01-100523 .r %
City of Federal Way
Community Development Services Electrical Permit #:01 - 100523 - 00 - EL
33530 l st 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: BELMOR MOBILE HOME PARK
Project Address: 2101 S 324TH Si Parcel Number: 162104 9037
Project Description: ELECTRICAL-Replace 200-amp mobile home meter pedestal,duplex type pedestal for spaces(154&
155)AND(177& 178).
Owner Applicant Contractor
BELMOR MOBILE HOME PAK BELMOR MOBILE HOME PAK SHEPPARD&NELSON ELECTRIC
2101 S 324TH ST#48 2101 S 324TH ST#48 SHEPPARD&NELSON ELECTRIC
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 PO BOX 3630
(206)878-7333
Electrical Fixtures
Description Quantity Description !Quantity Description Quantity
Service: up to 200 amps-Multi Famip 4
PERMIT EXPIRES August 6,2001,IF NO WORK IS STARTED.
Permit issued on February 7,2001
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 Wa .
Owner or agent: — 4Date: 2 "D 7 - 0)
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-..o, ,=_ CONSTRUCT ION PERMIT APPLICATION
FHL /
"'" JCGp 'j APPLICATION NUMBER; �l Z�0�? -
APPLICATION NUMBER:
GITY OF rt��tWAI WAY APPLICATION NUMBER: - -
BUILDINCa DEPT.
**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.=
l•-:::.:•:.74"... 7; _`:1:PROPERTY INFORMATION - ..- ,-'7...:,;..-:-.:,, ,,,:i.:.
SITE ADDRESS: 2/0/ S p v7Ji 2 2 4i 71 ASSESSOR'S TAX/PARCEL #: L 1,- 2 -_ Q Y - T IS a 2
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
/ ►_
l'>:•11::•.'''''': a.. .■ PROJECT INFORM' 4101. % . .. . .
TYPE OF PROJECT(This application): ❑ BUILDING V PLUM. ' A M ANI• L ❑ DEMOLITION
IXI ELECTRICAL ' ENGIN: E FIR' •a •ENTION SYSTEM
PROJECT DESCRIPTION(Provide d tailed des, 'on): G,.. ' d 2 w 1/ 4 AA P
/ . ' r —�z.�net� - �114 o �"MI/Jr"MI/JrAri ► -�� �d,`y�� 1. ry ti ro/t yInc�
# , IsL-, /S-- a .' . x/71
• Alk /
PROJECT NA - k `t ' ,s. 1 / O A A
ma
• • $ -:PEOPLE INFORMArON . _ _
PROP, Y OWNER: AME: DAYTIME PHONE:
6 4., Hy V�5 c may ) �zZ ���9
MAILING ADORES` `•EET ADDRESS;CITY,STATE,ZIP):
15"711.0 e A-v'e, vire I r' 4'4' ext Ric, V7i'IA-I
CONTRACTOR NAME: DAYTIME PHONE:
<6heppA-rd c se le.et-- ( 20 ) 878 - 7333
MAILING ADDRESS(STREET ADDRESS;CITY,STA ZIP• EVENING PHONE:
Pro. zex so J PA CO. IVa 2 (2oG ) P7P - 733,3
CITY Of FEDERAL WAY SS U SE NUI4BER: FAX NUMBER: 1
1 - l B I_89_6 -- _40� ( ) - I
CONTRACTOR'S REGISTRATION NUMB : EXPIRATION DATE: 1
(copy of card P required) ,6 P !' N E 5-3- 6 67 / 3 1 / 0 I
APPLICANT: NAME: DAYTIME PHONE: ;
SA '.e A5 A- bav ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR i
_ _- ': - .. :1:DETAILED BUILDING INFORMATION'-'-.I.:1-1- - _
EXISTING USE: /t/a AP hit)iiii,o y EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: 4 AA t 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: $
�: is aZ.. .•s..�w :f ,+.y.r t.*•,,.y r• S'o.�i. ri�`• '� t a,. it .. 7"::
::: ..; : ==;i:•,•� :� �f...4.;•��•.a ; �:.-• '�; :PR07ECT FLOOR AREAS :' ..; . _ - . _`.�'-
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL: ��y� ���+
�" .. ` -• . .. .�.-1ti.F.""•arw .r4 'k t ``-r. ?'• 1rj11 jxruRES k >•`.. :.V "•'r �`' —s . ..�, . ..
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)
-111 4:1ISCLAIMER/SIGNATURE BLOCK r .. ..'' .. .._ . ._._
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 tot(h�city as a part of this application.
NAM E/TITLE: /�CVLLc sti^�/ dv�L� DATE: 02 - o 7 0/
❑ PROPERTY OWNER ❑ APPLICANT 14' 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? 0 YES 0 NO CHANGE OF USE? 0 YES 0 NO