01-100070 City of Federal Way
Community Development Services , Electrical Permit #:01 - 100070 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210 Inspection request line: 253.661.4140
Ph:253.661.4000 Fax:253.661.4129
(3:30pm cut-off for next day inspections)
Project Name: WOOD TRAIL VILLAGE FIRE
Project Address: 1927 SW 322NDIULIT293 Parcel Number: 132103 9103
Project Description: ELE-Replace electrical wiring damaged by fire as follows: kitchen,laundry,dining room,air
conditioner&t-stat. Replace switches,receptacles,light fixtures,smoke detector,t-stat&trim plates.
10 circuits.
Owner Applicant Contractor
WOOD TRAIL VILLAGE NONE GRIFFIN ELECTIC INC
1427 SW 306TH ST
FEDERAL WAY WA 98023
NONE (253)529-2923
Electrical Fixtures
Description .Qui)ity - Description "Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Mull 1
PERMIT EXPIRES July 7,2001,IF NO WORK IS STARTED.
Permit issued on January 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 FederSl(L--
al W .,, .� ll f
Owner or agent: 0--tom -- $ Date: �/
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GTYOF CONSTRUCTION PERMIT APPLICATION
.\)\> — , • APPLICATION NUMBER: 0_I, - 10 0 O - EL
FrY
APPLICATION NUMBER: - - 1
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.
C•' . 1 • PROPERTYGINFORMATION
TE ADDRESS: I g tR 1 SW 22 211 1'•l� Z-q3 ASSESSOR'S TAX/PARCEL #: -
GAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
isir
• PROJECT INFORMATION •
PE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
4 ELECTRICAL ❑ ENGINEERING CI FIRE PREVENTION SYSTEM
OJECT DESCRIPTION (Provide detailed description): Repiact, L JL1. W t1u.y1 G(G p( (J �k
5 -Fall ams: K(--c l , n , 1--ni, dY , �u�U2 roar►v1 (ion eL,4i e. 'Ieymo5l��
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WPROJECT NAME: k e..k.d bra-Li (/t I `466- C404-4-4-num-1-5
■ PEOPLE INFORMATION
ROPERTY OWNER: NAME: DAYTIME PHONE:
n-(Arum p
�b .r C GS (253) Sig - ggI3
. MAILINGREET Ayyy,C 42`32v2Le II{) A( X+ Ril' !v
/St 2-3
✓ DAYTIME PHONE:
�NTRACT�tt�: NAME".
r2�Ail' 'l e_c�rr<. (A-53) S' - 212-3
ILING ADDRESS(STREET ADDRESS;CITY, TE,ZIP EVENING PHONE:
`: 4,i Sim; Loi' 1 . lac 9'3623( 264) 64 - Ss-di
• CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
H—q(4, - /b5v55 -c ) 131 - - (ZS3 ) 52e1 - Zi09
i - CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
G, ( 6440 L 1 / 7
(copy of card required) ( / �5 J G-
/ oZZ
PLICANT: NAME: DAYTIME PHONE:
•` 3a-+x.L_ &Y 41)46 K ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
t' RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS:
-
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ELCONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
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 0 HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY** - ' '•
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS �1
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
rther,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
ter urther agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in the
nvestigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
ederal Way,but onl where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
if the information s pplied to the city as part of this application.
(NAME/TITLE. DATE:
❑ PROPERTY OWNER ❑ APPLICANT ZCONTRACTOR
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