03-105090 City Federalof Wan
CommunityunityDevelopment Services Electrical Permit #:03 - 105090 - 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: BRACKETT
Project Address: 1150 S 299TH pi Parcel Number: 515160 0465
Project Description: Permit to final work done on previous permit,which expired. 01 _626 I
Owner Applicant Contractor
Louis J Brackett &Martha L Brackett LOU BRACKETT,SR. LOU BRACKETT,SR.
1150 S 299TH PL 1150 S 299TH PL 1150 S 299TH PL
FEDERAL WAY WA
98003-3751 \FEDERAL WAY WA 98003 (000)946-8189
Electrical Fixtures
Description Quantity Description 1Quantity Description Quantity
Circuits-Residential 1
PERMIT EXPIRES May 11,2004.
Permit issued on November 13,2003
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 in accordance with the laws,rules and regulations of the State of Washington and
the City of Federa Way. i
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Owner or agent: , 4...„ i i Date: `` `J
VJ ,
t
• REC •- CONSTRUCI ION PE MIT APPLICATION
CITY OF APPLICATION NUMBER: 03- j l J Siff 0 -
Federal Way NOV 1 3 2003 APPLICATION NUMBER: -
OITY OF FEDERAL WAY !APPLICATION NUMBER: - -
*'The k LPIQAuTed information—Please print(in ink)or type** M4--1) : SF
1:13-02-1_1(l E
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
1:1 PROPERTY INFORMATION
SITE ADDRESS: `,`'cL� '. l"� rC�— ASSESSOR'S TAX/PARCEL #: VS L:l7 r'4 J
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT INFORMATION
TYPE OF PROJECT(This application): "o BUILDING o PLUMBING o MECHANICAL o DEMOLITION
o ELECTRICAL 0 ENGINEERING o FIRE PREVENTION SYSTEM
PRO CT DESCRIPTION(Provide de �fled description): J t � -ic�`et�
crpi)\711-),sr
PROJECT NAME: j(k-
•
1� PEOPLE_INFORMATION
PROPERTY OWNER: NAME: ; DAYTIME PH9NE
NG
ITA
MAA (STREETADDRESS;LT/_ ✓\ n Loc , `
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1 IU
s
CONTRACTOR: I NAME: �_�^q 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: NAME: DAYTIME PHONE:
ato _ _ i )
MAILING ADDRESS( •EET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: j FAX NUMBER:
o ARCHITECT o TENANT 0 OTHER(DESCRIBE): i ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: O PROPERTY OWNER 0 APPLICANT O CONTRACTOR
.1-111 DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
t PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:a YES o NO
WATER SERVICE PROVIDER: O LAKEHAVEN O HIGHLINE 0 TACOMA O PRIVATE(WELL)
SEWER SERVICE PROVIDER: O LAKEHAVEN O HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• ■ PROTECT 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 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: ❑ ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S),- WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
K 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(including 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 supplieothe dty as a art of this plication.
NAME/TITLE: \\Jktk It 1► C?` �f DATE: t^b(-
PROPERTY OWNER o APPLICANT o CONTRACTOR
?(\s..
..FOR,OFFICE USE ONLY:-
RO NEW: - , (ADDITION .0 ALTERATION 5 e,REPAIR _ ❑,:TENANT IMPROVEMENT _
CENSUS CODE £ c ." - . . . . �._.,,
-� 5, ,F� „•.ate, _ .•LOT,SIZE •� �,.- - <�� .:4;sK ,„. .3 :..
ZONING DESIGNATION Mt f 4 BUILDING SHELL'ONLY? o:YES :%,: NOW
COMP PIAN DESIGNATION ,. . ..: VW ABASIC PLAN?- ,❑LYES ❑`NO,
;SECTIQN- TOWNSHIP_ RANGE „NEW ADDRESS REQUIRED? :=❑YES_- U NO
PLATTED LOT?; ❑YES _ a'NO ;€t• t'i0'M_ a- -CHANGE OF FUSE? --❑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
1 www.dtvoffederalway.com