05-104751 O
.010•-
City or Federal Way Electrical Permit #: 05 - 104751 - 00 - EL
4 Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-305a
•
Project Name: LEWIS
Project Address: 1116 SW 334TH PL Parcel Number: 926496 0600
Project Description: Add circuit for A/C unit.
Owner Applicant Contractor
Nicholas D Lewis INTEGRITY ELECTRIC INC INTEGRITY ELECTRIC INC
1116 SW 334TH PL 4501 KENNEDY RD NE 4501 KENNEDY RD NE
FEDERAL WAY WA TACOMA WA 98422 TACOMA WA 98422
98023-5318 (253)943-0500
Electrical Fixtures
Description Quantity _Description Quantity Description 1Quantity'
Circuits-Residential 1
PERMIT EXPIRES March 15,2006.
r- Permit issued on September 16,2005
I hereby certify that the above information is correct and that the construction on the above described propertynd
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: � Date: � O 5
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60 13
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-104751-00-EL
Owner: NICHOLAS D LEWIS
Address: 1116 SW 334TH PL
FEDERAL WAY, WA
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
0 Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) 0 Service(4235)
0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
0 Rough Electrical(4225) ❑ Ceiling Cover(4020) 0 Final-Electrical(4055) •
Approved Approved Approved
By Date By Date By'` 4\ Date 41 •
❑ Under-slab groundwork(4295)
Approved
By Date
1
OF N
RECEIVEDr - 1
Federal Way PERMIT - ��`
COMMUNITY DEVELOPMENT SERVICES SEP 1 6 2005 SF MF CO M;eL DE EN FP
33325 8M AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063-971¢.IT Y OF FEDEA�ijj,�y LI C AT I O N ' 41MIMF1/1b._
253-835.2607•FAX�53d35-260 '
o.cituolede„& tt. BUILDING DEPT.
The oilowi • is • fired in ormation-an inco •fete • ••lication will not be acce•ted. Please •rint le• •1 in in or
■ PROPERTY� INFORMATION i
SITE ADDRESS t 11 L L)S 3- ,.-i (
t ' 1 �I '`^'„-t 'v`) SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# - _ _ _ LOT SIZE(s)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate pagefar knet4 trial desaipttmy
_.
IIPROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL _
0 DEMOLITIONLECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
PROJECT NAME(Name of Business or Owner Last Name) 112-40`-'•
II PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER V\'IC.Ar``. 5 L.22�V. S ( )5.3) - . SLS
..MAILING ADDRESS CITY,STATE,ZIP
i 1 e S vJ 3 y' ('1• p,..._,L____A ...i. L. el- . 7 so.) . ,--,3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADD CITY,STATE,ZIP CELL PHONE
4 .( ..rc�,. C 'P.NE. w v--- 1-,%114k �( `{?"3-- (,2S3)' a-) -7 S s k
CITY OF FEDERAL WAY BUSINESS LICENSE MBER 1XPIRATION DATE FAX NUMBER
B L / ( )
CONTRACTORS REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
1 W 1 & 6 E `3 N es tS 1 I C, / o(_,
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
' MAILING ADDRESS CITY,STATE,ZIP - CELL PHONE
t
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant a Agent ❑ Other(Describe) ( )
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
I j Cpcsi�S 0-5S) 2z( -ic '
LENDER i,) d ! ) ' t Yr3t lY'J dii✓ ri, NAME -
MAILING ADDRESS CITY,STATE,ZIP
I ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ _
SPRINKLERED BUILDING? ❑YES ❑NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
=STOPS PROPOSED TOTAL ��� ��a_J'�1. - �..< 'k ED P ..7.171
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not indude existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(comm«d.q WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
• COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(*r Tub/Shower Combo) SHOWERS WATER CLOSETS(Nadi MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS it
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(eathroom stdoel VACUUM BREAKERS ELECTRIC WATER HEATERS
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
this application. I
NAME/TITLE v -� DATE S 9 i / 05
(Signatu (Title) 666
RELATIONSHIP TO PROJECT • •wne- 0 Agent ❑ Contractor 0 Architect 0 Other
1
• ,vel. 1 f‘((.11 ,W1 •DAt.441,i a � Ve. r. u �_
8ej11, re't ;rDf). a r.'P;) •:
/'I..1 I. =7ay(r..4',�' cc) ( eweb s e x i, d e .
F f ac): �y. 0341)6..6) - r.- tot {L' t4VI 'j, . _ Tt`e�
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Bulletin#100—January 7,2005 Page 2 of 4 k Handouts\Permit Application