03-103235 City unity Development Services eveWay
Community Electrical Permit #:03 - 103235 - 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: EVERGREEN BANK
Project Address: 1300 S 320TH 5+' Parcel Number: 082104 9241
Project Description: Relocate 1 low-voltage T stat
Owner Applicant Contractor
Derald E Martin &Margaret A Martin ELECTROMATIC SALES&SERVICE INC*E ELECTROMATIC SALES&SERVICE INC*I:
2791 152ND AVE NE BLDG 7E 2791 152ND AVE NE BLDG 7E
REDMOND WA 98052 REDMOND WA 98052
(425)216-1601
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Thermostat 1
PERMIT EXPIRES February 2,2004,
Permit issued on August 6,2003
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 Wa
Owner or agent: ge,A4 Date: 13-6,KJ
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�� CONSTRUC=I ION PERMIT APPLICATION
CITY OF �./. APPLICATION NUMBER: 0 - L 03230-00
Federal Way APPLICATION NUMBER: -
kPPLICATION 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
SITE ADDRESS: 1'600 S ' 52.-0 ASSESSOR'S TAX/PARCEL #: 0 5 Z- \ 0 - i 2 /J_I
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
1 PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING 0 MECHANICAL 0 DEMOLITION
ELECTRICAL a ENGINEERINGi` o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): ,lou.) . ( `/ 11"inA -
PROJECT NAME: 6.1e1yt& \ VD& F-.
- • PEOPLE INFORMATION -
PROPERTY OWNER:• NAME: DAYTIME PHONE:
l )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
i 1
CONTRACTOR: NAME- C i DAYTIME PHONE
tCc. -froom-ktc \.5 5,6.) .�.e (loco ) 62N -55-70
MAIUNG ADDRESS
,(STREET pDDF/A►SS;CITY,STATE,ZIP): /l � EVENING PHONE:
7C \ 152-" IAN— �� MU[� ( kA.IA - Iq VC52 ; (Ll ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
0Q - k_ o5cac - _ _ i (4Z ) 21L - (600 =
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(ropy of card required) F L E C - ✓ 5 0 C) 0c 6 ; 0 Z / i / 04
APPLICANT: ( NAME: DAYTIME PHONE:
e,rerk9 Moe,�lr�r (P9).) 62-9 - 3370
MAILING ADDRESS(STR ET ADDRESS:CITY,STATE ZIP): i ' �� ENING PHONE:
veil (52Y
A.Q k t„J '
RELATIONSHIP TO PROJECT: 1__ FAX NUMBER: 1
0 ARCHITECT 0 TENANT C�<OTHER(DESCRIBE): C, '"f tla£ 't } (1/'L6) V6 - ((yo
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? o YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES o NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN o HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE a PRIVATE(SEPTIC)