01-103359 ' t
1
City of Federal Way
City ity Development Services t ' Electrical Permit #:01 - 103359 - 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: SHELLEY
Project Address: 29635 20TH Rix PI SW Parcel Number: 012103 9003
Project Description: ELE-Service for residence.
Owner Applicant Contractor
PETER&ANDREA SHELLEY ADVANCED ELEC&SECURITY INC ADVANCED ELEC&SECURITY INC
29635 20TH AVE SW 3217 MERIDIAN AVE E 3217 MERIDIAN AVE E
FEDERAL WAY WA 98023 PUYALLUP WA 98371 PUYALLUP WA 98371
(253)848-8706
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•
Electrical Fixtures
Description ' !Quantity Description (Quantity °"s Description (Quantity
Service: -Residential 8743
PERMIT EXPIRES February 23,2002,IF NO WORK IS STARTED.
Permit issued on August 27,2001
• 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 accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: ( 7 7/6 2
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��_ CONSTRUCTION PERMIT APPLICATION
�� f3Y 1� � APPLICATION NUMBER: o 1 - I t7 .3 .3 •••-•=l- Qo-el_•
ww ,V APPLICATION NUMBER: _ - -
`e APPLICATION NUMBER: _
�'�*�' �e following is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
r �j ■ PROPERTY INFORMATION
SITE ADDRESS: 2 ` (e � L'
. ) ,4,.., c 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
ELECTRICAL �❑�EN�GIINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): �vI"t,iJ
PROJECT NAME: i � l•-; �. - r, t _e
1 PEOPLE INF( 1MAT;ON
PROPERTY OWNER: NAME: e..../.€ DAYTIME j 70
MAILING ADDRESS(STREET ADDRESS;CITY, +2Jr - 3 0
CONTRACTOR' NAEIEa7 DAYTIME PHONE:
1;62.64
MAILING ADDRESS(SIRE ADDRESS;CITY,STATE;ZIP): EVENING PHONE:
22 l "7 g_. ø11€- ,i-,-' `j t37/ ( ) -
CI Y OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - (2;-'S)WCC - lgio
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of caro requite) P 16- ii e s o et Z N' 7 en / Z-7 / o -z
APPLICANT:• NAME: DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
i RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
IN 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)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT 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 claim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the ity as a part of this application.
NAME/TITLE: DATE: b e;2-7A
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR 6666
FOR OFFICE USE ONLY: I
0 NEW •- ID ADDITION ❑ALTERATION ❑REPAIR -0 TENANT IMPROVEMENT
CENSUS CODE: - LOT SIZE
ZONING DESIGNATION: BUILDING SHELL ONLY? a❑YES" ❑ NO
•COMP PLAN DESIGNATION BASIC PLAN?" ❑YES ❑ NO
SECTION 'TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES 0N
,PLATTED LOT?'`- "❑ YES ❑ NO CHANGE OF USE? ❑YES Q NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718-253-661-4000•FAX:253-661-4129