01-100181 a.
City of Federal Way
Community Development Services Electrical Permit #:01 - 100181 - 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: BARKSHIRE
Project Address: 32309 11TH S41/Prv- S W' Parcel Number: 926493 0510
Project Description: ELE-Install low voltage security system for single family residence approx.1800 sq ft
Owner Applicant Contractor
Bernard D&Lorraine M Barkshire UNITED SECURITY SERVICES UNITED SECURITY SERVICES
32309 11TH AVE SW UNITED SECURITY SERVICES UNITED SECURITY SERVICES
FEDERAL WAY WA 3909 FREEMAN RD E 3909 FREEMAN RD E
98023-5555 EDGEWOOD WA 9837 (253)896-1211
Electrical Fixtures
Description ' Quantity Description JQuantity Description Quantity
Low Voltage Burgler Alarm-Residen 1800
PERMIT EXPIRES July 16,2001,IF NO WORK IS STARTED.
Permit issued on January 17,2001
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use ill be in accordat ce with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
/
Owner or agent: �! —t ��� Date: r 7/D/
0
F.
�YOF �� Y `� CONSTRUCTION PERMIT APPLICATION
u-- Ry ._ SAH 17 200'. APPLICATION NUMBER: /2 I - l G v_i '�� - EL
_,vk-D IAL No.~APPLICATION NUMBER: - -
GIT BUIL 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: ......3.,R 3.69 ( /�/4(4 .Su) ASSESSOR'S TAX/PARCEL #: 9Z6. V[ J - 6.57a
LEGAL DES RIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): L rA9 fle Ld,Lef
f Vlv- y
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING 0 MECHANICAL ❑ DEMOLITION
V ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTIION(Provide detailed descrip ion):A, ',Z1.,_/CZ.l.2 -;<` , S
PROJECT NAME: ...'
v
PEOPLE INFORMATION
PROPERTY OWNER: NA .;, DAYTIME PHO E:
.1/ 1e4/Ai 614-, 7<sA//,e (.2S3) W l5 - �yos
MAILINIkD
,RESS(STREET ADDRESS;CITY,STATE,ZIP):
3 a o�1 / s , �-•e (4- /�) . 96+2.61 „5;2
CONTRACTOR: NAME: .. • DAYTIME PHONE:
7)-' C .aJ (3) W6 - 12/ / i
MAILING ADDRESS(STREET ADDRESS; STATE,ZIP) EVENING PHONE:
q09 Fri � d. E4 � 7/ ( _
CITY OF FEDERAL WAY BUSINESS LICENSE N R: FAX NUMBER:
- - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRAN DATE: /^,
(copy of card required) a ,N 1 -re S ,SQ L tL T o4 / 3c / C I
APPLICANT: NLL2Iód
E:
DAYTIME PHONE:NE:
S iP,/,TAA) 05g9o /ozf/
MILNG (STREET ADDRESS; ATE,ZIP ll1_)A. EVENING
PHONE:
/1C � •JC// C �O J .%32/
RELATIONSHIP OIFAX NUMBER:
❑ ARCHITECT ❑ TENANT CI OTHER DESCRIBE):
-
E-MAIL ADDRESS: -
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
• 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 ❑ HIGHLINE 0 PRIVATE(SEPTIC)
f.
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PRO]ECT 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 . to the city pa .-s a.plication.
/ �� DATE: / I of
NAME/TITLE: / /
❑ PROPERTY OWN , ❑ 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 0 NO
PLATTED LOT? ❑ YES 0 NO CHANGE OF USE? ❑ YES 0 NO
(OMNI INTTY nFVFI OPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY.WA 98063-9718•253-661-4000•FAX:253-661-4129