any person, including the
undersigned,and filed against the City of Federal Way, but only where such claim arises out of the reliance of the city,
including its officers and employees,upon the accuracy of the information supplied to the city'as a part of this application.
NAME/TITLE: _. ,�n' "N't/ t
(_NADATE: /` -( —U t
(Signature) / (Title)
RELATIONSHIP TO PROJECT: ❑ Property Owner 0 Applicant 0 Contractor 0 Architect ❑
•
? d it'. D,. QN ,AAI ERATION; 't:?:F REPAIR.;; {FdfT ENANTiIMPROiEMENTi. � '`•°
SING HELL •'°_ ..a. .:`' O :+ tM" ` ~xBASIC,P7."AN?h� ''zSr2�M ' n YE.SF4.;;. pr sy
-10^7'G7 :ESIGNA'I ION:q ;: sVM .. . , ` CFIANGEwOFrUSE?T " .r.. 'x",5 % ".•.NO' �, ,;•1
,s r UP SEPA SU?' • O r
a:FEW,�lDD�tES3WQUIRED? .�4YES,E NOS s;,i�x'�:." . .x"�; ! /' / ;����:-.•";;3 � �,���YES.'I� !i0� �;'"
;PLATED I:OT?'`'"^°" a YES*,':G NOM DEMb PERMIT REQUIRED? • o YES