04-101953 City of Federal Way
Community Development Services Electrical Permit #:04 - 101953 - 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: MACLELLAl e,
Project Address: 32820 20TH S Unit12 Parcel Number: 144170 0120
Project Description: Install(1)30amp 240 volt circuit for A/C& 110 volt GFI outlet
Owner Applicant Contractor
PHYLLIS MACLELLAN GS ELECTRIC GS ELECTRIC
32820 20TH AVE S UNIT 12 5923 VICKERY AVE E 5923 VICKERY AVE E
FEDERAL WAY WA 98023 TACOMA WA 98443 TACOMA WA 98443
Electrical Fixtures
Description Quantity Description 'Quantity Description Quantity
Circuits-Residential 1
PERMIT EXPIRES November 15,2004.
Permit issued on May 19,2004
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` { &R,\ Date: ��//q/O q
6\k)'a
40 4
•
plc tVEL, CONSTRUCTION PERMIT APPLICATION
CITY OF �..� R APPLICATION NUMBER: .0 4 - _J f 9'S3 -
Federal Way _ T r -
MAY 1 9 2004 APPLICATION NUMBER:
APPLICATION NUMBER: - -
* g F FEDERAL.Wo information—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
- ■ PROPERTY INFORMATION . ' - - _
SITE ADDRESS: O c9644- Atp2 , c"-• . # lC ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• - I - - ■ PROJECT INFORMATION - ' -" '
TYPE OF PROJECT(This application): ❑ BUILDING 0 PLUMBING o MECHANICAL 0 DEMOLITION
)ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): IfnCAZX`i 3c Q CYl OLIO Jot+ o rc�n i
Poe . S\-p\. \\o �- ClipT c,i).+ it-t ...
or 4 le-
PROJECT NAME:
- , • - - -•• -■ PEOPLE INFORMATION -
PROPERTY OWNER: NAME: \�-�y1�` ; DAYTIME PHONE
MAILING ADDRE`S_TR\ET ADDRESS;CITY,JS(�0A,(1 L 1\c(\ I (3 )�o I coie
P):
(33.$a0 fgOs . Pt-().e . ' . ia F2.d0 axJ u..1-198oa3
CONTRACTOR: NAME:_ DAYTIME PHONE:
I : S elite-A-( ie-- ' (as-3) qac s'-mi-
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): 1 EvEffIIBT1440NE. C.ie 1 I
• — i, Am AI '.4 (0963) is- - 9s. ?
CITY OF FED RAL WAY BUSINESS LIr4 SE NUMBER: FAX NUMBER:
I o - b3ra1 g - a9 (A53)9,94 - 43031
CONTRACTOR'S REGISTRATION NUMBER:
_ y �,y EXPIRATION DATE: /�
(copy of card required) G S LC r 7� 9 $ 6, V 1 /a � / 0 LI
APPLICANT: I NAME: DAYTIME PHONE
! as -trcA-c ;Q._ (,96.3)9) (., - $yeq
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE
I``q1a3 the ke l E_ . Yoleanek 43 ( )
I RELATIONSHIP TO PROJECT: � T�-KI '' ( i FAX NUMBER
I ❑ ARCHITECT 0 TENANT 0 OTHER( DESCRIBE): �(*(OC_1t (a63) golf, 4303
E-MAIL ADDRESS.
, CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER 0 APPLICANT CONTRACTOR
- - • - '-IIIDETAILED BUILDING INFORMATION . - - -
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 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: a ELECTRIC a GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC a 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 sup 'ed to the dty as a part of this application. , J
NAME/TITLE: i C:eL5 DATE: 5_19-6"'1
a PROPERTY OWNER ❑APPLICANT CONTRACTOR
-FOROFFICE USE ONLY:..
tD NE{N 1 rADDITION ALTERATION- .., ;,'o REPAIR 7:£J' verafteigkeolig-k arrAtf,n,
LOT SIZE:` c. = -,'�'.;- ,_- ---3.
:, ,�.�..�Y,.-`•'i;', �. :ter:
ZONING-DESIGNATION," r61.1-= ; BUILDING SHELL ONLY?` 'a YES "::D NO
COMP_PLAN DESIGNATION,« a> .:; BASIC PLAN? "° YES' =`❑'NO `
:SECTION S y-=t TOWNSHIP; r'•"RANGE`= �� :NEPA%ADDRESS REQUIRED? ..=F '`o YES--t '❑ NO
-•'PLATTED Lo-r? a YES 'r SN0 '`Y" 'i •CHANGE OF USE? --qT,"' '=ry n YES =• 1a NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.cttvoffeceralway.com