01-103632 City of Federal way
Community Development Services Electrical Permit #:01 - 103632 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Pit:253.661.4000 Fax 253.661.4129 Inspection request line: 253.835.3050
Project Name: GILBERT
Project Address: 521.1 SW 326TH St Parcel Number: 189830 0270
Project Description: ELE-Electrical for new addition/remodel
Owner Applicant Contractor
Anthony R&Brenda M Gilbert Anthony R&Brenda M Gilbert Anthony R&Brenda M Gilbert
5211 SW 326TH ST 5211 SW 326TH ST 5211 SW 326TH ST
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98023-1932 98023-1932 (206)838-5469
Electrical Fixtures
'`Description Quantity Description Quantity Description Quantity
Circuits-Residential 4
PERMIT EXPIRES March 17,2002,IF NO WORK IS STARTED.
Permit issued on September 18,2001
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.
J
Owner or agent: OAA./.4.4-1?) /i2. Date: C i
_0 (
G'741 •Ge) o/fi —o
vP CONSTRUCTION PERMIT APPLICATION
N>N) APPLICATION NUMBER: 01 I -
SFP 1 8 ?(pi, APPLICATION NUMBER:
—
APPLICATION-NUMBER: —
O(,IlY' C�rr u�riAL.W Y
**The folio gzi qgj nrormation-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION
SITE ADDRESS: £I( 5 W 32 644A ST ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL 0 DEMOLITION
FE ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): A OO i Al c /g e/'TC/tt' /1-7•,0
p / •I /N c) 1172-cA
PkOJECT NAME:
■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE
FlulttOA d d2& "a4 61c4tn� (Z53) 83 — 31(6
MAILING ADDRESS(STREET RESS;CITY,STATE,ZIP):
SZ(► SAJ 326+4 Cr
CONTRACTOR NAME: DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- ( )
CONTRACTOR'S REGLSTRATION NUMBER: EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
)
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT 0 TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT 0 CONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES ❑ NO
WATER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
I
**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 INSERTS) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACES)
DUCTS) GAS PIPE OUTLETS) HEAT SOURCE: ❑ ELECTRIC 0 GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS.
H MACHINE VACR
UUM BREAKES) ❑ ELECTRIC D GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASOUTLET
GAS PIPE OUTLET(S) SINKS) 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 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 dty,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: c DATE: C?/(8{6 I
/'L�1.,1��i C J
Ii PROPERTY OWNER 0 APPLICANT ❑ CONTRACTOR
FOR,OFFICE=USE ON LY:.
NEIN 0 ADDITION ❑-ALTERATION '" tEPAIR ,1,-.,.,..,y,,
. 1 'ENANT=IMPROVEMENT
a CENSUS CODE.;F `e=°. LOTsSIZE :.,. :x._. 1 ,i.,.m,:a,.._...i0i::,ii';4::,,,•
'
ZONING DESIGNATION BUILDING SHELL ONLY? ❑YES LINO
,4„,,1::,',:„!,i:,:,4:,„:i.„0......,,,,,..:w,.,:::„:,:,1.::.:i,„,i,:ii:,,1.
OMP,PLAN DESIGNATION BASIC°PIAN? 3 YES`_.❑ NO
SECTIONS ,_. TOWNSHIP .RANGE, NEW;ADDRESSLEQUIRED? =;❑'YES ., ❑,NO , ,
PLATTED LOT?.` ❑ YES., =D NO . _s . . CHANGE OF,USE? ❑YES_ fl NO _
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129