01-104396 City of Federal Way Electrical Permit #:01 - 104396 - 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: BURN
Project Address: 30230 23RD8 A1/4/e5 Parcel Number: 042104 9161
Project Description: ELE-200-amp service change.
Owner Applicant Contractor
Stephen A Bum S C G ELECTRIC,INC. S C G ELECTRIC,INC.
30230 23RD AVE S PO BOX 58744 PO BOX 58744
FEDERAL WAY WA SEATTLE WA 98138 SEATTLE WA 98138
98003-4255 (206)824-2656
Electrical Fixtures
_ Deacrtptb* IQuantity 0044;,4;„:Description (Quantity DOcriptiph4, Quaniity
Alt.Serv./Feeder:0 to 200 amps-Res. 1
PERMIT EXPIRES May 15,2002,IF NO WORK IS STARTED.
Permit issued on November 16,2001
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.
s � )
Owner or agent:-_ :I �!� �� 'Jo" Date:
RECEIVED
«nom G r CONSTRUCI ION PERMIT APPLICATION
VV f=iY NOV `�DU f APPLICATION NUMBER: O I - L O / 5 9(- E
APPLICATION NUMBER: — —
CITY OF FEDERAL WAY APPLICATION NUMBER..
BUILDING 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.
■ 'PROPERTY INFORMATION -
SITE ADDRESS: ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
1 PR07ECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
ELECTRICAL 0 ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): .`ALD 41.7_- •s _
PROJECT NAME: a'T-8-7 ,f — ► j�-
P. 'PLE I..FORMATION: _ ..
PROPERTY OWNER: E: 111111LNIS DAYTIME PHONE
MAILIN 'D• "Ilik'Tim �� ■ ` .
CONTRACTO-. N• TIME
-- -°11° '4.-40.11irI l as,_V YPHONE:
) --
• LING ADDRESS(STREET 'DRESS;CITY,'• A --� EVENING PHONE:
fffP .7:117
a F FEDERAL WAY BUSINESS LICENSE NEI FAX NUMBER:
W
Q • 29- — — ( )
CONTRA ORS REGISTRATION NUMBER: EXPIRATION DATE
(copy of mrd required)
APPLICANT: NAME: DAYTIME PHONE:
MAILIN ADDRESS(STREET ADDRESS; ZIP): EVENING PHONE:
c
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): (
E-MAIL ADORFSS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
1 :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: $
■ PRO]ECT 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)
• .'z - . 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,including its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
•�ti S. •
NAME/TITLE: ���� � � �C��-f DATE: 1//'
❑ PROPERTY OWNER ❑ APPLICANTCONTRACTOR
TifOKOFFICE.M$E..PNVOEZD
Q NEIN 0_ [I ADDITION ❑'ALTERATION ❑':=REPAIR ❑TENANT IMPROVEMENT.
CENSUS CODE: LOT SIZE -.x_ ;
ZONING DESIGNATION ,x. , BUILDING SHELL ONLY?_x❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN?. .; . ❑YES ❑ NO'
SECTION . - TOWNSHIP �.RANGE °I NEW,ADDRESS REQUIRED? ❑ YES .'❑JVO
PLATTED LOT? ❑YES. ❑ NO CHANGE OF USE?, ❑YES ❑ NO ,
COMMUNITY DEVELOPMENT SERVICFS•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129