01-101653 City of Federal Way Electrical Permit #:01 - 101653 - 00 - EL
Community Development Services
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: SAFEWAY/RITE AID
Project Address: 2109 SW 336TH Sr Parcel Number: 873217 0020
Project Description: ELE-Electrical for replacement of freestanding sign.
Owner Applicant Contractor
SAFEWAY INC NONE PLUMB SIGN,INC.
1850 MT DIABLO BLVD#250 PLUMB SIGN,INC.
WALNUT CREEK CA 5838 S ADAMS
94596-4426 NONE (253)473-3323/10
Electrical Fixtures
Ci' � an x antrty I?e'scnptlon 14004* INV:044,00149.R.,
ion Quantity
I Sign 1
PERMIT EXPIRES October 23,2001,IF NO WORK IS STARTED.
Permit issued on April 26,2001
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.
�
Owner or :gent l/�� �-�-r�Q ((( - Date: YA(o�
- l"/
CIT../Of 1 CONSTRUCTION PERMIT APPLICATION
EOE I _ APPLICATION NUMBER: c> I - 10 I j 3- E,(�
uv FEY APR 2 6 e 11f1,
APPLICATION NUMBER: - -
:;`
T. 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.
- /e ■ PROPERTY INFORMATION -
,-,,e9/",e) S' 2
SITE ADDRESS: / J• 33 ASSESSOR'S TAX/PARCEL#423 .2 / 2 - 00 C7
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LE
Ilk
' • • PROJECT VFORMATIC
TYPE OF PROJECT(This application): ❑ BUILD • ❑ PL BING ❑ HANI L ❑ DE e LITION
rAELE Cl EN e• EERING❑ FIRE PREV ION - EM
PROJECT DESCRIPTION (Provide detailed descriptio 5% ' . ' O 0 - e72 A-PT
,'67 .N - - v-v 2 K i,N 7-i.�e_,--
� . c , -, ,
PROJECT NAME: � t...,_.,e)
• PEk. DLE It. 'ORMATION
PROPERTY NER: NAME: DAYTIME PHONE:
' . ' 146
MAI ADDRESS( • ADORES ,STATE,ZIP 9 YS c L
j-) , , ',QL 04✓19 `O ' c)7 ' E , _ c,9
CONTRACTO• • E: II DAYTIME PHONE:
"2_ e2 .4-1 ifG.CJS iti ( 3) X73 i 333
AILING ADDRESS(STREET A��D{{ORE - Q,SSTATTEE,,ZIP)):c EVENING PHONE:
IIY OF FEDERAL WAY BUSINESS LICENSE NUMBER: • FAX NUMBER:
Ci .'•CTOR'S REGISTRATION NUMBER: Q PIRATION DATE:
(co. card required) /'�. - /f'1 — — — — j/ / /D / v/
APPLICANT: NAME: DAYTIME PHONE:
ed../ .... -i,
MAILING DRESS(STREET ADDRESS:CITY, I EVENING PHONE:
'3 e . 5 o r77, 9d'kv. ( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:
El ARCHITECT Cl TENANT OTHER(DESC BE): /9-6'k.--s-i-7". ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: CI PROPERTY OWNER CPLICANT CI CONTRACTOR
• DETAILED BUILDIING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? CI YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
r--4101111.117,
**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 supplied� to the city as a part of this application.
C. -
NAME/TITLE: liDATE: f/oC/)
❑ PROPERTY OWNER RaPPLICAN ❑ CONTRACTOR
1
FOR OFFICE USE ONLY: 1
❑ 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? ❑ YES ❑ NO
COMMI INFry r)FVFI OPMENT SERVICES-33530 FIRST WAY SOUTH-P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129