01-103492 City of Federal Way
Community Development Services Electrical Permit #:01 - 103492 - 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: BLACKSTONE'S COLLISION ONE
Project Address: 35620 ENCHANTED S Parcel Number: 282104 9077
Project Description: ELE-Wire new prep station for auto body shop. Two to three circuits.
Owner Applicant Contractor
Robert K&Sandra Blackstone ACT-ON-ELECTRIC ACT-ON-ELECTRIC
35620 KIT CORNER RD S PO BOX 2118 PO BOX 2118
FEDERAL WAY WA LYNNWOOD WA 98036 LYNNWOOD WA 98036
98003 (425)743-4389
Electrical Fixtures
Description 'Quantity Description 'Quantity Description Quantity
Circuits- Commercial 3 •
PERMIT EXPIRES March 5,2002,IF NO WORK IS STARTED.
Permit issued on September 6,2001
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 .• ordan wi e law ''rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: L, .,CI"
0( rDc.
G - .�. ,,� ® CONSTRUCTION PERMIT APPLICATION
VV FAY APPLICATION NUMBER: 2 L - LICJ34 GJ -I.LV
APPLICATION NUMBER: _ _ _ — -SEP 0 6 7091 _ —
APPLICATION NUMBER:
**The followineig f tai,I L .uAoYn—Please print(in ink)or type**
Please note: Electrical,Fire PreventionnSSystems``PeL and Engineering permits may require a separate application.
I �*i'. / ■ :PROPERTY INFORMATION
{, SITE ADDRESS: "d S-62 2-0 (-N( /t/-" ) I H"-7 s(', 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
; I. RICAL ,fl ENGINEERING❑ FIRE PREVENTION SYSTEM
•
PROJECT DESCRIPTION(Provide detailed description):
/1?I£ /Va ipieirl St/t.
PROJECT NAME: W L/vCi( S 7-,i( 3 /r/ d Cl D i.
■"PEOPLE INFORMATION
•
PROPERTY OWNER: NAME: DAYTIME PHONE:
.P712-err 4 (L/,--0 J2/ ( )
•
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHONE:
0 /1c-ge7#('e (2-06 ) - V,4
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
P. e. 13tk 711/' 7 A/,is .-oo0/ L--j", 9 �G ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NU : FAX NUMBER:
- - ( y2f 7'J - 4' P,
CONTRACTOR'S REGISTRATION NUMBER: �y ` EXPIRATION DATE:
(copy of mi�C rd required) r /`e i/ L C `d ( l D.L e /V
APPLICANT: NAME: DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT XCONTRACTOR
■ 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 0 HIGHLINE ❑ PRIVATE(SEPTIC)
**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:
1
•
• ■ FIXTURES
Indicate number of each type of fixture
1
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) ) I
■ 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 city,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: DATE:
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR;OFFICE:USE ONLY:' I
❑ NEW:? ;. .!❑ ADDITION ❑ ALTERATION LIREPAIRT .. =❑TENANT IMPROVEMENT
CENSUS,CODE: I OTSIZE "
•
ZONING DESIGNATION_ BUILDING SHELL,ONLY?1:-❑ 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 DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH-PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129