01-103091 • I
City of Federal Way
Community Development Services Electrical Permit #:01 - 103091 - 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: CINNABON/QFC
Project Address: 31217 PACIFIC S Parcel Number: 082104 9186
Project Description: ELE-Ateration for the installation of(8) new lights.
Owner Applicant Contractor
QFC STORES SPARTAN ELECTRIC SRVC INC SPARTAN ELECTRIC SRVC INC
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
Description !Quantity Description Quantity Description !Quantity
Circuits- Commercial 1 5
PERMIT EXPIRES February 3,2002,IF NO WORK IS STARTED.
Permit issued on August 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 - .11 be accordance with the laws,rules and regulations of the State of Washington and
the City of Federal ay.
Owner or agent: Date: 7-0/
CrT10f eteCeIVED CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: Of - t0 U
\>\> ��zr-n_ AUG 0 7 20Ql -� � iC-�j_EL
APPLICATION NUMBER: -
Cay OF FEDERAL WAY APPLICATION NUMBER: - -
BUILDING DEP
**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.
- • �PROP`ERTY INFORMATION
SITE ADDRESS: 3/Z l 7 TGfG/T( � /[7w J ' ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• '' • • • PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICALL ❑/ENGINEERING❑ FIRE H /i 94PREVVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): /n-S-�4' //( 1'7C / ,ts i ih e/C C/i94-Co n
PROJECT NAME: G52 P-Zip�
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHONE:
SP T.9,S/ a -rg r L ( ) 76,3 - 044
MAILING ADDRESS(STREET ADDRESS;CITY,ST TE,ZIP): EVENING PHONE:
4024,3 £//s e- S . 9//8 ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
19 ` 1 - 1a c6 7 - BL (2o') 76,2_ - 57/?
CONTRACTOR'S REGISTRATION NUMBER: I N EXPIRATDATE:
(copy of card required) S ," 4 4 T "F `�c P 2 _ Q O / .3 r / ® /
APPLICANT: NAME: DAYTIME PHONE:
�� �1ec.4Tr a- ( )
MAIUN 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: $ /V00.C/0
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 111 LAKEHAVEN 0 HIGHLINE 0 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),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where s h claim arises out of the reliance of the city, including its officers and employees,upon the accuracy
of the information supplied t e city a a part of this application.
g1/4°-4/
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANT liCONTRACTOR
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? El YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? El 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