03-105535 1
City of Federal Way
Community Development Services Electrical Permit #:03 - 105535 - 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: CROSSPOINTE APARTMENTS
Project Address: 35810 16TH$ k1e 5 Parcel Number: 282104 9070
Project Description: Replace burned-out 3-gang meter pack for building H-101.
Owner Applicant Contractor
Kitts Corner Apts L L Crosspointe EVERGREEN STATE ELECTRIC INC EVERGREEN STATE ELECTRIC INC
33515 10TH PL S#15 PO BOX 1448 PO BOX 1448
FEDERAL WAY WA ORTING WA 98360 ORTING WA 98360
98003-7300 (253)770-0656
Electrical Fixtures
Description Quantity 1 Description Quantity Description [Quantity
Mast or Meter Repair-Comm. N 1
PERMIT EXPIRES June 20,2004.
Permit issued on December 23,2003
I hereby certify that the above information is correctand that the construction on the above described property and
the occupancy and the use will be ' a ordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way. l
Owner or agent: ..- 61Date:
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RECEIVED
CONSTRUCTION PERMIT APPLICATION
'" CITY OF "4.,-.`
Federal WayDEC 2 3 2003 APPLICATION NUMBER: 0?3- 1 0,��3S �i�
APPLICATION NUMBER: _ _ - — — — _ _ _ - _ _
CITY OF FEDERAL WAY APPLICATION NUMBER:
BUILDING DEPT. -- — - --— — — — _
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
Q J/-I� • PROPERTY INFORMATION
SITE ADDRESS: 3581D I lei- ftM_, S. ASSESSOR'S TAX/PARCEL#:.4i • -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
,LECTRICAL �1❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): ai / V:PE OUT EXIST/NC1 --67ft"/U6
YYt e:T E R_ ►?ftC Y _ lYlNc./UTEI -In e 5U.1/1.)/k161 ti -10 (
ME:TEP Prte_g IioFI-S -NtJT-uP - 1voT l.io1yIAJcv
PROJECT NAME: a FUSS P O I JU T i-1"rS
• PROJECT INFORMATION
PROPERTY OWNER: NAME: /DAYTIME PHONE:
)
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: I NAME: DAYTIME PHONE:
1 'Ev rgre e ) Si-a+-e_ El-eof 1r (2S3 ) 7 7b - d1.0S(0'
MAILING AD ESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
`Pb Bow l, L 3t tir c q$'3Lo0 _( -'
I CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:13. CI - ( 0 Co 6 3 9 - D 0 FAX 3)q o - I -1 A-
CONTRACTORS REGISTRATION NUMBER: (� C (7 EXPIRATION� DA/ V
DATE: /j
11 ,copy o(card `/required) E v E R G 5 E D 10 3- a /
I I L 101 1 / I+
APPLICANT: 1 NAMEDAYTIME PHONE
S& vim... OLS ODYk+(rc C-±0 r." , ( ) -
•MAIIING ADDRESS iSTREE) ADDRESS:CITY STATE,ZIP) I EVENING PHONE
l l ( )
' '15 A IIONSHIP 10 PRO IEC) f At NUMBER.
ARCHITECT • TENANT OTHER( DESCRIBE): ( )
.
— t MA;'1, ADDRESS
CONTACT PERSON FOR THIS PROJECT. •ROPERTY OWNER 'APPLICANT CONTRACTOR
• PROJECT 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: LAKEHAVEN I HIGHLINE TACOMA PRIVATE(WELL)
SEWER SERVICE PROVIDER: LAKEHAVEN 1 HIGHLINE PRIVATE (SEPTIC)
r
**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 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: o ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC 0 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 coned 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 sudi claim),whidi may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where sudi daim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the information supplied to the dty as a p•rt of this application.
NAME/TTTLE: /L�/��(, 1. A/! I..i/ .A..r DATE: 1?-
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY: 1
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES o NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES L1 NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY OEVFLOPMFNT SERVICES•33630 FIRST WAY SOUTH•PO BOX 9718•FEOERAl WAY WA 98063-9718•2S3-661-4000•FAX 263-661-4174