03-104728 -1
City Federalof Way
Community
Development Services Electrical Permit #:03 - 104728 - 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: STEEL LAKE ANNEX SOCCER FIELD
Project Address: /';}.y V;ao, Parcel Number: CITY WIDE
Project Description: Lower existing electrical conduits located at Steel Lake Annex Soccer Field on the corner of 28TH AVE
S.&312TH ST S.
Owner Applicant Contractor
CITY OF FEDERAL WAY CITY OF FEDERAL WAY NONE
PO BOX 9718 PO BOX 9718
FEDERAL WAY WA 98063 FEDERAL WAY WA 98063
Electrical Fixtures
DescriitionQuantity Description Quantity Description Quantity
IAlt.Serv./Feeder up to 200 amps Co 1
PERMIT EXPIRES April 13,2004.
Permit issued on October 16,2003
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.
3 Owner or agent: L # Date: / 4-i- . 7
`1 Z r
H 31 - o L v.,,. z s 3 - d. a L .- 113 Sr
RECEIVED CONSTRUCTION PERMIT APPLICATION
CITY OF Q3- , 0q7 nfr- )
Federal WayAPPLICATION NUMBER: - (1-((' {,7.,�/ �(�
�CT 1 6 2 O3 APPLICATION NUMBER:
ThCITY OF FEDERAL WAY
APPLICATION NUMBER: - -
#" iiej(iJId nd information-Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
111PROPERTY INFORMATION ,
SITE ADDRESS: 4I/e S. -3/`'2� q ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING 0 MECHANICAL o DEMOLITION
XELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): LQ L,c}ereii'4-0/4-1S,... -/e i c,
J/ A Z.ih. '_: -OA _ L@/`- .111 ,e / - Y C - ,
PROJECT NAME:
PEOPLE INFORMATION
PROPERTY OWNER: I NAME: / ;, i DAYTIME PHONE:
'e_/''Tza, of F�=,G'�P✓ / j ( )
MAILING DRESS(ST.R§V ADDRESS;CITY,STATE,ZIP): ^
6,Z3S 3:) / /.1`'�"7 S, e. c tx.
CONTRACTOR: NAME: DAYTIME PHONE:
\
`i / )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): I. EVENING PHONE*
II ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: I FAX NUMBER:
I ( )
CONTRACTOR'S REGISTRATION NUMBER: [�APA 4 [� j EXPIRATION DATE: �
(copy of card required) EGO LU/ AM * Z 7 L/"r 3 j / /.3 / / 66-J
APPLICANT: NAME: DAYTIME PHONE:
( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: -
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT o OTHER( DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES o NO
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
.f 4
**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 ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o 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 daim),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,induding its officers and employees,upon the accuracy
of the Information supplied to the dty as a part of this application.
NAME/TITLE: DATE: /07/6/, 3
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONT OR
FOR OFFICE USE ONLY:
oNEW VZ.3-0ADDITION , ALTERATION
---x" p.REPAIR , nTENANT IM
P%OVEMENT-,.
CENSUSLOT .
'ZONING,DESIGNATION.:_ -g.}.F ..$ ;'' , "` ,r`'-n'-
_.._.,�.. •BUILDING SHELL'ONLY?._'�- YES ,::❑ NO
=COMP PLAN DESIGNATION ., BASIC PLAN?= "❑YES D NO„
SECTION, , . , TOWNSHIP :"RANGE NEW ADDRESS REQUIRED? R.° ❑YES o NO
-PLATTED;LOT?,~,`o YES, oNO CHANGE OF USE?-7-;-=':* YES`-•fl NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,citvoffederalway.com