01-103531 City of Federal Way Electrical Permit #:01 - 103531 - 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: 253.0O
35.3050
Project Name: HOWARD
Project Address: 804 SW 360TH Parcel Number: 440561 0060
Project Description: ELE-Electrical work for the undergrounding of overhead pwer lines to meter/service for existing single
family residence.
Owner Applicant Contractor
William G&Lizabeth Howard William G&Lizabeth Howard William G&Lizabeth Howard
804 SW 360TH ST 804 SW 360TH ST 804 SW 360TH ST
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-7258 98023-7258 (253)927-8902
Electrical Fixtures
.,:, arc Des'cription 'Quantity Description 'Quantity Description 'Quantity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES March 9,2002,IF NO WORK IS STARTED.
Permit issued on September 10,2001
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: / 1 i Qi-��,l Date: 7/c/ 0 (
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:°' G SEP CONSTRUCTION PERMIT APPLICATION
EI�ElZf�L ? APPLICATION NUMBER: B /4e.2_\./� - S� l - O(--HZ
4,i
�� ED"- BUILDit D�� IA, APPLICATION NUMBER: _ _ _ _ _ _ _ - _
T.vil 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.
SITE ADDRESS: l 5 3(
0 0 -) ASSESSOR'S TAX/PARCEL#: /.4t7 ? I / - 0.06.0
Fe r1.0— 0.Q tt./3s9 "z$' o 3 — —
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
IllgIIII1MMIMMIIIIEZ
TYPE OF PROJECT(This application): ElBUILDIN ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION
LECTRICAL 0 ENGINEERINGO FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): pl
(_,OV\LY2-4-S--t--V-N,----, r-e---y-, 63frti•'2,\IN.D..10...4 p .. •
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PROJECT NAME: -14 �
PROPERTY OWNER: NAME: DAYTIME PHONE:
Q l & -i — r �r..�o->z,� ( .s3 ) S ate- o a\
MAILING ADDRESS(STREET AD CRY,STATE,ZIP):
4gb`( SL -_. o4-Srt Fes_ 9 7o 3
CONTRACTOR: NAME: DAYTIME PHONE:
t L t,•<-),' (( k'e„ 13,` ( ( ' /-(-t, (-s3) 3 7-0 - Do yo
MAILING ADC SSS(STREET ADDRESS;CITY,MATE,ZIP): EVENING PHONE:
(cs3 ) 9-23._ - &o
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- - ( ) -
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) I /
APPLICANT' NAME: l�i. DAYTIME PHONE: -
)
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
Q0(1 S w 3&03&0'.5t- F � , ^ 0.)-3 ( ) -
€ RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT XTENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
I PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
•
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
1
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT, PROPOSED SQ.FT. TOTAL 1
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: D 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)
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 daim),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 city as a part of this apps' tion.
NAME/TITLE: / , DATE: 9 / 1a /OI
2<i OWNER fJ APPLICANT ❑ CONTRACTOR
:FOR OFFICE USEONLY:
:U NEIN t, _;U ADDITION ❑'ALTERATION ❑;REPAIR D:TENANT IMPROVEMENT .'`.
CENSUS''_CODE : LOT:SIZE .
ZONING DESIGNATION,, BUILDING SHELL,ONLY? .❑YES ❑ NO
COMP P'L'AN DESIGNATION BASIC PLAN? . ❑ 1(ES ❑;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•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129