01-100599 City of Federal Way
Community Development Services Electrical Permit #:01 - 100599 - 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: HIGH POINT PARK 3/2
Project Address: 4230 SW 331ST Parcel Number: 327905 0020
Project Description: EL-Electrical service for new single family residence.
Owner Applicant Contractor
ADAM BAZIA GENERAL CONTRACTOR VALLEY ELECTRICAL CONST INC VALLEY ELECTRICAL CONST INC
2128 S 272ND S SUITE C-110 31816 109TH AVE SE 31816 109TH AVE SE
KENT WA 98032 AUBURN WA 98092 AUBURN WA 98092
(000)833-9234
Electrical Fixtures /
,,:,,Description Quantity Description Quantit : Description Quantit
Service: -Residential 1
PERMIT E ,2001,IF NO WORK IS STARTED.
i ed on
I hereby certify tha .e above information is correct and that the construction on the above described property and
the occupancy ani, the u - 1 be in = cordance with the laws,rules and regulations of the State of Washington and
the City of Feder. Way. op `
Owner or agent: ' Date: " ` - U
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Com of Federal Way Electrical Permit #:01 - 100599 - 00 - EL
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210 �' (I)) [� ,2 Inspection request line: 253.661.4140
Ph:253.661.4000 Fax:253.661.4129
iG 3/10/01 (3:30pm cut-off for next day inspections)
Project Name: HIGH POINT PARK 3/2
Project Address: 4230 SW 331ST pt Parcel Number: 327905 0020
Project Description: EL-Electrical service for new single family residence.
Owner Applicant Contractor
ADAM BAZIA GENERAL CONTRACTOR VALLEY ELECTRICAL CONST INC VALLEY ELECTRICAL CONST INC
2128 S 272ND S SUITE C-110 31816 109TH AVE SE 31816 109TH AVE SE
KENT WA 98032 AUBURN WA 98092 AUBURN WA 98092
(000)833-9234
Electrical Fixtures
,. 4Description, V 1,1Q1:161* ' :6ik ° escriptlon. - u ;.1Quantityj , . "<Description 4'7 -;IQuantity
Service: -Residential 1
PERMIT EXPIRES August 11,2001,IF NO WORK IS STARTED.
Permit issued on
I hereby certify tha .e above information is correct and that the construction on the above described property and
the occupancy an the u - :ll be in . cordance with the laws,rules and regulations of the State of Washington and
the City of Feder. Way. op
Owner or agent: ' sJ)„
NO-D Date: - 1 a - 0
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RECEIVED
Ca.Of ..INSTRUCTION PERMIT APPLICATION
VV FLY FEB 1 2 "i {j' APPLICATION NUMBER: 0
APPLICATION NUMBER: -
i.:i 1`t I 1-,-j, .
BUILDING 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.-
(t ■ PROPERTY INFORMATION
4
SITE ADDRESS: O S ' 331sT 4L ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTE
(Providedescription): EL -TR1�z R ji M 11
PROJECT DESCRIPTION detailed descri tion
• t. >..c.) 24.0,./ LIN _: " ii - v . Mr..
MI
AIMILW
0111kIllink MEI
PROJECT NAME: jillkMWIIM' ili
■ PE TEL `NFA A 1ATIt. I
PROPERTY OWNER: N^^E DAYTIME PHONE:
N �-V (20 -)22_40 - < l
MAA •DDR�SS(STR •ODRES ATE,ZIP): -- \ y}. C` 0
MMNIII- M111111. 11 ..-"NIP
CONTRACTOR: DAYTIME PH. E:
L-_,- -LW% -...1.. .xiasta inir in v ( )
r
L.._LING ADD• (STREET ADORES'. 11EVENING PH• E:
P . . \ `AVAMMINTIA 41111 I, ).ar - C.
4
wiiiiiiiiiiiimmirialmiLNUMBER:, -V
CONTRACT. .REGISTRATION NUMBER:_, !` MEIVIVIM EXPI•3/N%AT Me � / O 1
(copy of card r- ed) w(
APPLICANT: IIME DAYTIME PHONE: i
A w ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STA EVENING PHONE: -
( )
Ik RELATIONSHIP TO PROJECT: , FAX NUMBER:
❑ ARCHITECT ❑ TENANT I HER(DES BE): ( ) - j
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR j
■ 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 El NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHUNE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
•
**NEW RESIDENTIAL CONSTRUCTION ONLY** 4
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT 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) El 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 agre o •Id harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in the
investigatio and d- ense of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way but onl , : e su h claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the inform:tion s • e• to e ci as f thi a plication.
II elDATE: 9 - 1 �a-- -d
NAME/TITLE:
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
I
FOR OFFICE USE ONLY: 1
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
- ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? El YES El NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES El NO CHANGE OF USE? ❑ YES Cl NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129