03-103952 r
'City of Federal Way
Community Development Services Electrical Permit #:03 - 103952 - 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: JOHNSON f\
Project Address: 28618 25TH/S Parcel Number: 552900 0150
Project Description: Addition of(8)circuits for garage to living room conversion
Owner Applicant Contractor
Bobby Dampier &Jocelyn C Dampier William R.Johnson William R.Johnson
14335 24TH AVE NE 10911 80TH PL S 10911 80TH PL S
SEATTLE WA KIRKLAND WA 98034 KIRKLAND WA 98034
98125-3403 (206)931-7722
Electrical Fixtures
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Circuits-Multi Family 8
PERMIT EXPIRES February 22,2004.
Permit issued on August 26,2003
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.ay.W
Owner or agent: A_ SL 4,4,"-.,, Date: g-14-e.):
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�` CONSTRUCT l ION PERMIT APPLICATION
• CITY OF P" 1/
Federal Way RECEIVEDAPPLICATION NUMBER: os. _ la 3 q _
APPLICATION NUMBER:
APPLICATION NUMBER: - -
AUG 2 6 2003
**The Whawing is required information—Please print(in ink)or type**
Please note: ElectricaVEWPFERFuradiligyMAYs and Engineering permits may require a separate application.
I ► D
• 'PROPERTY INFORMATION
SITE ADDRESS: e(O( •-213b20 a 1 L. Si ASSESSOR'S TAX/PARCEL #: 55 2. q (� (`� - f S9
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): r,. c IS/ NI ILITAiQy A*.ti,S,
AccatA
■ PRO]ECT INFORMATION
TYPE OF PROJECT(This application): o BUILDING o PLUMBING o MECHANICAL o DEMOLITION
SALECTRICAL ❑ ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): YZAG6 C N ye l&S i( 'to Lt V 1 N G
DuPL.E L_TL l=I1L_YI W'LL N-GGL To Ant
L C"rP.. scJ < < 1tv ur'S} / ti ) PGA- vN rra Ca) ' r -c--AL:
PROJECT NAME: .36f (!)11.I
. IN PEOPLE INFORMATION
PROPERTY OWNER: NAME: ; DAYTIME PHONE:
i LL iA M R . 30k-4 Lv H2O R i (206) ct3 i - 77223-
MAILING ADDRESS Ct l l(STREET
'P LORE*CITY, 1`NG' t"�.lvkiAL V`FO l W A Ir tl®3`1
CONTRACTOR: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: I EXPIRATION DATE:
(copy of card required)
APPLICANT: NAM DAYTIME PHONE
k :
rt\t.Ca �_ 7E-�N G�1 ( ) c731 -7722
MAILING ADDRESS(STREET ADDRESS;CITY, ATE.ZIP): gr 14.1 ilk- of p I EVENING PHONE:
nos Ne I I)Mg. 73 LI tut Q AJ (425) c2- «iL
RELATIONSHIP TO PROJECT: j FAX NUMBER:
o ARCHITECT o TENANT o OTHER(DESCRIBE): ? ( ) -
�
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: (xpROPERTY OWNER o APPLICANT 0 CONTRACTOR
: '■ DETAILED BUILDING INFORMATION
EXISTING USE: 6)15)... ,.e.-;) I LEXISTING BUILDING ASSESSED/APPRAISED VALUATION $ / ��� 00 V
PROPOSED USE: NAL )C c t' lr/kL PROPOSED VALUATION FOR IMPROVEMENTS: $ /LI, 600
a
SPRINKLERED BUILDING? o YES TjQNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES XNO
WATER SERVICE PROVIDER: LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: SLAKEHAVEN ❑ HIGHLINE a 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
� sr-
FIRST J"1 /3sf1 7
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
59
HOW MANY FLOORS? 117 / "173 —
TOTAL: Li / 14 7 3 1 > / 1-i 73
/// ■ 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: 0 ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC o 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 daim),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,induding Its officers and employees,upon the accuracy
of the information L't..)
supto the dty as a part of this .f. ication.
NAME/TITLE: , , DATE:
PROPERTY OWNER o APPLICANT o CONTRACTOR
-FOROFFICE.USE ONLY: 1
MEW. :ADDITION 4 ALTERATION¢ -;.❑REPAIR . fTENANT IMPROVEMENT'1 ;r
=CENSUSCODE � ., , `%.' o .fx,.. OT SIZE ' ' - -..a x ``; ^=4 s ' _r,
?fit •;r: r
ONINGDESIGNATION.. � ? � B.UILDILVG SHELI ONLY7a.YE$, .,❑ NO
COMP PLAN DESIGNATION k ABASIC PLAN? ❑AYES fl NO :_
ECTIONr, .W
, -� -:�;,:TOWNSHIP.,��' .RANGE �„�, NEW ADDRESS REQUIRED?, z, ', ,-❑YES--•s❑NO
PLATTED LOT? - a YES >❑ NO CHANGE;OF USE? s; - .o YES 'fl NO ,, 1-
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