03-104266 City of Federal Way
Community Development Services Electrical Permit #:03 - 104266 - 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: BIG LOTS
Project Address: 1211 S 320TH $ Parcel Number: 150050 0030
Project Description: Adding up to 10 circuits to serve outlets and changing out light fixtures on 12 circuits.
Owner Applicant Contractor
1560 INVESTORS LLC ENERTECH ELECTRIC INC ENERTECH ELECTRIC INC
200 S BROAD ST#6 7925 NE ST JOHNS RD 7925 NE ST JOHNS RD
VANCOUVER WA 98665 VANCOUVER WA 98665
(360)513-5399
Electrical Fixtures
Description Quantity Description ;IQuantity Description JQuantity
Circuits- Commercial 22
PERMIT EXPIRES March 14,2004.
Permit issued on September 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.
Owner or agent: i i Date: 2/ /L
to ►s-e 3 u�O � � PP n
CONSTRUCTION PERMIT APPLICATION
CITY OF
,,,.4.0„,,_ .../ APPLICATION NUMBER: ,1-o f' 26 G -o
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.
- R PROPERTY INFORMATION :,
SITE ADDRESS: 12-1 l S 3.20 Ili -St- ASSESSOR'S TAX/PARCEL #: /S`y 0 5 O - 0 0 3 cj
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PRO]ECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING o MECHANICAL o DEMOLITION
)ELECTRICAL o ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): ' ✓ SI
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w 1 --t- p\ F rotrt („� 1 7- g } c '' r‘,?-71.442s (e/ ea���ti Ic
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PROJECT NAME: Ig/ G .c)-(—C' SfZi��
. . • PEOPLE INFORMATION .
PROPERTY OWNER: NAME: ! DAYTIME PHONE
gAI 6 G A��sSTRSEET ADDRESS;A4)/ 1 �P). 1 (6I1) oL,7 //� (�cp b O Mi
t 0 a _ v
CONTRACTOR: I ME DAYTIME PHONE:
NNe��ec /� E (e�c.�R-Ic, -,NL 1 (3‘0 )S( ? -1392;
7725-MAILING ADDRESS((STREET ADDRESS;CITY,STATE.ZIP): /� ^' I. EVENING PHONE-
CITYOfFEDERAL WAYBUSINESSStENToSE Rs a V 4 V c. `-(•'�. 9 c' 6 (AX NUMBER: ' /- , '
- - (3C0) S7$1 - 6/cps
CONTRACTOR'S REGISTRATION NUMBER: Q 1-70..1 EXPIRATION DATE:T
(copy /� Lpy of card required) !i t I t Z 0 2_ 6 0 6 '0' g / 0 -
APPLICANT: NAME: DAYTIME PHONE:
( ) it
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT:
FAX NUMBER:
0 ARCHITECT o TENANT ❑ OTHER( DESCRIBE): ( ) -
A
E-MAIL ADDRESS: I
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT )11 CONTRACTOR �
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE a TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: o 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 I
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: 0 ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.(
INTERCEPTORS) 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,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the dty,including Its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application. /� G�
NAMF./TITLE: / 7���� )7)4_,e, DATE: / /o
❑ PROPERTY OWNER ❑APPLICANTCONTRACTOR
FOR.OFFICE.USE',ONLY: <.
p,NEW p ADDITION u ALTERATION . o.REPAIR,�. * ❑.TENANT-IMPROVEMENT ,.,,,_
'CENSUS'CODE ° Ts' E ,..' 7- .�",: ..a- LOT SIZE`= '� ;r'',. e-_ ? ,fi ,•'- 3-.a,..
ZONING DESIGNATION: -V'
_,.� ;;c �-._�,.._.4�_.,;�; _BUILDING SHELLiONLY?A�D YES; `"-t3 N0 ..'' ;`
COMP PLAN DESIGNATION . , BASIC PLAN? -. ❑YES ' .❑.NO'"
SECTION - , TOWNSHIP r ,;RANGE f- NEW ADDRESS REQUIRED? ::n YES . 0 NO
'-PLATTED:LOT?:= ❑YES .o`NO ,'Y` .T,•.. CHANGE OF USE?-.75-.7. :n YES !'-o NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,cttvoffeieralway.com