03-105245 a
City of unityDevelopment Services FederalWay
Community Electrical Permit #:03 - 105245 - 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: GILMORE
Project Address: 30624 9TH 6 Prve-S Parcel Number: 174500 0050
Project Description: Installing new 125 amp panel
Owner Applicant Contractor
Linda D Gilmore ELECTRO SERVE LLC ELECTRO SERVE LLC
30624 9TH AVE S 13547 SE 27TH PL SUITE 3-D 13547 SE 27TH PL SUITE 3-D
FEDERAL WAY WA BELLEVUE WA 98005 BELLEVUE WA 98005
98003-4117 (425)451-3358
Electrical Fixtures
_ Description Quantity Description ,Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES May 31,2004.
Permit issued on December 3,2003
I hereby certify that the above information is correct and that the construction on the above described property andr
the occupancy and the use will be m accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: te,,,,a,i 7 431,_ Date: 10/Q3
$61 .
`iI
Rough-in inspection:
Date
Service inspection:
Date
FINAL inspection: . = G /.2 _ j
Date
VED BY
coMMUNm,DEVFrRECEI��,• pnRrr,nFn, CONSTRUCTION PERMIT APPLICATIOI`
VV fZY NOI/ 2 5 2003 APPLICATION NUMBER: j - Q ( .5--a)-
APPLICATION NUMBER: - _
APPLICATION NUMBER: _ _ - _ _ _
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention S stems and Engineering permits may require a separate application.
in, PROPERTY INFORMATION
(141
SITE ADDRESS: ak Q ` S cr41�1„ per,,, SSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
'. :.M PRO3ECTINFORMATION': +- . • :
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING ❑ MECHANICAL ❑ DEMOLITION
NiAELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): \'3 ..2 pi w A O
PROJECT NAME: (,:1 I I nil C
to PEOPLE INFORMATION •
PROPERTY OWNER NAME:IN ^ co
DAYTIME PHONE:
(.A3)(*k -LOC
MAIUNG ADDRESS ADDRESS;(STREET CITY,STATE,ZIP): `
IckoaLk S •'- ksik- \ ckOcu,s LLA ab003
CONTRACTOR: NAME:
DAYTIME PHONE:
Electro Serve LLC ( 425)653 - 4085
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENINGPHONE:.
13300 SE 30th St SU'I tP 109 RP1 LPvlJP�WA 98005 (425)653—'4085
•'4Q85::''
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBEI:
® - - (425)562-4-948
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
ELECTSL042M2 7 /22 /2004
(copyd card required)
APPUCANT: NAME: DAYTIME PHONE:
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
3 7' tIc \.C)5 l uacl `t MSS) 1653-q .:'
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT 0 TENANT A OTHER(DESCRIBE):Q t \ ICA-O ' (yam) t,a_ {cky
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPUCANT NgCONTRACTOR
.. , ■ DETAILED BUILDING INFORMATION'`:
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ -__
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES C! NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
,Y M
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
•
:' ■•PRO]ECT FLOOR AREAS
FLOOR EXISTING SQ.FT. • PROPOSED SQ.FT. TOTAL
BASEMENT ,
•
•
FIRST •
•
SECOND •
• -
THIRD - •
•
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
-t.n.lca.a.!:0 nisx-a,wewyaYw111
if:F=ATURESv�+*'"'"•vsra7N••r.++r�F•'rm�artu�+r:ew-'ac.ara:mc.,' ge. a�..�..;ai -�
Indicate number of each type of fixture
•
MECHANICAL
AIR HANDLING UNITS) 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 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAIN WATER SYS. VACUUM-BREAKER(S) 0 ELECTRIC ❑ 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 • e 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 claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the inform on supplied to the as a part of this application.
NAME/TITLE: DATE: \,\\a.Lk.\�3
0 PROPERTY OWNER 0 APPLICANT 4 CONTRACTOR'
FOR OFFI'CEaUSEy:ONLY '
ow REP €.... :a�_ _.. ti ,3,.r, �
�'ALTERATION � '- �. . AIR._.__>._. .® TENAN;t�IMPRU�/,EMENT"��n .���
two 3 .._ 2'3 a:
OT IZE `� ., ;,
ONI G I ESIG TI a N��[7_ .1BUILDfF GSHELL ONLY?, ' '13 WOW., 1"NO,
. N'DESIGN ATION rriU" RASXC.P11I $ r rS NQ41Mo€
1.SEC7IO,N itif6WNSHIP -RANGE ; :t��f r"" e''� a �a 0 s ' Oyu,,
"{� k P PY .f'^`�t H P2'h i '4" �-fi yh Y
_ �„r i�'�;...� �d NE1K,�DDRESS��L�QUIRED �„��ES .❑,•I�O�.g
. "51k�I l k -P ii ::. .l ra;;,� ,�m ,y l' CtrYESer Na::; k
,PLATTED LOT? w aY�Syy 6, ❑ NO �- fik � �,�� CHANGE OF�l1SE? `�*, a" ,u� t �f � . ,� �, rx
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.c1Noffederalway.com