04-100847 City of Federal Way
Community Development Services Electrical Permit #:04 - 100847 - 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: LESSLEY •
Project Address: 809 S 308TH" Parcel Number: 931500 0030
Project Description: Repair for the drop loop from the weatherhead
Owner Applicant Contractor
Jared N Lessley &Melanie Lessley Jared N Lessley Jared N Lessley
809 S 308TH ST 809 S 308TH ST 809 S 308TH ST
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003-4705 98003-4705
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Yard Pole Meter Loop B 1
PERMIT EXPIRES September 7,2004.
Permit issued on March 11,2004
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. ,"---"c.
Owner or agent. e.�0�2 '/ eeC.' Date: 1 ( i 9 L--/
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c COMMUNITY DEVELOPMENT SERVICES
CITY of ! a0 �� 33530 FIRST WAY SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063.9718
Federal Way 1 Zoog PERMIT APPLICATION 253 inacitualTe .di 1-4115.FAX:253-661-4129
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Far Office Ow only: F@'�,�3!)�i�&�ber: - _ p IP - . / i 1 /
The ollowin. is re•aired in ormation-an ince •lete a.•iication will not be acce.ted. Please •rint le•ib/ (in ink)or -.
■fJPRO,PERTY INFORMATION
SITE ADDRESS: 'O q SE 30,7 '-'-'--'57 FeciPtic CdU-t/� 04- 70 Ova SUITE/APT#
ASSESSOR'S TAX/PARCEL#: - SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION(e.g.:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT(This application): 0 BUILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION
e•-kELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provvide detailed descriptio of work included conn this a 't onl . CO L) f )-eSei £ 614%.4...
/3:itspe ci-;04 IPCetig.i/ 0 -VA;
1
PROJECT NAME(Name of Business/Owner Last Name): L.P W...,,
a PEOPLE INFORMATION
PROPERTY NAME: _ / PRIMARY PHONE:
OWNER: TaV.eQ (144 /A,�"ut�t 6L' Less/e ( ,53 ) g3? -aff2
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
?0? CO.Jo ` 5)1 Ic wk ?t003
CONTRACTOR: NAME COMPANY OFFICE PHONE:
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP CELL PHONE:
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: . FAX NUMBER:
— — _ / / ( )
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required with each application) / /
LENDER NAME: , DAYTIME PHONE:
(If Proposed value>$5,000) ..5,1"e ( )
MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: NAME: COMPANY OFFICE PHONE:
3 a.•,e, ( )
MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE.
( )
RELATIONSHIP TO PROJECT: FAX NUMBER
0 Architect ❑Tenant 0 Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: 0 Property Owner 0 Contractor 0 Applicant E-MAIL ADDRESS:
/ ■Q DETAILED BUILDING INFORMATION Q �+ �( C� • /
EXISTING USE: -5-) -lie Fa_s.a.i`x �ffh- tce PROPOSED USE: (e9 J/ CezetI'�3y(i/PGIVrca{ ( ai
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? 0 YES 0340.-
FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES a NO
WATER SERVICE PROVIDER //AKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER PLAKEHAVEN a HIGHLINE a PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL •
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED
"NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• FIXTURES
Indicate number of each type of fixture that is to be installed or relocated 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 HOODS(com..rd.:) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS or Tub/Shower Combo) SHOWERS WATER CLOSETS(milt) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sink VACUUM BREAKERS ELECTRIC WATER HEATERS
1111 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 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: DATE: 3--//-
(Signature) 44.11 (Title)
RELATIONSHIP TO P JECT: 0 Property Owner ❑ Applicant ❑ Contractor 0 Architect ❑
FOR OFFICE USE ONLY:
o NEW a ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION: CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? o YES a NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a NO
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