04-101222 City unity Development Services eveWay
CommunityElectrical Permit #:04 - 101222 - 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: SENOR TACO
Project Address: 33130 PACIFIC S, Parcel Number: 797880 0240
Project Description: Electrical service conversion from overhead to underground in conjunction with Pacific Highway ROW
expansion project.
Owner Applicant Contractor
BRIAN EDWARD McMILLAN POTELCO INC POTELCO INC
33110 PACIFIC HWY S#2 POTELCO INC POTELCO INC
FEDERAL WAY WA 14105 8TH ST E 14105 8TH ST E
98003-6444 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.
Owner or agent: See Application Date:
A- 7-0— ok
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7 — 1 - o SPrW( IrL' Z5
RECEIVED
0 4-( - I o I Federal Way PERMIT APR 0 1 20o4—
c1DnfMtllrm•DEVELOP1fEM'SF.RVJCEs SF MF CO ME 0'L DE EN FP
33530 FIRSTFEDERAL
WAY,WA..06DOX 9718 A P P LI CAT I� fi
FEDERAL WAY,WA 9d063-97Jd FEDERAL
253-661-/1 15•FAX 253-661-4129 I DING DEP . /
uneur.dtyo federotway.com
The ollowin• is re•uired in ormation—an incom.tete a.•lication will not be acce•ted. Please •tint le,ibl (in or
PROPERTY INFORMATION
SITE ADDRESS J J 2 (? cy�chC ) . -3 'C SUITE/UNIT It
ASSESSOR'S TAX/PARCEL M7 4 7 d g 0 --_`JO c- Le 0 LOT SIZE(sJ7
asac2K
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
/Attach separate page for lengthy legal deso{paonl
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ViNELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed des tion of work included on this ermit only)
�Iv ic-e cc Lee o- oc,ecke oc 4 d ee rc,c_t d _
ti
PROJECT NAME(Name of Business or Owner Last Name) r') `C.)
PEOPLE INFORMATION
PROPERTY NAME, A - (� {� 1 PRIMARY PHONE
-
OWNER /v I(tt'CA/Ct✓1 JC����icrlr'1 (c 'l Cl'' Qr'ttc\C-1 C(I (273 )l6 ) -44M-
MAILING ADDRESS CITY,STATE,ZIP
3'�S3o `t� C.. , spa-, I ,C,i. GcPOG�
CONTRACTOR COMPANY NAME
,\ APPLICANT NAME OFFICE PHONE
( e\co c Q-C S (2 ) K3 -may,e-i
MAILING ADDRESS
(��^ /D^ � �� CITY,STATE,ZIP CELL PHONE
a nt ,CSA q 9 ?o tc2rn66 -G136'
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
20-G \ - lot �"-.1 -B L 12. / 31 / C- (2S3 ) K3 -\3-9
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
Q C1'S'\---:‘ L:7\; 4f3 44 G (-t 7 /fit / OS--
APPLICANT C PANY NAME APPLICANT NAME OFFICE PHONE
Ge\Co O cyer- s 273 )g -C4er'c-E
Yr
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
tlAtC5 ''s\' S\- Sc r C,01 qt S-0 (Lan 7C( -0\-36
RELATIONSHIP TO PROJECT
^� C\ FAX NUMBER
❑Architect D Tenant O Agent (D Other escribe)t�(�1 X '\T (25-1) X3 -t3-7
CONTACT ♦ � PRIMARYP HONE E-MAIL ADDRESS
C <<t� �1 I(A- 26 -0541(-1 cctr cVIM."I Q p\e1ca 114..
B-
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? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES o NO
WATER SERVICE PROVIDER 0 LAKEHAVEN D HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 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=STING 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 Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS
BBQS FANS HOODS(comm•rclai) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS;or Tab/Shoucrcombo) SHOWERS WATER CLOSETS frok,) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Smks) 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•a 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 44Jc%(
( tgnaturc( (Ta ) c\\ """J
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent ❑ Contractor ❑ Architect t9[Other �.X7 (-Car-
FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? ❑YES a NO DEMO PERMIT REQUIRED? a YES ❑ NO
Bulletin#100—March 30,2004 Page 2 of 4 k\I landouts—Revised\Permit Application