03-105528 City of Federal Way
Community Development Services Electrical Permit #:03 - 105528 - 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: FEDERAL WAY LICENSING SERVICES
Project Address: j -756 S 3j77S t t1-4) 'I Parcel Number: 162104 9025
Project Description: Add(8)circuits for tenant improvements/expansion.
Owner Applicant Contractor
KUECKER LTD PARTNERSHIP*ATTN:LIS/ CEDAR GROVE ELECTRIC CEDAR GROVE ELECTRIC
KUECKER LTD PARTNERSHIP 5602 192ND AVE E 5602 192ND AVE E
32610 PACIFIC HWY S SUMNER WA 98390 SUMNER WA 98390
FEDERAL WAY WA (206)310-6066
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits- Commercial 8
PERMIT EXPIRES June 19,2004.
Permit issued on December 22,2003
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 .117 , dance with the laws,rules and regulations of the State of Washington and
the City of Federal Way. voir
Owner or agent: '�� Date: !Z
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''cIV CONSTRUCTION PERMIT MIT APPLICATION
CITY OF �� APPLICATION NUMBER: Q - L Q L575-2-? -
Federal Way = 2 2 2003 APPLICATION NUMBER: - -
oily of FEDERAL w�4Y kPPLICATION NUMBER: - -
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*'The following is require nTermation—Please print(in ink)or type*'
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY INFORMATION
SITE ADDRESS:326(0 L7'Kt so (31_001p'.
ASSESSOR'S TAX/PARCEL Ail C21 o _ O 15-c 5
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
60o' WCL iUCQE4Sro -r 4v
0 UT o l . c S i.i -(
'RO]ECT INFORMATION _
TYPE OF PROJECT(This application): o BUILDING o PLUMBING ❑ MECHANICAL o DEMOLITION
ELECTRICAL 0 ENGINEERING XFIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): A f♦ r` _ TO
PROJECT NAME: "Zg_"D' .141 (at..` LkcE ), SSI �•� c���'�`�' `� S
PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE'
IC Ck = L ti)A 0,t ki23\7\1 (253) g28-gi
MAILING ADDRESS(STREET ADDRESS; ,STATE,ZIP):
o X 3 c/ Iaz b E AL w .e t_k 28 0(3
CONTRACTOR: NAME: I DAYTIME PHONE:
C-1.0 QT!R►. - � (2"() 3103 6 6 6
(
MAILING ADDRESS(iySTTRREET ADDRESS;CITY,STATE,ZIP)- �+ Gy 6 3(AO. /EVEENNIING PHONE-
3
HONE: y /'q
CM4FOFED . WAY BUSINESS- 1DENSE V 2� E V LIQ� �UA(AO
(2 3) 8Zq \0
FAX NUMBER:
I ( ) {
CONTRACTOR'S REGISTRATION NUMBER: �. y� EXPIRATION DATE:
(coPY of card required) 20 -63 - c chi 2 �� — ®C�`�1LZ�. _ _ {/ 2 / 3 / / 05/
APPLICANT: ( NAME: DAYTIME PHONE:
4-+VIN -�vQ\K_G- rC,`� (20c) 3 to 6o 64
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE
I332-5o 2i Uro c - S ; ( ) N
I RELATIONSHIP TO PROJECT: j FAX NUMBER:
0 ARCHITECT ❑TENANT ❑ OTHER( DESCRIBE): U Cris i t!,i;( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: D PROPERTY OWNER „APPLICANT o CONTRACTOR
DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIREDES ❑ NO
WATER SERVICE PROVIDER: XLAKEHAVEN o HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: A LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT 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: 0 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)
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 city,induding its officers and employees,upon the accuracy
of the Information supplied to the dty as a part of this application. / / /
NAME/TITLE:VkCVN -'\i‘ C�(�V CV .E.t a}at C:(�1 1J DATE: LZ ! 6 3 ` d 3
o PROPERTY OWNER KAPPLICANT ❑ CONTRACTOR
_.FOR-OFFICE,USE ONLY -1
'❑uNEW ;�E ADDITION fQ ALTERATIUN 0 REPAIR , F 0 TENANT IMPROVEMENT
LOT SIZE::- .,:-.4-. .,.,h-
:ZONING DESIGNATION_x '- _ x;, " _ BUILDING SHELL'.ONLY?- D YES,' .❑NO ,.
COMP PLAN DESIGNA ION , ?, .BASIC PLAN? `0 YES D NO 'S
- 'SECTION': TOWNSHIP x RANGE . F' NEW ADDRESS REQUIRED?. 'o YES o NO
--PLATTED,LOT? ,•❑YES= O'NO ` `r,.-;=mak CHANGE OF USE?' _ Ci YES`:`=o NO
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