04-101605 City of Federal Way
Community Development Services Electrical Permit #:04 - 101605 - 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: YOUNG
Project Address: 1812 SW 317TH 01 Parcel Number: 179010 0080
Project Description: Provide electrical service and panel for newly constructed detached garage.
Owner Applicant Contractor
John&Stacey YOUNG John&Stacey YOUNG John&Stacey YOUNG
1812 SW 317TH PL 1812 SW 317TH PL 1812 SW 317TH PL
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-5102 98023-5102
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES October 26,2004.
Permit issued on April 29,2004
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. c
Owner or agent: / Date: 51-2- - 1.
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ERVICES
33ie 0530 FIRST WAY SOUTH•PIVITY DEVELOPMENTO BOX 9718
ant of�� G/1 I\ lfK WAY,WA 98063-9718
Federal Way PERMIT APPLICATION ���/115•FAX.253-661-4129
'mow dtyot]-ederalwoy mm
For Office Oar OnlyD ' - C) i (p b - �_ _A t 2 9 ZUU4
FW File Number:
The ollowin• is re.uired in ormation-an inco •lete a.•lication will not be acce.ted' OF FEDERAL WAY
■ PROPERTY INFORMATION
SITE ADDRESS: x$12 sw 3` 1 e\ V/49 vtl a 4 g3- 3 SUITE/APT #
ASSESSOR'S TAX/PARCEL#: - SQUARE FOOTAGE OF LOT:
LEGAL DESCRIPTION (e.g.:Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT(This application): 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
XELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only): /(J ) 2 A,Ai Q
1
PROJECT NAME(Name of Business/Owner Last Name): %y/U[�
■ PEOPLE INFORMATION
PROPERTY NAME: PRIMARY PHONE:
OWNER -aO\ S %O ti f ( ( � ) 6(a( - sin -zMAILING ADDRESS(STREET ADDRESS : CITY,STATE,ZIP
1812 5w °3 A-k. o.A-1 w4 Qgaz-3
CONTRACTOR: NAME L��( COMPANY OFFICE PHONE:
-MAILINGAD(RESS(STREET ADDRESS)). CITY,STATE,ZIP CELL PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE: FAX NUMBER:
/ /
)
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE
(copy of card required with each application(
LENDER: NAME: DAYTIME PHONE:
(If Proposed Value>$5,000) ( ) -
MAILING ADDRESS(STREET ADDRESS;) CITY,STATE,ZIP
APPLICANT: NAME: COMPANY OFFICE PHONE:
MAILING ADDRESS(STREET ADDRESS)- CITY,STATE,ZIP EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER.
0 Architect 0 Tenant 0 Other(Describe): ( ) -
CONTACT PERSON FOR THIS PROJECT: X Property Owner 0 Contractor 0 Applicant E-MAIL ADDRESS:
■ DETAILED BUILDING INFORMATION
EXISTING USE: PROPOSED USE:
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $
SPRINKLERED BUILDING? ❑ YES Of NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES ,e1 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER o 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 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(commemal) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS or Tub/Shower Combo) SHOWERS WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(BathroomSu,r 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 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 supplied to the city as a part of this application.
NAME/TITLE: F/�N 171.-2- --DATE: 05
($ignature) (Title)
RELATIONSHIP TO PROJECT: XPrope Owner o Applicant 0 Contractor ❑ Architect ❑
FOR OFFICE USE ONLY:
a NEW a ADDITION a ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? o YES ❑NO
ZONING DESIGNATION: - CHANGE OF USE? ❑YES a NO
NEW ADDRESS REQUIRED? a YES ❑NO UP/SEPA/SU? o YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? a YES a NO
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