03-105505 City of Federal Way
Community Development Services Electrical Permit #:03 - 105505 - 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: YAMAHA
Project Address: 33003 PACIFIC S Parcel Number: 172104 9124
Project Description: Move circuit serving relocated,illuminated monument sign. `
,,
Owner Applicant ontractor 0
Robert J Minkler I-5 SIGNS INC ULLER E I TRIC
1701 KENNEWICK AVE NE 8751 COMMERCE PLACE ' 11 LE' CTRIC
RENTON WA LACEY WA 9 -1326 37 H AVE S
98056-2601 (253)661-7181
EI rica to
Description Quantity De • n Quantity ription 71Quantity
Circuits- Commercial 1
)1111°' PERMIT E ' Vill
Permit is o.
I hereby - 1,11, above in 'a :tion is correct and that 11 ction on the above described property and
the occ •ancy use will be m accordance with the laws,ru es an. regulations of the State of Washington and
the City of Fed: or
Owner or agent: Aar /3.4.6L:,,,,,,, Date: /. ^2 Z O1
s .
RECEIVED
CONSTRUCTION PERMIT APPLICATION
CITY OF DEC DEC 2 2 2003 APPLICATION NUMBER 03- l 0.5:51(,)51Q(�
Federal Way APPLICATION NUMBER _ _ _ - _ _
CITY OF FEDERAL WAY
BUILDING DEPT, APPLI
**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.
,p ■'/PROPERTY INFORMATION
SITE ADDRESS: iJ 03 0�c ��c- �7 u�>'SC) ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
Yct. "ic, A. c1
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑BUILDING ❑PLUMBING ❑MECHANICAL ❑DEMOLITION
„ILECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
•
PROJECT NAME:
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
3 31703 PA , -F. iiL0y 50
CONTRACTOR: NAME: DAYTIME PHONE:
//'—r ,/f cif,` C -1-At C ( 1.s3) 66/ -)/J/
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
37/ 6? / 19i-ie -co ( 2s-) 66/ -?/S/
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
93 - / 0 3 -3 G Y- oU (2s3) 6 6/
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
m
(copy of rd required) F u l l e e ; O 2 2 k /
APPLICANT: NAME: DAYTIME PHONE:
( )MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT 0 TENANT 0 OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT 0 CONTRACTOR
IN PROJECT INFORMATION
DaSTINGUSE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE:. PROPOSED VALUATION FOR IMPROVEMENTS:. $ . _ -
� �..
OYES ' ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED. QYES s 0 NO
SPRINIQ
_ RED'BUILDING?:
WATER SERVICE PROVIDER: ❑LAKEHAVEN 0 HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑LAIO:HAVEN 0 HIGHLINE . 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
r
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: 0 ELECTRIC ❑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) SINKS) 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 claim(induding costs,expenses,and attorneys'fees incurred in the
;nvestirat on and defense of such c!ain:),which.rna be made 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,including its officers and employees,upon the accuracy
of the information suppliedplto the city as a part of this application.
NAME/TITLE: U'Gr C,/%7-^1 % 2�-�" DATE: %).--/ y- U
❑PROPERTY OWNER 0 APPLICANT ,CONTRACTOR
�d013£ ., ), "31C', ill, ' E ALID i ��' �e� 91. _J,-.- tr0
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CCMMUNSY DEVBAPt4 fr SERVIO5• c-c£ FIRST WAY SOUTI -PO BOX 9718••FEDERAL WAY WA 98063-9718.253-661-4000••FAX.253-661-4129
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