01-100574 . '\
City of Federal Way Electrical Permit #:01 - 100574 - 00 - EL
Commw�ity 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: WEST CAMPUS SPORTS AND ORTHOPEDIC THERAPY
Project Address: 32717 1STl Suite9 Parcel Number: 697900 0050
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Project Description: ELE-Alteration of up to(12)circuits for existing office space.
Owner Applicant Contractor
Floor Covering Pf Resilient D J ELECTRIC,INC D J ELECTRIC,INC
12886 INTERURBAN AVE S D J ELECTRIC,INC D J ELECTRIC,INC
SEATTLE WA 5126 S MEAD ST 5126 S MEAD ST
98168-3318 SEATTLE WA 98118 (206)723-5632
Electrical Fixtures
, Description Quantity] h Description Quantity Description Quantity
Circuits- Commercial 12
PERMIT EXPIRES August 8,2001,IF NO WORK IS STARTED.
'ermit issued on February 9,2001
I hereby certify that thy
binf.-. ation'• correct and that the construction on the above described property and
the occupancy and : .o l ance with the laws,rules and regulations of the State of Washington and
the City of Federal
Owner or agent: Date: V46:77
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G �� CONSTRUCTION PERMIT APPLICATION
ON
ED 1 APPLICATION NUMBER: ( I>O 74CZ__Ok® APPLICATION NUMBER: - -
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OF °GOV.I. APPLICATION NUMBER: - -
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G 'aThe following is required information—Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.-
- ' �j • PROPERTY INFORMATION •
SITE ADDRESS: 32 / / 7 / Sr c S- ASSESSOR'S TAX/PARCEL #: -
S c)r 7-Z-"
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PRO3ECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ M - . \,..L ❑ D' OLITION
$ LECTRICAL ❑ ENGINEERING❑ ir E• '` ION S .TEM
PROJECT DESCRIPTION(Provide detailed description): r _ 2. e•//7-r
PROJECT NAME: •1/2-.-5-7.-
1 57 c/I,,,b (FAIL --yze)/67
■ i 'OPLE INFJRMATION
PROPERTY OWNER: NAME: \it7IJII% DAYTIME PHONE: ,
Q
- A. i ce. A �4'f''• #.0
MAILING A.. ADDR , !.•TE,ZIP):
11"5
"41 1116f
CONTRACT•. - DAYTIME PHONE:
N'
j, r- lc_ C s? O' v , ) ,-C , (zcc) - ?gs-
AILIN�ADDRESS(VR' •DDRESS;CITY,STATE,ZIP) EVENING PHONE:
/y 6.X ?....6, •Oa S- ( ) -
i CITY OF FEDERAL WAY BUSINESS LICENS MBER: FAX NUMBER:
- (V/ r)4132_ -as-is
•TRACTOR'S REGISTRATION NUMB : _ EXPIRATION DATE:
(co. .rd required) 6- C •L Z 7 L 2 / /
APPLICANT: NAME: DAYTIME PHONE:
5E-e- K. - VD"4 `1/64- 4j ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT 16 OTHER(DESCRIBE): `/�� E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 1:1 PROPERTY OWNER CI /�CONTAPPLICANT CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES Cl NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: El YES El NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 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) RANGES) 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 th City of F•- ral Way as to any claim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of s -'m), hich may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only her cl.i arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information .ppli-: . , ci as a part of this application.
Jam'
NAME/TITLE: ( DATE: (/ Z( _ /
❑ PROPERTY OWNER i APPLICANT XCONTRACTOR
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? Cl YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
rnMMI RdrTV f1F\/FI CIDMFNT GFRVTCFC•11S-1n FTRCT WAY Cni m- .P n any 971R•FFI)FRAI-WAY.WA 98063-9718•253-661-4000•FAX:253-661-4129