03-104398 City Federalof Way
CommuunityityDevelopment Services Electrical Permit #:03 - 104398 - 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: THE POINTE AT WEST CAMPUS II
Project Address: 622 SW 330TH 43 Parcel Number: 182104 9034
Project Description: Install 100-amp service and 1 street light.
Owner Applicant Contractor
KEN DANIELSON SAFE AND SOUND ELECTRIC SAFE AND SOUND ELECTRIC
4826 LAKEMONT DR SE 2103 HARRISON AVE NW 2103 HARRISON AVE NW
OLYMPIA WA 98513 OLYMPIA WA 98502 OLYMPIA WA 98502
(360)866-7586
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Service/Feeder: 0-100 amps-Comm. 1
PERMIT EXPIRES March 22,2004.
Permit issued on September 24,2003
I hereby certify that the above inf.& ration is correct and that the construction on the above described property and
the occupancy and the use will a in; -.rdance with the laws,rules and regulations of the State of Washington and
the City of Federal Wa .
9 Owner or agent: ' Date: ��
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CONSTRUCT HON PERMIT APPLICATION -
CITY OF � APPLICATION NUMBER: 03 - 4 Q q3 1 T-0
9
Federal Way APPLICATION NUMBER: - -
(APPLICATION NUMBER: - -
**The following is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
I .PROPERTY INFORMATION ,
th—
SITE ADDRESS: 11 U Sty 330 ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): Tt—
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): 0 BUILDING o PLUMBING ❑ MECHANICAL ❑ DEMOLITION
XELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 1 00 A 1.,,?_5-5(2.V L -e„,, pj A,° ` -5W (_.1
PROJECT NAME:
. I PEOPLE INFORMATION-
PROPERTY OWNER: NAME: ; DAYTIME PHONE
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): I ( )
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CONTRACTOR: NAME: DAYTIME PHONE:
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MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): I. EVENING PHONE:
2A.o'S kLA eels*o►J c� t�+-J 0 L• )Y,-:L A- SO2J — -
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CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
i5 l..- Pr Ir S S' b ' FSS �- / 0 f /e:3(7/...
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: � FAX NUMBER
" :
❑ ARCHITECT ❑TENANT OTHER(DESCRIBE): I r\.�
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT XCONTRACTOR
- -■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES o NO
/
WATER SERVICE PROVIDER: 0 LAKEHAVEN o HIGHLINE ❑ TACOMA O PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• ■ PRO]ECT 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 Value of Mechanical Work: $
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 o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ 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 aim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such •im arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the information sup•lied to*
:ty as a part of this application.
NAME/TITLE: , DATE:
❑ PROPERTY OWNER • APPLICANT CONTRACTOR
FOR.OFFICE,USE ONLY: I
..r„ .. . ...�.____ .sem ...� .� .:.-,
NEWS# .-Ei ADDITION t ALTERATION d�REP.,AIR .: b TENANT-IMPROVEMENT!' . _?
CENSUSCODE 0.- . s. 4i4 LOT;SIZE 411 - g", ft .''*O. `=a.
ZONINGµDESIGNATION <, � BUILDING SHELL'ONLY? ii YES o NO ,, -
=COMP PL AN DESIGNATION- - k=.' �, BASIC PLAN? `❑AYES �d;NO � . ,
�,�_; TOWNSHIP,_,_ RANGE ��, , ,. .NEW ADDRESS REQUIRED? _;� .❑YES._ ❑I:NO ,`
'PLATTED LOT? ❑YES' o`NO " "'CHANGE,OF USET, �, II YES `n
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000.FAX:253-661-4129
www.cftyoffederalway.com