02-104592 City of Federal Way
Corrnnumty Development Services Electrical Permit #:02 - 104592 - 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 SPACES 91 &92
Project Address: 2101 S 324TH Parcel Number: 162104 9037
Project Description: ELE-Replace meter pedestal for mobile homes-SPACES 91 &92.
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
Descr*ti' " ir +r ,
stand MEtta rMt ua ti
Service or Feeder-Manu./M.H.Park 2
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. See Application
Owner or agent: Date: b CT/
t (__ — 1-7 ,A)4 elrp
•
G CONSTRUCTION PERMIT APPLICATION
•uV FE3Y�L_ RECEIVED APPLICATION NUMBER: 0 L--
APPLICATION NUMBER: -
OCT 1 7 2002 APPLICATION NUMBER: - -
**The ferikurisasaeiNLiN Xnation—Please print(in ink)or type**
s DEP
Please note: Electrical,Fire Pr ron n ystemT.s and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
2
SITE ADDRESS: 24 Q ! .669 &z,I ASSESSOR'S TAX/PARCEL#:
4 .6, ? 112y - YQ1z
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
•
■ PROTECT INFORMATION •
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
• Ji4 ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): gee bite_ I S
ON ' 4.1 ` ,P i v S r 4 -1 66 r I f it-e-I/ / (2 8 69 .p _n
-, _ PAC- Z , S x-4.1 t96 .7 /t >D/
S, , c- A2 - / 5 4-c 1 Z.Z J J alrizy,
PROJECT NAME: Ale to A4 Yt & P eC/L✓1 j_4
■ PEOPLE INFORMATION .
PROPERTY OWNER: NAME: DAYTIME PHONE:
A 40 icb ZIP): Li-13 , ( )
MAILING ADDRESS STREET AS;CITY,
/-5'2/ 4/k vet- 4ve, 1 S vil-se ZIO CA)
CONTRACTOR: NAME: DAYTIME PHONE:
�R S 14,4-rd
-rd .6 AA'1 bo'r/ ,E-Ae a i (2DG) 878 - '7 33. 3
M NG ADDRET ET ADDRESS;CITY,STATE, P): EVENING PHONE:
7 ,D i3 ox 3 G 30 1<w.L,7-, W41 980 2 ( NUMB)CITY OF FEDERAL WAY BUSINESS LICENSE NJMBER:
_17 - a LQff_ oo-gL ( ) 878- 7,07
CONTRACTORS REGISTRATION NUMBER: ATE:
fi F P PA/ '�- `� 14.1 IJ. J / 0
3
APPLICANT: „ NAME„ / • ) 2 b "7/9-
7`L+ �_ 27E-
�AYIIME PHONE:
1 t)
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 CONTRACTOR
■ 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 ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 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
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: ❑ ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) 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(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),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 d as a part of this application.
NAME/TITLE: DATE: JD - 12 D
❑ PROPERTY OWNER 0 APPLICANT tgl,CONTRACTOR
OR OFFICE USE ONLY: I
ADDITION- -=❑ALTERATION = REPAIR ❑,7'ENANT1MPROVEMENT
CENSUS CODE: _ - -i.OTSIZE:
;:eONthGbESIGNATION:- - = == UICDING SHELL'ONLY? '❑YES R,E3 NO - _ -
CO IP„i'LANDESIGNATION _- -- -=- _ - ) t$ASIC:PLAN' ❑YES .NO,-=> x -
• SECTION TOWNSHIP RANGE NEW,ADDRESSREQUIRED? 13YES fl NO
LATTED LOT? ❑YES 13 NO CHANGE OF USE? '❑YES 7.1=3
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063.9718.253- 61-4000•FAX:253-661-4129