04-101231 City of Federal Way
Community Development Services Electrical Permit #:04 - 101231 - 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: MIDAS MUFFLER
Project Address: 32530 PACIFIC S Parcel Number: 162104 9051
Project Description: Electrical service conversion from overhead to underground in conjunction with Pacific Highway ROW
expansion project.
Owner Applicant Contractor
CITY OF FEDERAL WAY*MARWAN SALL( POTELCO INC POTELCO INC
33530 1ST WAY SOUTH POTELCO INC POTELCO INC
14105 8TH ST E 14105 8TH ST E
\FEDERAL WAY WA 98003 SUMNER WA 98390 (253)863-0484
Electrical Fixtures
Description !Quantity Description Quantity Description Quantity
Alt.Serv./Feed 201 amps-600 amps- 1
PERMIT EXPIRES September 29,2004.
Permit issued on April 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. i I
Owner or agent: See Application Date: -1 '2 -09
3
°`.�' RECEIVED `f - / .n
Federal Way PERMIT A.3 --L
COMMUNTYDEVELOPMENT SERVICES
SF MF CO MED PL DE EN FP
33530 FIDR A WAY 253-661-4175•FS PO AX -7 9"d A P P LI CATI O 1 z°'
FEDERAL WAY,WA.4d063-97Id
uww.dtgolTederdway.mm CITY(��OF FEDERAN77--a / /
The ollowin• is re•uired in ormation-an inco 'Tete a.•iication u/llPnoli Ibe aced. Please •rint le•ibl (in in or
PROPERTY INFORMATION
SITE ADDRESS `32 S'30 Gct-1►c X S' SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 1 (Q I Q q _ 0 S /
V u cc LOT SIZE(s.0
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal de-scripl,on)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING ❑ MECHANICAL
0 DEMOLITION 3NELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed des tion of work included on this permit on r
S r k tC-e COn_e e(1 o' CX 4 OCA e c 2.rNC.ik _
PROJECT NAME(Name of Business or Owner Last Name) At VV c -CLIer-
PEOPLE INFORMATION
PROPERTY NAMEPRIMARY PHONE
OWNER
HONEOWNER f uZ1/4X (1 To` (Xt�1 (G .-1 cP ,lCI (G7g )/6-
1 -gm.
MAILING ADDRESS CITY,STATE,ZIP
S� \r� C S > I c ,c1 ./A qdOG�
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
C e\ccs --A3n C_ C <<.(50/- Andkrec...3 s (ZS?) K3 -CA kit
MAILING ADDRESS
I��^ ^ � CITY,STATE,ZIP
Ifs ar LL PHONE
CITY
/O^F�FEDERAL/� 1WAY BUSINESS LICENSE NUMBER ` S� ,rg-L W (-� K-(Zrn66 -C��36'
20-0 \ - l d l - J -7 -B L l2 EXPIRATION
I 3( 1 C64 N DATE (2 )
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application(
9 Cr7{-� ' '344 O EX/ .- 1
D/
TE
OS-
APPLICANT C PANY NAME APPLICANT NAME OFFICE PHONE
Oe\C O' Yr\c C�\cJel— ,re r (Z5? )(Kg -C 444-{
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
kl-kkC53 'N ' S\ `== SCmnar,C • Ct�' nC) (x-12r)7c( -o\-36_
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant o Agent ' Other(Describe) C} (2S-3) X?
-
` G
CONTACT I PRIMARY PHO6- E-MAIL ADDRESS
C the r N/ atewl L (253)k
- {Py oc ra roc.AJ Q e0\-e1cQn �
LENDER
Per RCW 19.27.095: Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS
CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN O HIGHLINE ❑ 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 to be installed or relocated as part of this project. Do not Include existing fixtures to remain.
MECHANICAL
Value of Itlecharucal Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS
BBQS FANS HOODS(comm,oy( 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 noir) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom smk J VACUUM BREAKERS ELECTRIC WATER HEATERS
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 ma•e by any person,including the undersigned,and filed against the City of Federal Way,but only where such claim
arises out of the reliance o ec't incl ing its fficers and employees, upon the accuracy of the information supplied to the city as a part of
this application. /'
NAME/TITLE DATE `-f'4/0C(
( Ignaturq (lit )
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent 0 Contractor 0 Architect stOther J(X,L'6/nc\s-C-Grtiv--
FOR OFFICE USE ONLY
❑ NEW o ADDITION ❑ALTERATION a REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? o YES 0 NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? 0 YES ❑NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? 0 YES o NO
i
Bulletin#100-March 30,2004 Page 2 of 4 k\l-Iandouts-Revised\Perinit Application