04-102046 -
City
ofFederal
Development Services eveWay
ComElectrical Permit #:04 - 102046 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.400i) Fax.253 661.4129 Inspection request line: 253.835.3050
Project Name: ANDREWS
Project Address: 1264 SW 301ST Parcel Number: 515320 0280
Project Description: Replace 200-amp residential service
Owner Applicant Contractor
Hugh C Andrews LANDER ELECTRIC SERVICE LLC LANDER ELECTRIC SERVICE LLC
1264 SW 301ST ST 13359 NE 16TH ST 13359 NE 16TH ST
FEDERAL WAY WA BELLEVUE WA 98005 BELLEVUE WA 98005
98023-3413 (800)794-4321
Electrical Fixtures
Description Quantity L Description Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES November 20,2004.
Permit issued on May 24,2004
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: • • Date: S.-- ki
THIS CARD IS TO REMAIN ON-SITE
Cllr OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-102046-00-EL
Owner: LANDER ELECTRIC SERVICE LLC
Address: 1264 SW 301ST ST
FEDERAL WAY, WA 98023-3413
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
O Slab/Concrete Floor(4255) ❑ Ditch cover(4030) ❑ Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) ` k Final-Electrical(4055)
Approved Approved Approved
•
By Date By DateBy a L, Date' •ai PAN
,
❑ Under-slab groundwork(4295)
Approved
By Date
+� ••MMUNITY DEVELOPMENT SERVICES
r OF CO)(�JM f7�� �/ 530 FIRST WAY SOUTH•PO BOX 9718
federal Way PERMIT APPLICATIOT "Eco'P' ° a 5366 115•FAX:253-661-4129
' uEPART>t �(�tuc((ederalwau corn
AY 2 4 2004 ID.
"ICIV
For Office Use Only. 0 - / ^^ , 0 4. ( A
FW File Number: \V/ -/F /�.G/ (�aL� / /
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
III PROPERTY INFORMATION
SITE ADDRESS: /21-t- V �Y /ur UtiVer ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION (eg:Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
SQUARE FOOTAGE OF LOT:
• PROJECT INFORMATION
TYPE OF PERMIT (This application): `❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
.,/lc ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description,of work included on this permit onlU):
pepIa( ' 2orAiry9 corn 1 e
PROJECT NAME(Name 0 Business/Owner Last Name):
• PEOPLE INFORMATION
PROPERTY NAME
4.!Qtyu , 4ke PRIMARY PHONE.
OWNER: (LJg) Upy/ -71'qG
- MAILING dti
/1 ,' J"W -i-olfrf e L
W , ;fel. 9(o2.
CONTRACTOR: I NAME COMPANY
L / � 'r E er• /-/ c ( OFFICE PHONE:
( l GG (�2r�3 2 - 177/
/SLING ADDRESS(STREET ADDRESS,). ti/ I li v ''n/` �� WO ,CELL PHONE: -
CITY OF FEDERAL WAY BME /IUSINEISS(LIICCENSE NUMBER '/l/7` (� /I�SCPIRATION DATE:_ , FAX NUMBER:
° It - Lo 1 . ° 07 - o0_ /2 .3/ ay- (y-25 )1'2 -)8
CONTRACTOR'S REGISTRATION NUMBER. �y/� EXPIRATION/ DATE.R
(copy of card required with each application) / '/ C ///{ / 0j /e"5
',ENDER: NAME DAYTIME PHONE:
If Proposed Value>65,0001
( )
MAILING ADDRESS(STREET ADDRESS;)• CITY,STATE,ZIP
kPPLICANT: NAME: . COMPANY OFFICE PHONE:
M-i11 A fr/frjr LtA4�r Elec fr C (0-IAN -/III
MAILING ADDRES STREET CITY,STATE,ZIP EVENING PHONE:
V� 1 . 1., (OAti-,10 to Y ( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER.
0 Architect 0 Tenant 0 Other (Describe): ( ) -
:ONTACT PERSON FOR THIS PROJECT: 0 Property Owner ❑ Contractor 0 Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE:
IXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES 0 NO
RATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
;EWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
U 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: $
U FIXTURES
ndicate number of each type of fixture that is 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(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS 10,Tubj$lGw2Combo) SHOWERS wCTER /1CTTv ToiEf MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sink VACUUM BREAKERS ELECTRIC WATER HEATERS
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 claim(including costs, expenses, and attorneys'fees incurred in the
investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of
Federal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of
the information
suppliedsuto the city as a part of this application. �j L�
NAME/TITLE:/ ,li ,1 I �V DATE: ✓ 2- .� /
ig ure) (Title)
RELATIONSHIP TO PROJE T: ❑ Property Owner 0 Applicant 0 Contractor 0 Architect 0
FOR OFFICE USE ONLY: -
o NEW ❑ADDITION o ALTERATION ❑REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION: CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? ❑YES o NO UP/SEPA/SU? ❑YES o NO
PLATTED LOT? ❑YES a NO DEMO PERMIT REQUIRED? • ❑YES a NO
;. ,Ar: 1. u004
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