04-101215 City of Federal Way Electrical Permit #:04 - 101215 - 00 - EL
Community Development Services
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: SECOMA VILLAGE
Project Address: 33324 PACIFIC S Parcel Number: 797820 0025
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
141058TH STE 141058TH STE
\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.
Owner or agent: See Application Date: 'l . -01
— 4-0 k S-erast - ?prcti-e0
r I ,\,e
(*„ 7-ft
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'�ECEwEr
Federal Way PERMIT
COMMUNTIYDEVELOPMENT SERVICES SF MF CO ME OPL DE EN FP
33530 FIRST WAY SOUTH•PO BOX 9218
F5SAX3 A P P L I C AT I O M 1 2011`6
I23-6 / /
61 F256-4129
wwwdtttotkderohwov t m
The oilon. is re.uired in ormation-an into •lete a..lication) OF FEDERAL WAY
oilman.
,.4,4:..c 'Y;- i;-d. Please .rint ie•ibi (in in or
. PROPERTY INFORMATION
SITE ADDRESS is �) 3 3 31 Li �,( `c. N-u, s
SUITE/UNIT#
TAX/PARCEL#79 _ .. 8' A D - Q Q _- LOT SIZE(sj)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
/Attach separate page for lengthy legal desonpaon)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING 0 MECHANICAL
❑ DEMOLITION INELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed des tion of work included on this toermit only)
SN -e Cc Lec-C 1 on CjC, t--head 40 C de roc rC
PROJECT NAME(Name of Business or Owner Last Name) Se_.-C--0-1/K.e. \(( ` /a_
•
PEOPLE INFORMATION
PROPERTY NAME
/�`
1 A 1 PRIMARY PHONE
OWNER GI�CJ�X".t✓-1 TCS 1``dC.crlr'1 (c •-7 C.�f� l (251 ) 1 -`/
-A l 5~L.
MAILING ADDRESS CITY,STATE,ZIP
7>S'o `r� C,.x3 S �. \c 'CU)/1 G.fiGG3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
( e\cc n c OX. . Irec...w s (Zi?) K3 -o4
MAILING ADDRESSCITY,STATE,ZIP CELL PHONE
LL ACS F��^ a-' _ Samna',CAJ A G' r0 earnGS -G136'
CITY OF-cFEDERAL -`USO BUSINESS NUMBER B L ( EXPIRATION1DATE C (2FAX
J'NUMBER
K3 -,3-9
'(^Cc/ONTTRRACTOGR'S REGISTRATION NUMBER(copy of card required with each appliiccation)) EXPIRATION DATE
c, C \-'C= LE- 344 GLi /�1 / Gs
APPLICANT C PANY NAME APPLICANT NAME OFFICE PHONE
YG \co�rc O\,(ret- t`C�.t.r 1253 )<96 -0414
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
1l-kCD S'a 7=-- Sc,M,) c . q S`nc) (can 7CC -G\3G
RELATIONSHIP TO PROJECT \ \ FAX NUMBER
0 Architect 0 Tenant ❑Agent Other(Describe)SCX�C�t\'crc r (253) y6- -e--n
J
CONTACT N�� PRIMARY�HONE-MAIL ADDRESS
tl HVarew1 � 26
-C -SPH cxtrdrac."1 Qt-30\elcuene
LENDER Per RCP/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 o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ 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 Mechanical Work S
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG SYSTEMS
BBQS FANS HOODS(comm«<,m) W OODSTOV ES
BOILERS FIREPLACE INSERTS RANGES MISC(Descnbe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(rolr) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom SD,ks) 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 arty claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim) which may be mase 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• incl ing its fficers and employees, upon the accuracy of the information supplied to the city as a part of
this application. �
NAME/TITLE 1 DATE �-/'
4kC/
( ignature) (Title( �\
RELATIONSHIP TO PROJECT 0 Owner 0 Agent ❑ Contractor 0 Architect ((Other JCk)C6r r-OrOr'
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 ❑ NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES a NO
PLATTED LOT? a YES ❑NO DEMO PERMIT REQUIRED? ❑YES n NO
Bulletin#100—March 30,2004 Page 2 of 4 k\I landouts—Revised\Penni(Application