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City of Federal Way
Community Development Services Electrical Permit #:03 - 105506 - 01 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.667 4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: HOMESTREET BANK
Project Address: 33525 PACIFIC S 5t e l 0 Parcel Number: 926503 0020
Project Description: Installing 100-amp service/meter base with circuit and J-box for relocation of illuminated monument
sign.
Owner Applicant Contractor
SHDP ASSOCIATES LLC FULLER ELECTRIC FULLER ELECTRIC
120 W DAYTON ST#D9 FULLER ELECTRIC FULLER ELECTRIC
EDMONDS WA 37107 12TH AVE S 37107 12TH AVE S
98020-4181 FEDERAL WAY WA 98003 (253)661-71.81
Electrical Fixtures
Description Quantity Description [Quantity Description [Quantity
Circuits- Commercial 1 Service/Feeder: 0-100 amps-Comm.' 1 1
PERMIT EXPIRES July 3,2004.
Permit issued on January 5,2004
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 Wa .
7 Owner or agent: d Date: / S----6) 7
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City'of
ity Development Services eWay
CommunityComElectrical Permit #:03 - 105506 - 00 - EL
3353E 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax 253.661.4129 Inspection request line: 253.835.3050
Project Name: HOMESTREET BANK
Project Address: 33525 PACIFIC S Parcel Number: 926503 0020
Project Description: Move existing circuit and J-box for relocation of illuminated monument sign.
Owner Applicant Contractor
HOMESTREET BANK FULLER ELECTRIC FULLER ELECTRIC
33525 PACIFIC HWY S FULLER ELECTRIC FULLER ELECTRIC
FEDERAL WAY WA 98003 37107 12TH AVE S 37107 12TH AVE S
FEDERAL WAY WA 98003 (253)661-7181
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Circuits- Commercial 1
PERMIT EXPIRES June 19,2004.
Permit issued on December 22,2003
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 accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way. � -
Owner or agent: \ (Yl�'C /Vn
Date: /2- 72-0 3
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•
RECEIVED CONSTRUCTION PERMIT APPLICATION
CITY OF 111"-"illiam•'
Federal WayDEC2 2 2003 ApPLrCATI01�NU1�[BER: Os- 1 Qs�jp=
.
APPLICTIOIV IC1W(BER: _ - - _
CITY OFFEDERALWAY APILE�I �!IBE . _ _
**The � ffiigGs1regwred information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
• PROPERTY INFORMATION
SITE ADDRESS: 3 S-IsS /Q 4--.' C /---/-A1y-TD ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
f�Orhe .S f/ e e
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑BUILDING ❑PLUMBING ❑MECHANICAL ❑DEMOLITION
'ELECTRICAL ❑ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
M01/ € Ccc , 7'L -f'or J.9M •
PROJECT NAME:
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
I7.G 46-"e ( ) -
MAILING ADDRESS(STREET ADD CITY,STATE,ZIP):
3 3 5 S c, f'. /16A-,>, f v
CONTRACTOR: NAME: DAYTIME PHONE:
Fic-//E,/, EA- (Jr'. c ��, c ( D,s3) ‘6/
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
3)/ 0? /)J AveSo (Is3) - 7/p
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- / v_ 3 Y - C Q (153) 6/
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) F (t / / i` c- / .2_ 7 , 3�' / / /2_ / 2.c i-6
APPLICANT: NAME: DAYTIME PHONE:
( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT 0 TENANT 0 OTHER(DESCRIBE): ( ) -
EMAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT 0 CONTRACTOR
■ PROJECT INFORMATION
EXISTING:USES '" EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ ,
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINIQ EKED BUILDING?. OYES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:DYES.
WATER SERVICE PROVIDER: ❑LAXEHAVEN 0 HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
. SEWER SERVICE PROVIDER. ❑LAIEEHHAVEN ❑HIGHLINE 0 PRIVATE(SEPTIC)
i
**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 OGAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC ❑GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTORS) 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 claim),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 city as a part of this application.
stir 7�,� I2-
NAME/TITLE: '1^2'/L�� DATE:
❑PROPERTY OWNER 0 APPLICANT „DirO3NTRACTOR
—1:
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COMMUNITY DEVELOPMENT SERVICES• r WAY SOUI1Se0 BOX 97111 lanilt0Oli•TEDERAL WAY,WA 98063-9713.253-661-4000•FAX:253-661-4129