02-104594 % 1
City Federal Way
Community Development Services Electrical Permit #:02 - 104594 - 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: BELMOR MOBILE HOME PARK SPACE#126
Project Address: 2101 S 324TH Parcel Number: 162104 9037
Project Description: ELE-Replace meter pedestal for mobile homes-SPACE#126.
Owner Applicant Contractor
BELMOR HOLDINGS LTD SHEPPARD&NELSON ELECTRIC SHEPPARD&NELSON ELECTRIC
1571 BELLEVUE AVE W SUITE 210 PO BOX 3630 PO BOX 3630
VANCOUVER CN KENT WA 98032-0210 KENT WA 98032-0210
(206)878-7333
Electrical Fixtures
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Service or Feeder-Manu./M.H.Parkl 1
PERMIT EXPIRES April 15,2003,IF NO WORK IS STARTED.
Permit issued on October 17,2002
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. r n
Owner or agent: See Application Date: lo / ( 0"(/
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;r � � RECEIVED CONSTRUCTION PERMIT APPLICATION
�� �� APPLICATION NUMBER: 02'- £ 0 t s' -DU_a--
OCT 1 7 2002 APPLICATION NUMBER: - -
I APPLICATION NUMBER: - -
**The 1!ol y iTplf4(ie4EPid information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
G ■ PROPERTY INFORMATION
SITE ADDRESS: Z.)D 1 -6(e) , 1Z.A ASSESSOR'S TAX/PARCEL#: 4 .6, 2_ 1 £2y - Y Q , z
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
•
• ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING 0 MECHANICAL ❑ DEMOLITION
ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): Ry l/t G i! A4 V 7Y� �l S j'A 2 16
INE ' Li' ' ' to r . A' S r A(...'tf 6 G V'_6 , Ai �i-ei F ( 8 'If-to 9 5 A c-
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PROJECT NAME: /Veto /4'?t "( PeJ,L07.)4
■ PEOPLE INFORMATION .
PROPERTY OWNER: NAME: DAYTIME PHONE:
e AlliA )40)Ch, g L7730 , ( ) -
MAILING ADDRESS STREET ADD S;CITY, ZIP):
/-5"7/ ,t,/levee 4W G&I, � S " Zld lir ,vcovv•e/Qi CV
CONTRACTOR: NAME: DAYTIME PHONE:
S 1)%e
Ertrci AA,ibn.. ,E/,ec-7i ik (24G) 878 - 733. 3
M7ôt
NG ADD ( ET ADDRESS;CITY,STATE, P): EVENING PHONE:
Max- 3( 30,/ 1{,,n,7, W4 . 9fr803.2. ( NUM ) -
,.• CITY OF FEDERAL WAY BUSINESS LICENSE NNMBER: FAX
_1a - c t2 LSPPL L (7) 87'- 7A'7
CONTRACTORS REGISTRATION NUMBER: . l i F P p N t—s- 4_,T� EXPIRATION DATE: l / 0
5
APPLICANT: NAN/ I 0 / Ft2 d 6 "7/9 P 77a DAYTIME PHONE : -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 ARCHITECT 0 TENANT 0 OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT jitCONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
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 0 TACOMA 0 PRIVATE(WELL)
R
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
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**NEW RESIDENTIAL CONSTRUCTION ONLY** •
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PRO3ECT 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
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 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) - MISC.( )
INTERCEPTORS) 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 daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supp'ed to the ci as a part of this application.
NAME/TITLE: DATE: ) - 1? 0
❑ PROPERTY OWNER 0 APPLICANT $t,CONTRACTOR
:FOR OFFICE LSE ONLY: I
53 iiNEWZIADDITION ❑ALTERATION: 1tEPAIR :❑` 'ENANTOMPROVEMENT - -
_CENSUS CODE: - - r:K3�tOTSIZE:
SNI*G SIGI(AUON: .` J m ' "04 iiiItffNG SHELL ONLY?-J YES , .❑.NO -
:COMPJLAAN bESIGNATiON BASICCPLAN? ❑ YES - '❑f10:,; : • .
SECTION':__ ,TOWNSHIP RANGE -: -NEW 1DDRESS REQUIRED? Cl YES '0 NO . .
l iITTED_LOT?_ ❑YES ❑ NO -,x = ttiloidE OF USE? -.❑YES . io
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718.253-661-4000•FAX:253-661-4129