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01-102864 • Cityof Services FederalWay Community DElectrical Permit #:01 - 102864 - 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: MOTA Project Address: 134 SW 305TH 5f Parcel Number: 556000 0240 Project Description: ELE-Alteration of up to(4)circuits for residential living room addition. Owner Applicant Contractor Guadalupe&Gloria Mota GUADALUPE MOTA GUADALUPE MOTA 134 SW 305TH ST 134 SW 305TH ST 134 SW 305TH ST FEDERAL WAY WA FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 98023-3948 (253)946-3005 Electrical Fixtures Description Quantity Description 71Quantity Description Quantity Circuits-Residential 4 PERMIT EXPIRES July 16,2002,IF NO WORK IS STARTED. Permit issued on January 17,2002 110 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 Way. Owner or agent: _ %r. iC Date: l- < 57—0 / 30 — CO2 �Ok y� 1� i,J fteN � v ©u ��-1Ny ✓�� — 617 6 - - - z, 4:\ (3 2 • r � __ or Elo R- 1 CONSTRUCTION PERMIT APPLICATION • C � (?Y APPLICATION NUMBER: Q / - �Z.o4 APPLICATION NUMBER: - APPLICATION NUMBER: - - **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. A PROPERTY INFORMATION SITE ADDRESS: 3 -( Q7(n' -30 k s( ASSESSOR'S TAX/PARCEL #: LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): • it PROJECT INFORMATION TYPE OF PROJECT(This application): I. .UILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION .ggi ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM "� ` �D PROJECT DESCRIPTION (Provide detailed description): -. py u�K '� /1, PROJECT NAME: eletIc '74 Ir PEOPLE INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE: (74:„Lr1,giet/64-7>\ If •(,2 3 )9' /(, - MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): /3G/ 5t-) �� T eeatWci Wel WA— ?gbZT CONTRACTOR: NAME: DAYTIME PHONE: A,vt•t.e C c-k,6 e ( ) MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: ( ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: ( ) CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) APPLICANT: NAME: DAYTIME PHONE: r Cc.b 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: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) S -� **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PRO]ECT 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) Cl 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 perju 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 as a part of this application. NAME/TITLE: DATE: 7`p9-D/e/ ❑ 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 Cl NO COMMI INFTY DFVFLOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:753-661-4129