01-100211 City of Federal Way Electrical Permit #:01 - 100211 - 00 - EL
Conununity Development Services
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: MADISON
Project Address: 29827 23RD S. AvE_S Parcel Number: 768380 0204
Project Description: EL-Provide electrical service to newly constructed garage.
Owner Applicant Contractor
James Lee&Sherry D Madison James Lee&Sherry D Madison James Lee&Sherry D Madison
29827 23RD AVE S 29827 23RD AVE S 29827 23RD AVE S
FEDERAL WAY WA FEDERAL WAY WA FEDERAL WAY WA
98003-4252 98003-4252 (253)529-9503
Electrical Fixtures
Description Quantity '44 `'Description Quantity 11'1; Description Quantity
Outbuilding/Garage-Residential 1
PERMIT EXPIRES July 17,2001,IF NO WORK IS STARTED.
Permit issued on
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: j��! Date: — - 2 Cre)
61; I- o/ =b/
Tc' ed—K' t / —Z y= nl ,za
i
2 / l/ �>
REVISION DATE -- . 0
ClTieY or = CONSTRUCTION PERMIT APPLICATION
JAN 1 8 2001
i VV APPLICATION NUMBER: 0L - 1002_11_ L-
APPLICATION NUMBER: - -
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.-
'
f • PROPERTY INFORMATION .
SITE ADDRESS: 29 gG / 23 ve.. So ASSESSOR'S TAX/PARCEL #: i 4 S 3 S 0 - 0 2 o 4.
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
51n_31Q. cam iI v R.eSla0_,A.KAI nAf�.,
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
XELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
PROJECT NAME:
• Pi."r. •E INFORMATION
PROPERTY OWNER: NAME: DAYTI' PHONE:
��.N`'�',,1�cv � aC� or 9g07)3(25* 5—Z9
9sc3
MAILING D7C DRESS(STREET ADDRESS;CITY,STATE, ): 1 '
,�`�S32fI 23 J2 o �ZC�¢fc� W� W �
CONTRACTOR: NAME �ry DAYTIME PHONE:
( )
MAILING AES$; EET ADDRESS;CITY,STATE,ZIP) ;FEVENING PHONE:
)
�4�2: ( -
CITY OF FEDERI.,WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
- ( )
CONTRACTOR'S REGISThATION NUMBER: . EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: DAYTIME PHONE:
Sw (253)5 956
MAILING ADDRESS(STREET ADDRESS; ITY,STATE,ZIP): EVENING PHONE:
( )g'2y - iSc3
RELATIONSHIP TO PROJECT: FAX NUMBER: 'eQ�
❑ ARCHITECT ITENANT ❑ OTHER(DESCRIBE): � )nti ( ) G�rJyy 9
3
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: PROPERTY OWNER ❑ APPLICANT CI CONTRACTOR
•
• ■ DETAILED BUILDING INFORMATION
EXISTING USE: erosiQ -611....y. EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ 1(Dl0O0
PROPOSED USE: G0.(2J'�L. �trigt 2 PROPOSED VALUATION FOR IMPROVEMENTS: $
s �
SPRINKLERED BUILDINGS ❑ YES KNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:CI YES KNO
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.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 Yapplication.
NAME/TITLE: rA/Y 'L ) Q,jSo;'Y� DATE: .60,/y‘ 14rN 2
op
pf PROPERTY OWN ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? Cl 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
(TIMMI RATTY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129