04-101018 City of Federal Way Electrical Permit #:04 - 101018 - 00 - EL
Community Development Sen ices
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: PACIFIC DENTAL&DENTURE
Project Address: 33505 PACIFIC S Parcel Number: 926503 0010
Project Description: Retrofit lamp and ballast
Owner Applicant Contractor
Du S Jung &Ann Y Jung UNITED ENERGY TECHNOLOGY INC*CHI UNITED ENERGY TECHNOLOGY INC*CHI
33501 PACIFIC HWY S UNITED ENERGY TECHNOLOGY INC UNITED ENERGY TECHNOLOGY INC
FEDERAL WAY WA 33310 PACIFIC HWY S SUITE 404 33310 PACIFIC HWY S SUITE 404
98003-6809 FEDERAL WAY WA 98003 (253)835-1900
Electrical Fixtures
L_ Description Quantity Description Description Quantity
Circuits- Commercial I I
PERMIT EXPIRES September 20,2004.
Permit issued on March 24,2004
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: See Application
Date: ,O'(
8 f i s+ o4 Ft-vv.„cl 41/41?,
1
�VEDCONSTRUCTION PERMIT APPLICATION 1211-'ciTY oa +' RC APPLICATION NUMBER: (, kI - it. Q LU 1 g- ( O
Federal Way APPLICATION NUMBER:
MAR 2 3 ZUu4PPLICATION NUMBER: -
**The following iscligghvIIIiphirig gi se print(in ink)or type**
Please note: Electrical,Fire Prevention SATdhiding Eng nearing permits may require a separate application.
• PROPERTY INFORMATION
SITE ADDRESS: 334-1)5 PG-CC-Pre- I ftp S. ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): o BJJILDING 0 PLUMBING ❑ MECHANICAL o DEMOLITION
la4LECTRICAL ❑ ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): VP-�-Lo"�Z'f�C✓L_ �`1r' . ���«s
PROJECT NAME: PG-GT--Ft-1 V_e"„"-4-z`k,-
• PROJECT INFORMATION
PROPERTY OWNER: NAME: ¢{�./ DAYTIME PHONE: {�_^
MAILING ADDRESS1ETO..REf1l CITY,t70 o). 'el�� ( 0) CP i (-- �, V v
�3�� Po 14--� Rwr . s . F-cL-e'-04- t-. r CJ 4. Pa°'ao-
CONTRACTOR: NAME: (J g.:-/-1 DAYTIME PHONE:
314A`I WADMAPFT)g P![)bacri$,3fA1E44): EVENING PHONE:
FEDERAL WAY, WA 98003 (()--) rs p OM
CITY ' 9!L 243ssassur7egfMBER: FAX NUMBER:
- - ( )
_
CONTRI32C1N§JMU:8 !
/�/ /'�/ /� f'T /''/' EXPIRATION DATE: 1
(copy of card required) (�f' (v l e C—�f O eF c -s`--1 /0/ z7
APPLICANT: NAME: DAYTIME PHONE:
Sot w2 al a bo v-c__ ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT 0 TENANT OTHER(DESCRIBE): Cit.t.4 dVY.L / ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER a APPLICANT o-CONTRACTOR
• PROJECT INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE a TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE o PRIVATE(SEPTIC)
•
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT 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: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC o 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 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 flied 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 . e ci s •art of this application.
NAME/TITLE: DATE:
o PROPERTY OWNER ❑APPLICANT ❑ CONTRA •R
FOR OFFICE USE ONLY:
❑ NEW ❑ADDITION ❑ALTERATION a REPAIR ❑TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑YES a NO
COMP PLAN DESIGNATION BASIC PLAN? o YES o NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? a YES o NO
PLATTED LOT? a YES a 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.citvoffederalway.com