01-103799 City of Federal Way
Community Development Services Electrical Permit #:01 - 103799 - 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: PAVILION CENTER II
Project Address: 31811 PACIFIC S Parcel Number: 082104 9126
Project Description: ELE-Install(1) 100 amp 480 volt service-296 feet off of Best Buy.8x10 metal connect.
Owner Applicant Contractor
L L C Acrocapital NONE FULLER ELECTRIC
13010 NE 20TH ST#C FULLER ELECTRIC
BELLEVUE WA 37107 12TH AVE S
98005-2034 NONE (253)661-7181
Electrical Fixtures
Description iQuantity Description IQuantityi Description (Quantity
Service/Feeder: 0-100 amps-Comm. 1
PERMIT EXPIRES March 26,2002,IF NO WORK IS STARTED.
Permit issued on September 27,2001
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 Wa .
Owner or agent: O�(i�/1i�'� �'v"`'��t�=mac�\ Date: 9"� -O/
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C/ —7-,17'7" j //d//
'1 :•°f G CONSTRUCTION PERMIT APPLICATION
EOEL 2 /�
, NNFY (lf' APPLICATION NUMBER: d� - QJ -L - L.
APPLICATION NUMBER: -
4Lo ,,, a i'pEppT�A 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: 3 I Sr I I - Pae 1 fr C 141,41 • s. ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING . 0 MECHANICAL ❑DEMOLITION
1 ECTRICAL 0 ENGINEERING❑ FIRE PREVENTIC*1 SYSTEM
PROJECT DESCRIPTION (Provide detailed description): yS -/l '(i ) )6044P '•/&)(/ ..<EX UAL
e
c-t f c 1 f L',,} ? V b i r,.( (e - r€.:
t
PROJECT NAME: 1O I 1 I1 o tJ * (..,e -Re. T
■ PEOPLE INFORMATION
PROPERTY OWN NAM : �pDAYTIME PHONE:
lteSG/ l- 014-11e-ir 'I Pore 41 eI (2O ) (4') -
MAILING ADDRESS(STREET ALRESS;CITY,STATE,ZIP):
c - 6 I L kit f- $vA loot leek.#-f-,tet 1.14.. °Ig/O I
CONTRACTOR: NAME: DAYTIME PHONE:
1 kg Etfc4 "" 'C.... - it c - (75,) 661 -71r1
MAILING ADDRESS(STREET ADDRESS;Cib'.STATE,7 P; EVENING PHONE:
37 /o7_ /2TNA.LJt'• S• Marti 4014 t.J/4. ggeo3 (gig) 66/ -7/F/ i
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: / FAX NUMBER:
- - EZn ) 641 -6?sc
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: DAYTIME PHONE:
( ) -
MAIUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 ARCHITECT 0 TENANT 0 OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT CONTRACTOR
- ■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 0 YES ❑ 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 ❑ 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) RANGES) 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 claim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supplie to the city a a rt of this application. (�r
NAME/TITLE: (i) DATE: —/'� 7— .
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW 0 ADDITION ❑ ALTERATION 0 REPAIR 0 TENANT IMPROVEMENT
CENSUS CODE: _ LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES 0 NO
COMP PLAN DESIGNATION BASIC PLAN? 0 YES 0 NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? 0 YES 0 NO
PLATTED LOT? 0 YES ❑ NO CHANGE OF USE? 0 YES 0 NO