01-101071 City Federal Way
Community Development Services ELLctrical Permit #:01 - 101071 - 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: WALTOS
Project Address: 1409 SW 296TH S-I' Parcel Number: 515320 0035
Project Description: EL-Electrical for new single family residence.
Owner Applicant Contractor
RICK WALTOS RICK WALTOS RICK WALTOS
32819 43RD PL SW 32819 43RD PL SW 32819 43RD PL SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
(206)948-3104
Electrical Fixtures
Description Quantity '� Description [Quantity , Description 11Quantityityi
I Service: -Residential 4315
PERMIT EXPIRES September 16,2001,IF NO WORK IS STARTED.
Permit issued on March 20,2001
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./
7
Owner oragent: C� J�� ' Date: • d
✓�-lG- G% e":"" f-77
cu•.o, G_ CONSTRUCTION PERMIT APPLICATION
MAR 20 2001 APPLICATION NUMBER: Q l - 10 L Q 2 L -E L
VV FiY�L
APPLICATION NUMBER: -
v,i I CF F I2 RAL WAY
BUILDING DEPT. 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: / T O' - S Ltd ��6-11"j7 ASSESSOR'S TAX/PARCEL #: 5.7 5--3 2 c7 - L o Z $r
i
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): `, o4 9 44 G ";AA_V',FLl
l= -fa`-e s ;4-1.-daf4.l wr/
' - ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ■ • UMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRIC• I E • EERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description. \ •U or ( .4_ liko 1.•-S
1\111111)
PROJECT NAME:
IkL k
■ `EOPLE INFORMATION
PROPERTY OWNER: NA •IP
DAYTIME PHONE:
t.... _ fls (253) i2r- ic(c(
MAXI a(STREET •ESS;CITY,STATE,ZIP): I
C21. 1 • . 4\,S•.t„-N.
r4)\-i-
of taZ3
CONTRACTOR' NA DAYTIME PHONE:
^ t ( ) -
MAILING A SS(STRE DDRESS;CITY,STATE,ZIP): •. EVENING PHONE:
( ) -
C •F FEDERAL SINESS LICENSE NUMBER: FAX NUMBER:
-
_ _ _ _ _ ( )
. U ••CTOR'S REGISTRATION N R: EXPIRATION DATE:
• of card required) / /
APPLICANT: NA DAYTIME PHONE:
`\C-'-' Li•-1)CN\O s (20 0 9y8- - D o e
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZI EVENING PHONE:
2 & 1 7 - Li Sr `P .sr (--ectkv- Nyl n. 13 (2s3 )92S— - /57 el
RELATIONSHIP TO PROJECT: ( _ FAX NUMBER:
CI ARCHITECT Cl TENANT OTHER(DESCRIBE): C)(,L.)N' 0- (ZS ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT:CCC PROPERTY OWNER CIAPPLICANT CICONTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? Cl YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:Cl YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA Cl PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ 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:
■ 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 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 supp'ed to the city as p of this application.
NAME/TITLE:
(A-5 d) DATE: „, /,:::;: 0/6)I
PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ 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 TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? El YES Cl NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129