01-100891 City on Federal Way
Community Development Services Electrical Permit #:01 - 100891 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax 253.661.4129 Inspection request line: 253.835.3050
Project Name: TEUYAK1 MASTER
2:Net
Project Address: 28 MILITARY! 1Qd S Parcel Number: 042104 9037
Project Description: ELE-Re-wiring and wiring for hood and make up air
Owner Applicant Contractor
Rodney W Snyder GOLD ELECTRICAL GOLD ELECTRICAL
28815 PACIFIC HWY S#10A 5121 GALLEON DR NE 5121 GALLEON DR NE
FEDERAL WAY WA TACOMA WA 98422 TACOMA WA 98422
98003-3905 (253)227-7712
Electrical Fixtures
Description Q; entity ''' Description 'Quantity Description Quantity
Alt.Serv./Feeder up to 200 amps-Co 1
PERMIT EXPIRES September 3,2001,IF NO WORK IS STARTED.
`�.,. Permit issued on March 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 Way.
/
Owner or agent: ���j jJ 40,2, , Date: / v /
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u„.o. , CONSTRUCTION PERMIT APPLICATION
WE=AL APPLICATION NUMBER: (2 - I_GO 3.11 - _
r ,�?��JJ APPLICATION NUMBER: - -
I APPLICATION NUMBER: - -
**The following is required information-Please print(in ink)or type**
�� -_ ,_ .AL WAY
BUILIDtti ' t'T Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
■ PROPERTY INFORMATION / ` ..
•
SITE ADDRESS: �` L� A. /r - i' ASSESSOR'S TAX/PARCEL #: D q Z L U (-1 - q 6 37-
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 SYSTEM
PROJECT DESCRIPTION_ (Provide/674,E.
description): c /ya / ,25'a%-'e..+2-1 Grj//`/3
,j4 A/eie,c/ /c:/4.Cce c:.999 /4/."' -, .1/7_,* ,_..,-
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PROJECT NAME: 414 5',,,-'- ..40- ,-
h PEON E INFORt ATION
PROPERTY OWNER: NAME: T NI, DAYTIME PHONE:
(
M• ING A. S(STREET ADD'; ;CITY, E,ZIP):
CONTRACTOR' NAME: DAYTIME PHONE:
I �r�� 1 IL 20) Za 7 - 72/e___
LING ADD• (STR -•DDRESS;CITY,ST E,ZIP): NING PHONE:
572/ . -A .9 /, . - .l" AOP ( ) -
CITY OF FEDERAL BUSINESS UCENSE NUMBE• FAX NUMBER:
CONTRACTOR'S REGIST•.•TION NUM - - EXPIRATION DATE:
(copy of card required) 6 d • --?f- Z-'' ' — — 2_. / 2 3 / Zco .
APPLICANT: AME: DAYTIME PHONE:
( -
MAILING ADDRESS(STREET ADD •CITY A IP): EEVENING PHONE:
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RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(D SCRIBE): ( ) j
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT yI.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)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
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) ❑ 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 tt,application.
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NAME/TITLE:
'� j� � � �2 DATE: /'7 i0/
❑ PROPERTY OWNER ;❑ APPLICA 'N CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION El 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? El YES ❑ NO
PLATTED LOT? ❑ YES Cl 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