01-102133 City of Federal Way
Cocrnnunity Development Services Electrical Permit #:01 - 102133 - 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: GBENRO
Project Address: 32822 28TH S$t Ave 5W Parcel Number: 894520 0430
Project Description: ELE-Install(2)circuits for switches and outlets in new addition.
Owner Applicant Contractor
Adkunle S&Kathryn Ann Gbenro ACTION PLUS ELECTRIC INC ACTION PLUS ELECTRIC INC
32822 28TH AVE SW P.O.BOX 1423 P.O.BOX 1423
FEDERAL WAY WA MAPLE VALLEY WA 98038 MAPLE VALLEY WA 98038
98023-2821 (206)650-7754
Electrical Fixtures
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Circuits-Residential 2
PERMIT EXPIRES November 26,2001,IF NO WORK IS STARTED.
Permit issued on May 30,2001
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 W. .
Owner or agent: Date: 5 _0 e
C^•°F ' CONSTRUCTION PERMIT APPLICATION
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APPLICATION NUMBER: C - ZQ ` j -, Z)-_e7,__-
APPLICATION NUMBER: -
MO 1 , fir`/ APPLICATION NUMBER: - -
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-fith g gPiequired information-Please print(in ink)or type**
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Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
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INFORMATION • -
SITE ADDRESS: 32�j U 28AV( ✓o ASSESSOR'S TAX/PARCEL #: I z _VT L•-G - 49c-:?,36
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING V PLUMBING ❑ ECH AL MOLITION
❑ ELECTRI ❑ ENGI ERING❑ E VENTION EM
PROJECT DESCRIPTION(Pro • d: .filed des 'ption). A k Z Q/r^
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PROJECT E: ••4 .t IA ilk i .
I PEOI .E INFCMMATION
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PROPERTY I'• NAME: ` DAYTIME PHONE:
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MAILING ADDRESS(STADDR��,STATE,ZIP):
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CONTRACTOR: NAME: DAYTIME PHONE:
#677 ern 5 - .4 ' - - (-2-0 )6.co -7?,s-e/
MAILING ADESS(STREET ADDRESS;C ATE,ZIP - EVENING PHONE:
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CITY OF EDERA •Y BUST NSE BER: - I FAX NUMBER:
CONTRACTORS' I . .ER: EXPIRATION DATE:
(copy of card req .) G d" --/ - • 3 / / !'
APPLICANT: NAME: DAYTIME PHONE:
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MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
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RELATIONSHIP TO PROJECT: FAX NUMBER:
El ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) - ,
f E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: /or EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES )4NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: • ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE El PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PRO]ECT 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) El ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
A DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury t at the information furnished by me is true and correct to the best of my knowledge,and
further,that I am authorized by the owner ofthe 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 •- .de by any person,including the undersigned,and filed against the City of
Federal Way,but only where such claim ail;•s •� - e reliance of the city,including its officers and employees, upon the accuracy
of the information supplied to the city . a !" 'f this application. - cC z
NAME/TITLE:
tAA-13 DATE: J /0/• 7
❑ PROPERTY OWNER ❑ APPLICANT U CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW Cl 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? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY f1FVF1OPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX 253-661-4129