01-101813 City of Federal Way Electrical Permit #:01 - 101813 - 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: JOHNSON-UNIT A
Project Address: 2508 S 286TH PI Parcel Number: 552900 0080
Project Description: ELE-Alteration for(2)circuits for lighting&receptacle outlet for existing apartment unit "A"
Owner Applicant Contractor
Robert&Roberta Chadwick CHRIS JOHNSON ELECTRO SERVE
115 SW 300TH PL 2508 S 286TH PL 13456 SE.27TH PL#240
FEDERAL WAY WA FEDERAL WAY WA 98003 BELLEVUE WA 98005
98023-3558 (425)451-3358
Electrical Fixtures
Description Quantity Description Quantity) Description Quantity
Circuits-Multi Family 2
PERMIT EXPIRES November 4,2001,IF NO WORK IS STARTED.
Permit issued on May 8,2001
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: 7e, jj
/ 1 ` O U
Date: i
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. CfreY Of = CONSTRUCTION PERMIT APPLICATION
ELZI APPLICATION NUMBER: U
N) FEY 0t 70 WA at ( 4_,13- Do001-‘7___APPLICATION NUMBER:
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f'eDe? . APPLICATION NUMBER: -
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**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 h
SITE ADDRESS: 41048 30. �8(0 P ASSESSOR'S TAX/PARCEL#552100 6 v
LEGAL DESCRIPTION OF SU JECT pROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
IY)k; ) i C-Pcry,\14
' ■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBIN El MECHANICAL ❑ DEMOLITION
i5 ELECTRICAL ❑ ENGINEE' G■ ENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): i •
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PROJECT NAME: -.........0 -1 ,
lik
■ '`EOP► ?INFk. QMATION
PROPERTY OWNE' NAME: DAYTIME PHONE:
[1 S ;1k (:;)6(() i!9 -S;44 3
MAILIN? "IDRESS( ADOR �`.ITY,
CONTRACTO•: NDAYTIME PHONE: el
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(Bf -8"(.5--
AILING ADDRESS(STREET ADDRE ,CITY,STATE,ZIP): EVENING PHONE:
I1 Sof, 027P( Q ;: ( )
ODERAL WAY BUSINESS LICENSE NUMBER:lir
— j - FAX NUMBER:)
CO OR'S REGISTRATION NUMBER: y�,, EXPIRATION DATE:(copy of card required 7. /I T / l
APPLICANT: NAME: DAYTIME PHONE:
M c 'i ( )
MAILING ADDRESS(STRE ;• ,STATE, • EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
CI ARCHITECT ❑ T ':FAOT R(DESCRIBE) ( ) -
// E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT , KCONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
I 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 ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT 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)
OISCLAIMER/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 su•plied to the city as a parpf this application.
NAME/TITLE: �--�_ DATE: J ~ O /�
❑ 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? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129