01-102655 •
City of Federal Way
Community Development Services Electrical Permit #:01 - 102655 - 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: DO IT YOURSELF DOCUMENTS •
Project Address: 31830 PACIFIC S UNITF Parcel Number: 092104 9221
Project Description: ELE-Electrical for internally illuminated wall signage.
Owner Applicant Contractor
DO IT YOURSELF DOCUMENTS FEDERAL WAY SIGN CO CULBERTSON SIGN SERVICE
31830 PACIFIC HWY S FEDERAL WAY SIGN CO CULBERTSON SIGN SERVICE
FEDERAL'WAY WA 98032 30665 MILITARY RD S 213 FRONTAGE RD S
• AUBURN WA 98001 (800)925-6011
•
Electrical Fixtures
Description Quantity Description 'Quantity Description 'Quantity
sign
•
PERMIT EXPIRES January 1,2002,IF NO WORK IS STARTED. •
Permit issued on July 5,2001
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in acco nce with the laws, rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date:
Cfr.or
_ RECEIVED�r CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: )J - J Q 2. 4 ss-- EL
VV FAY JUL 05 2001 APPLICATION NUMBER: -
CITY OF FEDERAL WAY APPLICATION NUMBER: - -
BUILDING DEPT
**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 INFORMATION
SITE ADDRESS: 31830 P& ;f 1 L. t(f. 5 ASSESSOR'S TAX/PARCEL #: 09 al Q q - a -2.2i
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
' ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERIn ❑ FI' IN SYSTEM
PROJECT DESCRIPTION(Provide detailed description): *"• =�..� ,h.. .
\1
PROJECT NAME: D I -r 0tkg,..S - `1 �_ LA.:a. L N S
4"*„.,...„
• PEOPLE IL•"ORMATXON
4
PROPERTY OWNER: NAME: DAYTIMI PHONE:
MAIU DDRESS •(STREET`. c SS;C A v�
CONTRACTOR: NA • , 1 , • - -4 YTIME P`/
�'
HONE:
MAILING• ' S(STREET ADDRESS;CITY, ZIP. ENING PHONE:
, "Ft....-%•--4.a-- 'L� 1 < ( )
CITY OF FEB•.,WAY BUSINESS LICENSE NUMBER: Q - FAX NUMBER:
CONTRACTOR'S RE 'w• ION NUMBER: ; EXPIRATION DATE:
(copy of card required) ' / /
APPLICANT: NAME: DAYTIME PHONE:
� ..� e,. ( tC ) S _°- 20 11
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHE (DESCRIBE): ( ) - , i
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)
**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),w • h may be made by any person,including the undersigned,and filed against the City of
Federal Way, but only where such claim ari.e out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supp•-d to the cityzs a ..rt of this application.
NAME/TITLE: 1
DATE: tOco
❑ PROPERTY OWNER (PPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW El ADDITION El 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
COMMUNITY DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253 661-4000•FAX: 253-661-4129