04-101822 City of Federal Way
Community Development Services Electrical Permit #:04 - 101822 - 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: ZIMMER
Project Address: 1937 S 369TH St Parcel Number: 721265 0030
Project Description: Install circuit for air conditioner
Owner Applicant Contractor
Vincent J Zimmer &Janet E Zimmer INTEGRITY ELECTRIC INC INTEGRITY ELECTRIC INC
1937 S 369TH ST 4501 KENNEDY RD NE 4501 KENNEDY RD NE
FEDERAL WAY WA TACOMA,WA TACOMA,WA
98003-7573 98422 (253)943-0500
Electrical Fixtures
Description Quantity Description Quantity]I Description Quantity
Circuits-Residential 1
PERMIT EXPIRES November 8,2004.
. Permit issued on May 12,2004
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: er".:-..." Date: S ' 2,—Gy
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t , �� CONSTRUCTION PERMIT APPLICATI
•CITY OF �.� RECEIVED APPLICATION NUMBER: 0 q- 1._ 0� S2L--01
Federal Way APPLICATION NUMBER:MAY 1 2 2004 APPLICATION NUMBER: - -
rrftl 1vn frAw WAYnformation—Please print(in ink)or type**
Please note: Electrical,FT-VIl�t'ANGticlg1 (stems and Engineering permits may require a separate application.
- . . = -, . . -- ■ ,PROPERTY INFORMATION , ,- - - - . .
SITE ADDRESS: n 3 1 S- �(cci tN cT • ASSESSOR'S TAX/PARCEL #: —7 )-I k 5 - .1)Cd S O
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
3 0-eyer�� i7ocits D. v , Wo O 1.
- _ , ' -. - - ■ PROJECT INFORMATION - _ _- - •
TYPE OF PROJECT(This application): ❑ BUILDING o PLUMBING 0 MECHANICAL 0 DEMOLITION
pcELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): ,v15 `1 (/-t.� G... i c Q.,.1., 4r G„-''-"
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t PROJECT NAME: J�v-‘ —L-.v---•vre....‘,---
- -• -■ PEOPLE INFORMATION - - -
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PROPERTY OWNER: I NAME:
•
i DAYTIME PHONE•
01/4`^ Z,mrti—r, ; ( z-5. 35-OZS
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
1CI3-7 s . SE ;Lci11' SE. p 4...,__1 ,.„..),3.,jtA,A ctc-tv.�
CONTRACTOR: NAME: i ' DAYTIME PHONE:
/?% /s/1 MAILING ADDRESS(STREET A ESS;CITY,STATE.ZIP): EVENING PHONE'
6775// ! CITY OF EDE i L WAY BUS LIS CENSE UMBER: ,v� FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER:
I EXPIRATION DATE:
(copy of card required) 1 iv r E c. x 9 ' a /1/4/ v/( cc/ / I L, / "1-;:,�-1
APPLICANT: NAME: �qy ,rt#M' DAYTIME PHONE•
V' I \ 3Crr,, - (2-‘s-". �'�
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($c-eVY'G-t ) I ( )
MAILING ADDRESSSTREET ADDRESS;CITY,STATE,ZIP):) !EVENING PHONE:
- � W� KL
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RELATIONSHIP TO PROJECT: i FAX NUMBER.
0 ARCHITECT 0 TENANT %OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS.
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER 0 APPLICANT CONTRACTOR
-•■ DETAILED BUILDING INFORMATION - . .
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
S PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL Value of Mechanical Work: $
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: 0 ELECTRIC ❑GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC ❑GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ 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 daim(induding costs,expenses,and attorneys'fees Incurred In the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the Information su plied to the dty as a part of this application. �}
NAME/TITLE: �J _ ilr� �- DATE: 5 - \-2--0
❑ PROPERTY OWNS LICANT ❑CONTRACTOR
-FOR.OFFICE USE ONLY
apQADDITION£ ap ALTERATION b . _ k :F:< -
NEW �- ��, . ;REPAIR:�.���i�;TENANT.IMPROVEMEIVT•�_k�
`,"%! :..'LOT:SIZE: � e� `����•''�x� .+" '_3=
ZONINGTDESIGNATION: •=-4_ =- ; W _ NO '•� ;
COMP PLAN DESIGNATION :, '' _=rBASIC PLAN? t7:YES;, a NO_; `-
,SECTION TOWNSHIP; ',.'RANGE =_ ,NEW ADDRESS REQUIRED?'`-.'' f--7o'YESI_ ci NO -
^PLATTED LOT?a=;❑
its-7-13-NO ;'_ ;a` 'Arl `.5 '•'CHANGE OF USE?=-7!'4-'17" '=�❑YES=`=o
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.cityoffederalway.com