01-103720 City of Federal Way '
Community Development Services Electrical Permit #:01 - 103720 - 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: SACAJAWEA JUNIOR HIGH
Project Address: 1101 S DASH POINT Rd Parcel Number: 052104 9024
Project Description: EL-Install new feeder for power to portable classroom.
Owner Applicant Contractor
FEDERAL WAY PUBLIC SCHOOL SHEPPARD NELSON ELE. SHEPPARD NELSON ELE.
31405 18TH AVE S P.O.BOX 3630 P.O.BOX 3630
FEDERAL WAY WA 98003-5433 KENT WA 98032-0210 KENT WA 98032-0210
(000)878-7333
Electrical Fixtures
21,11EZEIMEWSRTITZ � > �fl ... WeNfwnµtnQuant►t
Alt.Sery./Feeder up to 200 amps-Cot 1
PERMIT EXPIRES December 28,2002,IF NO WORK IS STARTED.
Permit issued on July 1,2002
IDI 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.
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Owner or agent: Gyp-/ Date: / /611
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G_ CONSTRUCTION PERMIT APPLICATION
VV FiY - APPLICATION NUMBER: 01, - I Q 3 -EL,
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.
■ PROPERTY INFORMATION
SITE ADDRESS: it
0 1 6W 1&511 P3- t26 ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROTECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
V,ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
SPROJECT DESCRIPTION(Pr ide detailed description): .I M570,,L L_ .L•c-c-rpt ( a L
r—e-a-ev l- N-e. w-- ,oma u bc-C_..
PROJECT NAME: SGta, 6tAJL/LN( Cflr I-1-45
• - ■ PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
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MAILING ADDRESS(STET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHONE:
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MAILING ADDRESS( �'� ADDR CITY, TI X): EVENING PHONE:
.CITY OF FEDERAL A`Y'BUSILICENSE IiER: ` ) (AX �28 - ®7
/ \ - - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(opy of card required) / /
APPLICANT• NAME: e ► C p�� DAYTIME PHONE:tw
-
MAILING ADDRESS(STREET ADDRESS;ICITY,STATE,ZIP): EEVENING PH)ONE:
)
• RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ 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 ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
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**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 daim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,inducting the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,inducting its officers and employees,upon the accuracy
of the information supplied to the city
a a part of this application.
%S. NAME/TITLE: / Ge2Ct �R�
- ' ‘ DATE: /
77
❑ PROPERTY OWNER L APPLICANT El CONTRACTOR
FOR OFFICE USE ONLY:
"El 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 1 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