03-105508 City of FedeWay
Community Development Services Electrical Permit #:03 - 105508 - 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: BOB'S MAYTAG
Project Address: 33029 PACIFIC S Parcel Number: 104 9
Project Description: Move existing circuit and J-box for relocation of illuminated monument sign. ,
Owner Applicant Con
Robert J Minkler FULLER ELECTRIC FULLER ELECTRIC
1701 KENNEWICK AVE NE FULLER ELECTRIC ULLER ELECTRIC
RENTON WA 37107 12TH AVE S 07 12TH AVE S
98056-2601 FEDERAL WAY WA 98 3)661-7181
ii Electr
Description Quantity •-scriptio Qua Description Quantity
Circuits- Commercial 1
P; • u1 . "IBES 4.
41111101
Permit issue. 1 ec• •r 2,2003
I hereby certify th, le above info . *roc .d - c t ction on the above described property and
the occupancy and .. use will be in a .rd• • e with - • , s and regulations of the State of Washington and
or
the • Federal .k
er or agent: A1a& /v%s[.,fa_1.. Date: _42 Z-d)
i 4,-zo v,;4,4___ Ca,-.✓- tf(J rv,...✓ $
RECEIVED ��--
' CONSTRUCTION PERMIT APPLICATION
CITY OF .� DEC 2 2 2003 APPLICATION NUMBER: 05- 1 0.� - .( -
Federal Way
CITY OF FEDERAL WAY APPLICATION NUMBER _ — -
_
BUILDING DEPT. PI=I O. . MBER
**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.
• PROPERTY INFORMATIONS'-
SITE ADDRESS: 3 3 ct iP<< T i L J7yspESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
£3 o ' r)'1 a_y y D l {'
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑BUILDING ❑PLUMBING ❑MECHANICAL ❑DEMOLITION
ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
PROJECT NAME:
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
8046 S 71-,a TCL. ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
3 34)X Pec c.., c Iyc y .-‘u
CONTRACTOR: NAME: DAYTIME PHONE:
Fw1I:, L (.253) 6 6/ - 7i.1'/
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
37/ x ? Uf Sc) (2S3 ) 66 - >1P/
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
93 - 6 , 3 Y - Ga ( z3) 6 (/ -6yS '
CONTRACTOR'S REGISTRATION NUMBER: \1- EXPIRATION DATE:
t'
(copy of card required) f ( / / C / ,Z , / l LI
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
• PROJECT INFORMATION
EX ISTINGUSE. ' EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS:.$
SPRINKLEREDBUILDING? " _ OYES ONO FIRE SUPPRESSION SYSTEM PROPOSED/
REQUIRED...Q,fES.` QNQ
WATER SERVICE PROVIDER: ❑LAKEHAVEN ❑HIGHLINE ❑TACOMA 0 PRIVATE(WELL)
SEWERSERVICE PROVIDER. : ❑LAKEHAVEN ❑HIGHLINE ❑PRIVATE(SEPTIC)
Eur«ry#' .. 2r .. ;at-trOr`f iP`*-r. `i° ti r _ xa!• s M
•
**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) FURNACES)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ELECTRIC ❑GAS
PLUMBING •
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKERS) CI ELECTRIC ❑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 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.
�NAME/TITLE: ��-'..� � LL2_SC� Z DATE:
❑PROPERTY OWNER 0 APPLICANT .CONTRACTOR
ra0I Is{
aj.7...4_4a 'w0"" ..19.a.,, _ ;,„i a , i u "_tiff+_7 m % 'sem i, _ Y �'
COMMUNITY DEVELOPMENT SERVICE•33530• WAY SOUTH,%0P0 BOG9718•FEDERALWAY WA 980639718.253-661-4000•FAX:253-6661-4129
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