01-102602 City of Federal Way �J Electrical Permit #:01 - 102602 - 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: BUHL
Project Address: 30326 21ST S' Ave 5 In/ Parcel Number: 012103 9038
Project Description: ELE-Extend service to garage addition.
Owner Applicant Contractor
William&Connie Buhl William&Connie Buhl William&Connie Buhl
30326 21ST AVE SW 30326 21ST AVE SW 30326 21ST AVE SW
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-2305 98023-2305 (253)661-3195
Electrical Fixtures
Description (Quantity Description Quantity Description ,Quantity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES December 26,2001,IF NO WORK IS STARTED.
Permit issued on June 29,2001
4'lereby certify that the above information is correct and that the construction on the above described property and
e 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.
ASOwner or agent: L ,_. Date: =.."? i o /
7—f ci( G�--�'�� �.�/ Y14 (
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6/ }C/72 (
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RECEIVED
c,Tor ' CONSTRUCTION PERMIT APPLICATION
VV FAY - JUN 2 9 2001 APPLICATION NUMBER: D L - L(..) � 6 0 Z- EL_
APPLICATION NUMBER: -t.,11
WAY
BUILDING DEPT.
APPLICATION NUMBER: - -
**The following is required information-Piease print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
- • PROPERTY INFORMATION
Sec)SITE ADDRESS: �22J� .2I S T /IV SCJ ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
," ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ UILDING ❑ PLUMBING ❑ MECHANICAL El DEMOLITION
ELECTRICAL ❑ ENGINEERING CI FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): SQ' f(C-Q. -TO 54)Pt/y ./a#1/j V e.
PROJECT NAME>) ((J (74_
///"' ■ PEOPLE INFORMATION
�( PROPERTY OWNER: NAME: DAYTIME PHONE:
ill i3u6 r�Y3 ) �‘/-3i"S.A.-
MAILING
-MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
30320 a/ 51 My se,j fretke,94 Gv0Ey tvlf 9723
kCONTRACTOR: NAME: DAYTIME PHONE:
OCe 41)e12 ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
- E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
- ■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
• 4.
**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 claim (including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information supplied_ to the city a a part of this application. A/
NAME/TITLE: ��� DATE: E% ��` a/
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
rnMnit INrTY nFVFl OPMFNT SFRVICFS•33530 FIRST WAY Sn11TH•P D BOX 9718•FFDFRAL WAY.WA 98063-9718•253-661-4000•FAX• 7S"3-8(1-4179