03-104282 f
`City of Federal Way
Community Development Services Electrical Permit #:03 - 104282 - 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: LEE/NELSON
Project Address: 1276 SW 300TH ft Parcel Number: 515320 0160
Project Description: Add(3)circuits for garage addition.
Owner Applicant Contractor
PHYLLIS NELSON PHYLLIS NELSON PHYLLIS NELSON
1276 SW 300TH PL 1276 SW 300TH PL 1276 SW 300TH PL
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
(253)441-4919
Electrical Fixtures
L Description Quantityl Description Quantity Description iQuantity
Circuits-Residential 3
PERMIT EXPIRES March 15,2004.
Permit issued on September 17,2003
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.
Owner or agent: _// •��_ Date: r 77e).3
/Z- /7-- 4 ./ 77ri _ , c 0.4'41" w;// !\
/7— /1— 0 3 fr-.i 41 / � //�a/ti off.
Cir)
4*4
BEEIVEDt---
. CONSTRUCTION PERMIT APPLICATION
CITY OF 44P11114%......" 7 7003
Federal Way SEP 1 APPLICATION NUMBER: Q3 - 1 �����_�L-
iTY OF FEDERAL WAY APPLICATION NUMBER:
BUILDING DEPT. �gppLICATION 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.
- III INFORMATION . - - `
SITE ADDRESS: I 76 5 ' Cifp P1 ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
-. .. ■ PROTECT INFORMATION - _
TYPE OF PROJECT(This application): o BUILDING o PLUMBING 0 MECHANICAL o DEMOLITION
$ELECTRICAL 0 ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): W ) Vit_ NSA) G A
L
PROJECT NAME: Lee_ r"e CSON
- R PEOPLE INFORMATION.',
PROPERTY OWNER: NAME:
4y l l` ; DAYTIME PHONE
5 N (2s 3) 5V1 - (19ly
MAILING ADDRESS(STREET ADDRESS;CITY, ATE,ZIP):
ta7lD sw 30.7) f D v\/44 , V1/A•
CONTRACTOR: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): ! EVENING PHONE:
I ( ) -
I CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
( )
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: ! DAYTIME PHONE:
T6 ir'(, L ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP)• EVENING PHONE:
f1& 5 c,v 7.3 Ot Pt (,.J/ J, ! (2.97) IV - Li9/
RELATIONSHIP TO PROJECT: j FAX NUMBER:
I
0 ARCHITECT oiell-NI
ANT 0 OTHER( DESCRIBE): I (
)
E-MAIL ADDRESS:
!
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER ❑ APPLICANT 0 CONTRACTOR !
- - ■ 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:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA o PRIVATE(WELL) `
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** • l
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 Value of Mechanical Work: $
AIR HANDLING UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGES) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: a ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC a 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(induding 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 daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the Information supplied to the city as a part of this application.
NAMEITITLE: DATE:
o PROPERTY OWNER a APPLICANT o CONTRACTOR
FOR OFFICE.USE;ONLY J
• NEW_ ttIADDITION. ;i ALTERATION o,REPAIR' .a TENANT>IMPROVEMENT :
CENSUS`CODE c 4**-rkr °.a410S7A tx ' 'LOT SIZE:; `a " 'r a€^" VV`: '. .:.- a:
ZONING DESIGNATION;' ' €SA
r� � °BUILDING SHELL"ONLY7„� ❑YES- nNO .„. ..T:
COMP PLAN DESIGNATIONAfi” .. ..-.x '< BASIC PLANT [7 YES ❑;NO
SECTION= * . TOWNSHIP_ ,RANGE : , ,NEIN ADDRESS REQUIRED? :❑YES .a'NO •:
PLATTEDLOT? _ a YES o'NO ',CHANGE OF USE2= fid,,.' a 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.dtvoffederalway.com