03-100336 City of Federal Way
Community Development Services Electrical Permit #:03 - 100336 - 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: - CAVAGDAN
Project Address: 29854 30TH)fcpyArt. s � Parcel Number: 868040 0030
Project Description: Circuit for freezer outlet
Owner Applicant Contractor
OSAIS CAVAGDAN MERIDIAN CENTER ELECTRIC INC MERIDIAN CENTER ELECTRIC INC
29854 30TH AVE S 11109 66TH AVE E 11109 66TH AVE E
FEDERAL WAY WA 98003 PUYALLUP WA 98373 PUYALLUP WA 98373
(253)848-5595
Electrical Fixtures
! - + :•t al. r `:Quantity =' = Ott * 07010
Circuits-Residential 1
PERMIT EXPIRES July 23,2003,IF NO WORK IS STARTED.
Permit issued on January 24,2003
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 /t/ Date: l--o? 4
L-7 -0j 1-2IV,L
•
C-Gi9S 0 — 03 goo
01-23-2003 02:03PM FROM-Meridian Center Electric +253-841-0892 1-760 P.002/005 F-051
cl-v of 011116%... " LvIv rL_r\I•IA I i-srrLLL,/-\I .LUIN
federal Way APPLICATION NUMBER: (J3 - €2-473
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 •
SITE ADDRESS: RS-(' 307" f e S ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
•
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING CJ MECHANICAL 0 DEMOLITION
)JLECTRICAL ❑ENGINEERINGI ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): Gt.C(CLL C i rGu,�f-- w
OV,1_ j- y '
PROJECT NAME-
PEOPLE INFORMATION:. .
PROPERTY OWNER: NAME;
1 _ DAYTIME w
QNE,• V S {ZCcA a G� )
MAILING ADDRESS(STREET ADDRESS, -
QTY,STATE,ZIP);
9_R, L1 ,$ (n't f}YC. .S C oL (A) Oc-. �l g(9O
CONTRACTOR: NAME: OA,rIHE PHONE;
Meridian Center Electric (253 ) 848 - 5595
MAI GtINMAI G ADDRESS(STREET ADDRESS;Crrr,STATE.ZIP): EVENING PHONE'
11109 66th Ave E Puyallup, Wa 98373 ; { ) -
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER: j FAX NUMBER:
20014216200 _ _ _ - _ _ I (253 ) 841 - 0892
CANTRACTOR^S REGISTRATION NUMBER: W I EXPIRATION DATE:
(mPy of card required) rIERIDCE318S2 J 2 / 28 / 03
APPLICANT: NA�EE DAYTIME PHONE:
Reri { ) - f
MAILING ADDRESS(STREET ADDRESS;CfTY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT': I { )
FAX NUMBER:
❑ ARCHITECT 0 TENANT 0 OTHER(DESCRIBE): ( )
E-MAIL ADDRESS: -1
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER ❑APPLICANT 0 CONTRACTOR• � I
• _ . . . -■ DETAILED BUILDING INFORMATION •
EXISTING USE: . _ EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? C] YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES D NO
WATER SERVICE PROVIDER; 0 LAKEHAVEN O HIGHLIN>; ❑TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
01-23-2003 02:03PM FROM-Meridian Center Electric +253-841-0892 T-760 P.003/005 F-051
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
•
_ FLOOR EXISTING SQ.Fr. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
•
THIRD
FOURTH •
•
OTHER FLOORS(DESCRIBE)
DECK
GARAGE •
HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S)
FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCTS) _ GAS PIPE OLfTLET(S) HEAT SOURCE: ❑ ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ra GAS
DRINKING FOUNTAIN(S):' SHOWERS) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK( 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 claim(including 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 claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: - X i 'il-� 1'�/ DATE: 1 •=: "
o PROPERTY OWNER a APPLICANT o CONTRACTOR
•
FOR OFFICE USE ONLY:
fa.NEW''Ii xF ii'''k0 ADDITIO
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',CENSUS CODE:1;., . _.:;I°I • NT OVEMENT.•. . .;,I;�,"
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. N DESIGNATION
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COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•2S3-661-4900•FAX:253-661-4129
www.ceyofferociuw3Y.corn