03-105529 City of Federal Way
Community Development Services Electrical Permit #:03 - 105529 - 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: HOLMQUIS�Qx�
Project Address: 32330 HOYT SW Parcel Number: 142103 9062
Project Description: Add(2)circuits for addition to single family residence.
Owner Applicant Contractor
Paul H Holmquist Paul Holmquist Paul H Holmquist
32330 HOYT RD SW 32330 HOYT RD SW 32330 HOYT RD SW
FEDERAL WAY WA FEDERAL WAY WA 98023 FEDERAL WAY WA
98023-1926
Electrical Fixtures
Description Quantity Description 1Quantity Description 'Quantity
Circuits-Residential 2
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 be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: ,%� Date: /Yg.a/d3
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^E�VED CONSTRUCTION PERMIT APPLICATION
CITY OF �./ REV APPLICATION NUMBER: 03 - 1 Q .5____„3)11- ....1--
Federal
i1 -
Federal Way DEC 2 2003 APPLICATION NUMBER: -
kPPLICATION NUMBER: - -
Y
*OIP1fQFo URAL W ed information-Please print(in ink)or type**
BUIL'SEPT.
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
. PROPERTY INFORMATION
SITE ADDRESS: 32-330 Rd. 5 &U ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING o PLUMBING 0 MECHANICAL 0 DEMOLITION
'ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide de ailed description): deb: , t.t. /e a-iid5Lv`yeAej' / 1y-
add,'4
PROJECT NAME: bia//11 Lt,f $ f.
i
PEOPLE INFORMATION '.
PROPERTY OWNER: NAME: ..---" //// : DAYTIME PHONE'
ra r ft• #40414Oii/-5 4I (253) ws -g3'35-
MAILING ADDRESS(STREET ADDRESS;CITY,CIFATE,ZIP):
3.23 ;du��— ,(, .4 p- /Y4 l�yr14,0 fgag-
CONTRACTOR: NAME: .l DAYTIME PHONE:
gott OC G✓ , ( r .et-si- — a s 4A2�� t J ' ( ) -
MAILING ADDRESS(STREET ADDRESS; ATE,ZIP): EVENING PHONE:
I ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: { FAX NUMBER:
( ) 1CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(ropy of card required) /
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): EVENING PHONE'
(
RELATIONSHIP TO PROJECT: j FAX NUMBER:
0 ARCHITECT ❑TENANT ❑ OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT:XROPERTY OWNER 0 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/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 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
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 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 city,induding Its officers and employees,upon the accuracy
of the information sup ' to the city as a part of this application.
NAME/TITLE: 4,1;717...— DATE: /g/..-i-;-103
v
PROPERTY OWNER ❑ APPLICANT (3 CONTRACTOR
-FOR.OFFICE.USE ONLY :s1
-11511-641&:r: n'ADDITION - 0 ALTERATIOtV o.REPAIR � 0 TENANT IMPROVEMENT j
?CENSUS CODE 0 14r; c.....-40 : A"n •• .
ZONING DESIGNATION , , x_- ,' BUILDING:SHELL ONLYf? a YES 's-1j NO
COMP PLAN DESIGNATION
=� ABASIC PLAN?. ,..,o YES a❑ NO ¢ �; •`
`SECTION • TOWNSHIP , A' RANGE"MV.=- ,NEW ADDRESS REQUIRED? - ❑YES ❑
• PLATTED•,LOT? -:=❑YES:-.7,,-13-NO ,-•'CHANGE OF USE?,,,-,4-.7- :❑YES 1:3 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