01-104067 ' -
City of Federal way r s
Electrical Permit #:01 - 104067 - 00 - EL
Community Development Services
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: KINDERCARE
Project Address: 28715 18THI AitC 5 Parcel Number: 332204 9037
Project Description: ELE-Electrical work for the installation of(1)monument sign.
Owner Applicant Contractor
KINDER CARE LEARNING CENT NONE PACIFIC NORTHWEST SIGN CO
1777 NE LOOP 410#1250 13427 SE 27TH PL
SAN ANTONIO TX BELLEVUE WA 98005
78217-5234 NONE (425)643-3599
Electrical Fixtures
Dp r ptior = Quantity y" Description ° JQuantiti id1I "r! °Description 'Quantity
Sign 1
PERMIT EXPIRES April 20,2002,IF NO WORK IS STARTED.
Permit issued on October 22,2001
SI 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: A----)///c� Date: l Z)/Z'2./O
fj —t A--C'' t Ccrv-e o. •1--t cvt j
- 1 5 - c .a 1=,:\,V,l 0 ( - . S
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CONSTRUCTION PERMIT APPLICATION
N>.\> FIY RECE'!\rur APPLICATION NUMBER: al- 1 oirceo]- Od—
APPLICATION NUMBER: _ _ - _ - _
OCT 2 7 2[fIVi APPLICATION NUMBER: _ - - _
**trifediritipg jHeicyaired information–Please print(in ink)or type**
Please note: Electrical,Fni NeQStr s
ystems and Engineering permits may require a separate application.
�! PROPERTY INFORMATION
SITE ADDRESS: 42-'6-3 ( 5^ AS Pry E ASSESSOR'S TAX/PARCEL#: 3 3 Z Z O "4 - `T (3 '3
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): d.-Tt1 -e_14 1) 'To 1 lbw 11—
G PRO3ECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING 0 PLUMBING 0 MECHANICAL ❑ DEMOLITION
pekLECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): I t"'-Cr"-,ks'^ -E - T 'Si t...1•41. (_O Ni
-
•51-2443 t_(S-H c lb 20 /4- /'z o C.r 2L u 7'v L_( _R b 13-sr
PROJECT NAME: /'--«Z)EZ. • (1'N ( Ni -&J ' E-,rc_
►� PEOt'LE INFORMATION
PROPERTY OWNER: NAME: A DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;QTY,STATE,ZIP):
2_°67 I /t2. s
CONTRACTOR:. NAME: DAYTIME PHONE:
PA-C l ?F /L/ 5 / ? N (qty16y3 - 3 7
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,IIP): EVENING PHONE:
/ Z"7 s '2_'7 ' ' ?L 73TLL£)IA c 4v..X+ ( ) S A vfex
CITY OF FEDERAL WAY BUSINESS UCENSE NUMBER: y Z;Oc- FAX NUMBER:
( es-) 6(43 - 34,7 S
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) P•4 C IF NJ (3 a 08 / C=J
APPLICANT' NAME: DAYTIME PHONE:
41 Tv eR1 it 111 Q Li f S7 ( LIZ'6 i 3 -3T/9
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): 7eC)11>! EVENING PHONE:
rS Z -j 47-._.. Z-7 7---/-1 L• I LC-'�V bi � 1vA ( ) `7r 1�+✓VI
4 RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT OTHER(DESCRIBE): (Oa T'fl-,4-<.a-DR ('-z. '444 3- 34.11 E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR //1/LAA C @,H0T1444/L-,L"i
■ 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 0 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 0 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 )
•
I 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 daim(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application. /
NAME/TITLE: DATE: G///ZZ-/O /
❑ PROPERTY OWNER ❑ APPLICANT 1,74 CONTRACTOR
FOROFFICE.U.SE ONLY:
0 NEW '` .0 ADDITION € ❑'ALTERATION 0 REPAIR D TENANTIMPROVEMENT
CENSUS CODE: .- . • -LOT SIZE . :
ZONING DESIGNATION BUILDINGSHELL ONLY? :❑YES" ❑ NO
COMP PLAN DESIGNATION BASIC PLAN?. „- ❑YES ❑ NO'
SECTION "_. :TOWNSHIP : RANGE NEW;ADDRESS REQUIRED? --0 YES t❑:NO
;PLATTED LOT?''- ❑YES ❑ NO CHANGE OF.USE?,, • ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129