04-101214 City of FederalWay
CommunityityDevelopment Services Electrical Permit #:04 - 101214 - 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: STEVENSON MOTEL
Project Address: 33330 PACIFIC S Parcel Number: 797820 0045
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 1QUantity Description Quantity Description IQuantity
Alt.Serv./Feed 201 amps-600 amps-t 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. See Application
Owner or agent: Date: Z -09
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PERMIT
COMMUNTIY DEVELOPMENT SERVICES RECEIVEED MF COMOPL DE EN FP
33530 FIRST WAY SOUTH•PO BOX 9718
FEDERAL
3-6t;�WAY,
5 FAX 253 6-4129 APPLICATION .s T°
www dhloffederalwaq com /
APR ,,
The ollowin. is re.uired in ormation-an inco •lete a.•lication will not be acce•ted. Please .rint le.ibl (in in or
. PROPERTY INFO1! IAra m
3333 0 Sze i RC_ �q S =. .
SITE ADDRESS g SUITE/UNIT#
q
ASSESSOR'S TAX/PARCEL# 7 / 7 v1 C) 0 O C. S1 LOT SIZE(sf)
2•SoO0
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal desmpnon)
PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING 0 MECHANICAL
0 DEMOLITION IIINELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed dens tion of work included on this permit only)
lPrtC-e CCY tic"('l CY1 - -o-r' OCre�c-h eOd - c, unde rcx__r d
PROJECT NAME(Name of Business or Owner Last Name) S frA Aej,A-SA •_- l'-'4 Q'(.!
PEOPLE INFORMATION
PROPERTY NAME/ {� fPRIRIMARY PHONE
OWNER i�/`C.l2AX�✓1 ca V\oC_t(1r1 (Cs` lcam' Qrr..ek I t[. )l'X'� -cm-2
MAILING ADDRESS CITY,STATE,ZIP
2>So `.r3. c 3c I E-. c\C_. ,CLI)N1 GAGS
CONTRACTOR COMPANY NAME
APPLICANT NAME OFFICE PHONE
C e\co �n c Q -(itt- ,r eC-'• t (Z ) Ks E
MAILING ADDRESS
'��^ ^ CITY,STATE,ZIP CELL PHONE
- '
F S - 5� ,CSA C90 �c2rn6C -G136'
CITY OF FEDERAL.WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
20-0 k - 1 G t S'7 - BLL 12 / 31 / C (2S3 ) F63 -1.3-
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
C1---\-'t--z t_-_-_\:_ 3 4 4 G (-( 7 /3( / o(—
APPLICANT 9akPANY NAME APPLICANT NAME OFFICE PHONE
G ,e\C o' Yr c O t crec- - rec,t r (253 )(96 -0414-1
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
1lAkCDS t. ' S- \:= TCir r1r,C AA\ �' S"�o 01217(( -0\-3G _
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant ❑Agent ' Other(Describe) Crx C} (2 S-I) Jt ? _+ G
CONTACTtt�V``.� PRIMARYPHONg E-MAIL ADDRESS
NehaiNal-,A-e"1 ,-,)QC6 -cs_t c, co Irk rac"l Q ex\-act,e rle4-
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 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE('TELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ 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 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(Coammormal) W OODSTOV ES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS
Rodcq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sulks)s) 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 e c't incl ing its fficers and employees, upon the accuracy of the information supplied to the city as a part of
this application.
i
NAME/TITLE DATE 44kCI
( ignature) (Title( \ \\
RELATIONSHIP TO PROJECT ❑ Owner o Agent o Contractor 0 Architect (Other SCXjC6A-c-Cs .
FOR OFFICE USE ONLY
o NEW o ADDITION a ALTERATION ❑ REPAIR ❑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? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑ NO
PLATTED LOT? a YES ❑NO DEMO PERMIT REQUIRED? o YES ❑ NO
Bulletin#100-March 30,2004 Page 2 of 4 k\l landouts-Revised\Permit Application