01-101953 f
City of Federal Way
Conmamity Development Services Electrical Permit #:01 - 101953 - 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: JACKSON
Project Address: 3735 SW 332ND Q) Parcel Number: 109961 0890
Project Description: ELE-Wire sunroom addition(including heater circuit). 200 amp panel replacement.
Owner Applicant Contractor
Donald M&Kim M Jackson Jr. NONE NORTHWEST ELECTRIC&SERVICE
3735 SW 332ND PL 10224 29TH ST EAST
FEDERAL WAY WA EDGEWOOD,WA
98023-2920 NONE (253)445-7029
Electrical Fixtures
ascription �Qtia� ih! W
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Alt.Serv./Feeder:0 to 200 amps-Res. 1
• PERMIT EXPIRES November 12,2001,IF NO WORK IS STARTED.
Permit issued on May 16,2001
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 agent: Date: )//y J
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Cff.°F G "cif=') CONSTRUCTION PERMIT APPLICATION
� APPLICATION NUMBER: D - 4 0 L ' S,- 6L
FTY
MAY 1 6 ?' r 4`! APPLICATION NUMBER: -
APPLICATION NUMBER: - -
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**The followi44i t formation-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�3 .57.W 37Z n�,P1J ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ‘S/4 A i4,41,11),
4 - C,,r.1 to
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
Oil/ELECTRICAL ❑ ENGINEERING FIRE PREVENTION/ �JSYSTEM
PROJECT DESCRIPTION(Provide detailed description): /�/--Ory U i.. ,i v,,,'L 4.•- c
G,-.-'L v.,-.4 . e/s.../c./ 7 to_ z).,t er^'I e., / , -irrj ANS
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PR9JECT NAME: t
■ P. IPLE I. 'FOR IATION
PiOPERTY OW R: NAME: DAYTIME PHONE:
14 MAILING ADDRE `I REET ADD' •TE, P):
CONT NAMES / DAYTIME PHONE:
crv,Le. � i (&z,)g� - 1191
MAI CRESS( ,'` ADDRESS;CITY,STATE,ZIP): ,: : , EVENING PHONE:
•
C' OF FEDE• AY BUS NESS LICENSE NUMB: °' ! a ". NUMBER:
/7- - 0.6. _ '• z . - - 3> y 7371/
4.•CTOR'S REGISTRATION NUMBER: tet *: _ EXPIRATION DATE:
( rd required) . ` i^ ,,i • 6
APPLICANT: NAME: DAYTIME PHONE:
*/
MAILING ADDRESS(STREET i ''•TE,ZIP): ; EEVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TE• - ❑ OTHER(DESCRIBE): ( ) - ,
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER Cl APPLICANTNTRACTOR
■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
k 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: 0 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.SYSTE'i$(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 plication.
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NAME/TITLE: JZ°L'✓/1 1.�1� DATE: 1/).n
1
❑ 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
COMMI INITY OFVFLOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX-253-661-4129