01-100372 City of Federal Way
Community Development Services 1Jlectrical Permit #:01 - 100372 - 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: MONTGOMERY
Project Address: 33004 29TH VFV Al'e SW Parcel Number: 894520 0860
Project Description: ELE-Install new 200-amp meter& panel box in existing single family residence
Owner Applicant Contractor
Sharon A Montgomery NONE QUICK WIRE ELECTRIC
33004 29TH AVE SW 31665 56TH AVE S
FEDERAL WAY WA AUBURN WA 98001
98023-2714 NONE (253)887-9650
Electrical Fixtures
Description Quantity Description ` Quantity Description Quantity
Service: -Residential 1
PERMIT EXPIRES July 29,2001,IF NO WORK IS STARTED.
Permit issued on January 30,2001
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: / ��� — c'�
.r • .
JEErcFfl_
CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: dr - (��
FIY
,AN 30 APPLICATION NUMBER:
OF I_c- ,„
�y APPLICATION NUMBER: - -
**The folfb�Yvg► 3{lgcf 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:3367 ,29/40/"6-sell ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTT�ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ B(J G CI PLUMBING CI MECHANICAL CI DEMOLITION
ELECTRICAL ❑ ENGINEERING CI FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed des ription): 194_,•,_,e , , / 4 Ador.. _, dQ i ,,.
L-� , -�/7 5--/L✓/ '- ,/
PROJECT NAME:
• PL IPLF ,'WORM. TION
PROPERTY OWNER: NAME: re DAYTIME PHONE:
g
., iG ADDR. (SIRE: '`;S • ,STATE,
301 Av III
CONTRACTOR: NAME: DAYTIME PHONE:
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,..ILI • •ESS(STRE ' 'DRESS; ..: STATE,ZI , � L������������������yyyyyyyyyyyyyyyyyy������������������� EVENING PHONE: -
G7 i/ • �L (//cam// K//YYY J`
1 f EDERAL WAY BUSIN NSE NUMBER: FAX NUMBER:
_ _ - _ - _ _
i OR'S REGISTRATION NUMBER: / EXPIRATI DATE:
(copy of. .required) 9 / A lc . i .2 �, / / / / D Z
APPLICANT: NAME: DAYTIME PHONE:
.5 F4 U (i ) 7 - 9cfv
MAILING ADDRESS(STREET ADDRESS' •ATE,ZIP): EVENI G PHONE:
(
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT I HER SCR E):4111- Nfei¢/7-02 ( ) -
&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: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
. • .>p
**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 s pliedto the ci a a part of this application.
NAME/TITLE: / �„'"( UX%O` _ DATE: / rYe)- OCj
❑ PROPERTY OWNER CPPLICANT COCONTRACTOR
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