03-105540 City of Federal Way Electrical Permit #:03 - 105540 - 00 - EL
Community Development Services
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: IDENTITY MINE,INC.
Project Address: 2505 S320TH]ccS��uite450 Parcel Number: 797820 0535
Project Description: Adding(5)cirFiiits and recepticles&switches as needed.
Owner Applicant Contractor
PRIMESTAR INVESTMENT CORP*Mr NIZA CORNERSTONE ELECTRIC INC CORNERSTONE ELECTRIC INC
PRIMESTAR INVESTMENT CORP 8425 25TH ST E 8425 25TH ST E
2505 S 320TH ST SUITE 101
FEDERAL WAY WA 98003 \PUYALLUP WA 98371 (253)922-1191
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits- Commercial 5
PERMIT EXPIRES June 21,2004.
Permit issued on December 24,2003
I hereby certify that the above informationis correct and that the construction on the above described property and
the occupancy and the use will be in accori. ice with the laws,rules and regulations of the State of Washington and
the City of Federal
Owner or agent: /I ( / Date:
�-- 3 V\)Akk eavtr App
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' D -22- 0,5222- CONSTRUCTION PERMIT APPLICATION
�" RECEIVED
CITY OF �� APPLICATION NUMBER: Q -r� 5,� D_ -C�tJ
Federal Way APPLICATION NUMBER: _ _ - _ _ _ _ _ _ - _ _
DEC 2 4 2003 APPLICATION NUMBER: - -
**The following btepeoefwe'i kiti YPlease print(in ink)or type**
Please note: Electrical,Fire Prevention 5t 'r andEEn ineerin
g' g permits may require a separate application.
Ki,PROPERTY INFORMATION : '
SITE ADDRESS: 5O- 5 5,10- k Ur
t51! ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
11 PROJECT INFORMATION
TYPE OF PROJECT(This application): o BUIL•ING o PLUMBING 0 MECHANICAL 0 DEMOLITION
ELECTRICAL 0 ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIO (Provide dtailed description): - •
5 Orai,c Gi w C "S f 5a i 'c Qs he. : /V COtiny/c i
PROJECT NAME: 6/114-;4- 1,4�V I.e -i c'
11 PEOPLE INFORMATION
PROPERTY OWNER: NAME: - DAYTIME PHONE
b.(Y' 41 (4 �° G ) -
MAILING ADDRESS(STREET DDRESS;CITY,STATE,ZIP):
CONTRACTOR: I NAME DAYTIME PHONE.
e rs-ivii e E7 (.7 r(61316 (253) Wa,--,9/9"
MAI G ADDRt SS(STREET ADDRE;CITY, A ZIP): __ed i. EVENING PHONE
15 4 IS D-b E.
eUz,1 d rn ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - ( ) -
CONTRACTOR'S REGISTRATION EX
NUMBER: / 7 0
(ropy a card required) CO1. r E.ET J 1(p ; PIi;pT}ON'ATS: 1 /
APPLICANT: NAME: DAYTIME PHONE:
( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): I EVENING PHONE:
( ) -
RELATIONSHIP TO PROJECT: j FAX NUMBER:
0 ARCHITECT 0 TENANT ❑ OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT AONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING AS •PRAISED VALUATION $
PRO•; EI SE: ___ PROPOSE' ALUATION FOR 'PROVEMENTS: $
SPRI LERE B ILDING? 0 YES , NO IRE SUPPRESSION SY PROPOSED/RE• •ED:o YES ■ NO •
WATER ERVIC• •ROVIDE'. o LAKEHAV ❑ H LINE 0 TACOMA 0 PR •TE(WEL
SEWER SE•VI r E PR• - •ER: o LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• ■ PROTECT FLOOR AREAS
•OR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL: Adik
■ FIXTURES
Indicate number of each type of • re
MECHANICAL Valu: s f Mechanical Work: $
AIR HANDLING UNIT( EVAPORATIVE COOLER(S) GAS L• S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: . ELECTRIC o GAS
PLUMBING
B• 'TUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
SHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o 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)
1 DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury tha 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 . e 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 ere such daim • uses out of the reliance of the city,induding its officers and employees,upon the accuracy
of the informations d led the d a a p• is appl'cation. 'J
NAME/TITLE: " (! Kier(
rl DATE: I/3
o PROPERTY OWNE ❑APPLICANT ❑ CONTRACTOR
FOR.OFFICE USE ONLY:
r„.. ,, .,.. . __. : ,o REPAIR 0 TENANTeIMPROVEMENT'
O!'NEW.� .,,�.„�O ADDITION , ,----.❑ALTERATION
CENSUS'CODE'- _. - -* -LOT SIZE:
• � ”BUILDING SHELL'ONLY?' 'o YES -❑ NO
•;ZONING,DESIGNATION.' , �
COMP PLAN DESIGNATION r:! : .' :BASIC PLAN? ❑YES -r o'No =
TOWNSHIP RANGE NEW ADDRESS REQUIRED? Cl YES ❑ NO
PLATTED LOT?. "'.•'❑YES .❑`NO CHANGE OF USE? o YES te=n NO "
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www•cityoffedera Iway.Com