01-104688 City on Federal
Services eWay
Community
D , Electrical Permit #:01 - 104688 - 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: QFC#867
Project Address: 31217 PACIFIC S Parcel Number: 082104 9186
Project Description: ELE-disconnect said bar for removal install chinken warmer in its place.
Owner Applicant Contractor
QFC#867 SPARTAN ELECTRIC SPARTAN ELECTRIC
31217 PACIFIC HWY S 6263 ELLIS AVE S 6263 ELLIS AVE S
FEDERAL WAY WA 98003 SEATTLE WA 98108 SEATTLE WA 98108
(206)763-1144
Electrical Fixtures
Discriptioi . q,, . tQuantit Description 4 r k Description ,, .` ".Quantity
Circuits- Commercial 3
PERMIT EXPIRES June 5,2002,IF NO WORK IS STARTED.
Permit issued on December 7,2001
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use : := in acco ance with the laws,rule and regulations of the State of Washington and
the City of Federal W.
Owner or agent: `' / Date: / �— / — 1
RECEIVED BY
a COMMUNITY DEVELOPMENT DEPARTM • CONSTRUCTION PERMIT APPLICATION
MY' 200 APPLICATION NUMBER L Q t .
DEC 07
**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.
f '■ PROPERTY INFORMATION
SITE ADDRESS: 3/Z/7 / /-c 1 T I C Wy 3-- ASSESSOR'S TAX/PARCEL#: O $ L 1 Q q - I L g fp
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICALS� ❑ ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION/(Provide detailed description): .4t fCon n e_e-16 Gr41 .L , ,Cr regi d(/q I
!.."S7 ! / - IC 4e., (,..-4 ,i-t / / f
PROJECT NAME: RFC •tt-g10-1
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
arc_ g(00 7 (z53) 9'f( - a8/
MAILING ADDRESS(STREET ADDRE9)CITY,SIFE,ZIP):
3(2-/7 rncI ec ("ti S -
CONTRACTOR: NAME: DAYTIME PHONE:
..5,WrA4/ zrie--(G ( a. L O (2 ) 7(.3 - //5".7L
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
/o?43 5/ti i¢vc- - Sir/t' 44 9f/of ( ) -
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER:
(2067) 7/o Z -S7/9
CONTRACTORS REGISTRATION NUMBER: 'T[ EXPIRATION DATE:
(copy of card required) / 9 9 do U 5-- 6 7 ,o a( ( 13/ " o3
APPLICANT: NAME: DAYTIME PHONE:
C_
`e ALS 17baVe ( )
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT ❑TENANT o OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER 1, APPLICANT ❑CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**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 ❑ 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) 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 daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the ci a part of th'. application.
NAME/TITLE: / / DATE: /2-174,
GIPROPERTY OWNER D APPLICANT NCONT„",/iOR
'FOR OFFICE USE ONLY:-.]
o NEW- ._'0 ADDITION ❑ ALTERATION ❑;REPAIR '.` ; ❑ TENANT IMPROVEMENT
CENSUS CODE: " = LOT.SIZE:
;ZONINGDESIGNATION: R BUILDING SHELL ONLY? :❑ YES ❑ NO
COMPlPLAN DESIGNATION BASIC PLAN? ]YES - ❑ NO
,SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES 0 N
PLATTED LOT? -' ❑YES ❑ NO CHANGE OF USE?, .. ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129