05-100954 ra
City of Federal Way
Counity Development Services Electrical Permit #: 05 - 100954 - 00 - EL
mm
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: CONOCO-PHILLIPS
Project Address: 2535 S 320TH 51 Parcel Number: 599970 0010
Project Description: Remove and replace light fixture ballast.
Owner Applicant Contractor
TOSCO CORPORATION*TOSCO CORPORA CHRISTENSON TECHNOLOGY SERVICES CHRISTENSON TECHNOLOGY SERVICES
72 CUMMINGS POINT RD 631 NW THERMAN ST FLOOR 2 631 NW THERMAN ST FLOOR 2
STAMFORD CT PORTLAND OR 97209-2558 PORTLAND OR 97209-2558
06902-7919 (503)419-3600
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits- Commercial ll 1
PERMIT EXPIRES August 28,2005.
Permit issued on March 1,2005
I hereby certify that the above information is orrec t and that the construction on the above described pro.. rty and
the occupancy and the use will be in accordance the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: fie_iippliehtiCricl Date: 31g(OS
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THIS CARD IS TO REMAIN ON-SITE
CITY OF
ACommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-100954-00-EL
Owner: TOSCO CORPORATION
Address: 2535 S 320TH ST
FEDERAL WAY, WA 98003-5443
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.
0 Slab/Concrete Floor(4255) ❑ Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved Approved
By Date By Date B(---(7: Date �-- l
(i_vir
•
. _
❑ Under-slab groundwork(4295)
Approved
By Date
AUTOMATION FEE: $5.00
C _a-4
OMMUNITyD CE�pED gy 1-5 CIRCUIT ALTERATION =$89.00
MENTDEPgRENTTRICAL TOTAL FEE: /- $94.00 /
�s M,R22z ECC Q� - dQ _1
Federal Way 005 PERMIT
COMMUNITY DEVELOPMENT SERVICES
SF MF CO M:�PL DE EN FP
33325 AVENUE SOUTH• BOX 9718 APPLICATION
FEDERAL W.4};W.9 9806363.9718 TD / /
253-835-2607•FAX 253-835-2609
www.0 lgo(tedcralwa y.con. JOB• 67-44992
The oilowin' is re•aired in ormation-an ince •lete a••lication will not be acce'ted. Please •rint le•ibl in ink or f• .
• PROPERTY INFORMATION
SITE ADDRESS 2535 S 320TH ST FEDERAL WAY,WA 98003 SUITE/UNIT# N/A
*
ASSESSOR'S TAX/PARCEL *UNKNOWN TO CONTRACTOR LOT SIZE(s)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)*
(Attach separate page for lengthy legal description/
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION XXELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
REMOVE 400W BALLAST AND REPLACE WITH 200W BALLAST IN LIGHT FIXTURE. REPLACE LENSE IF NECESSARY
LSI INDUSTRIES CONOCO—PHILLIPS STATION #
PROJECT NAME(Name of Business or Owner Last Name) 2705483
MI PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER CONOCO-PHILLIPS ( ) -
MAILING ADDRESS CITY,STATE,ZIP
AS ABOVE
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
HRISTENSON TECHNOLOGY SERVICES,INC. (503 )419 -3600
l MAILING ADDRESS CITY,STATE,ZIP CELL PHONEI'OM KOSMAS
-T631 NW THURMAN ST 2ND FL PORTLAND, OR 97209-2558 603 )260 -4269
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
PENDING
-B L (503 )419 -3636
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application( EXPIRATION DATE
CHRISTS9Z7 OG 11 / 3 )05
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
SAME AS CONTRACTOR ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
1631 NW THURMAN ST 2ND FL PORTLAND, OR 97209-2558 ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
TOM KOSMAS ( 503 ) 260-4-269
LENDER3F?• ., Z� i«i� k1 � NAME
N/A n 1 #440ac QI. x, .
MAILING ADDRESS CITY,STATE,ZIP
• DETAILED BUILDING INFORMATION
EXISTING USE STATION PROPOSED USE SAME
*UNKNUWN TO CONTRACTOR
EXISTING ASSESSED/APPRAISED VALUE $ N/AVALUE OF PROPOSED WORK $ 2.097.00
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)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
s
r N/A
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. Q.FT. SQ.FT-
S
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
weTI° nonan
"mi.
! M�cb 11n, ,, „a(xiv., `` '! i.4 OT
NUMBER OF FLOORS , I, i'°` .,
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
N/A FIXTURES
Indicate number of each type of fixture 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(commerciaq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(orru6/ShoW�combo) SHOWERS WATER CLOSETS iroiloq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sink.) 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. J 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 t�/ �- ?.:.'�� A.MARK WALTER PRES IDENT DATE 2/16/05
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent contractor 0 Architect 0
Other
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Bulletin#100-January 7,2005 Page 2 of 4 k\Handouts�Permit Application