05-104517 City of Federal Way Electrical Permit#: 05 - 104517 - 00 - EL
I Community Development Services
P.O.Box 9718
r
A
8
Ph (253 835-0 Federal Way,7V0009 Fa 3 •
-9718(253)835-2609 Inspection request line: (253) 835-305€
Project Name: HOLY INNOCENTS
Project Address: 2530 S 298TH Sr. Parcel Number: 768380 0032
Project Description: Electrical service repair(emergency)
Owner Applicant Contractor
HOLY INNOCENTS SOCIETY HOLY INNOCENTS SOCIETY HOLY INNOCENTS SOCIETY
2530 S 298TH ST 2530 S 298Th ST 2530 S 298TH ST
FEDERAL WAY WA 98003-4219 FEDERAL WAY WA 98003-4219 FEDERAL WAY WA 98003-4219
(253)839-0788
Electrical Fixtures
a ua ' m
'.� ,gip 04sdr) ior�: �. •: Quai ti
Mast or Meter Repair-Comm. 1
PERMIT EXPIRES March 5,2006.
Permit issued on September 6,2005
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 W
Owner or agent: , Date: iV(//eRs
•
F11\1
/ 1
C/(,,
C
THIS CARD IS TO REMAIN ON-SITE
CITY OF A Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE# (253) 835-3050
PERMIT#: 05-104517-00-EL
Owner: HOLY INNOCENTS SOCIETY
Address: 2530 S 298TH ST
FEDERAL WAY, WA 98003
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.
❑ Slab/Concrete Floor(4255) ❑ 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) ❑ Feeders/Sub-panels(4045)
Approved Approved Approved
By Date B Cc7 Date (�,ep- By Date
❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) ,❑ Final-Electrical(4055) ,
Approved Approved Approved
—❑By Date By Date t By 5 Date g-4-c( ----
0
Under-slab groundwork(4295)
Approved
By Date
,
1` RECEIVED
of : . Q5. _ DL
Federal Way SEP 6 2005
PERMIT 2
COMMIT a7T,neVacorYENr SERVICES
f SF MF COM EL L DE EN FP
3J325dMAVENUBSOfrfff• ,� 'p LI CATI O N
FEDERAL wAY,.: ; _ =V t FEDERAL
253435.2607..aIyo FAX 2s3 u.am IJILDING DEP
r
/ /wwweityollederalwau.00m1
The ollowl • is -. fired in ormation-an i ,. •Tete . ••lication will not be acce•ted. Please 'tint le• •1 n or •e.
�Jer 3 V; c J 1•I PROPERTY INFORMATION
SITE ADDRESS o` q r cl% SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# LOT SIZE(4)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separaeeMelo,Sengehiile al duoipdua)
_
1.I PROJECT INFORMATION
TYPE OF PERMIT 0 B t i DING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
FIQcTrt.
cet ( S-ervl' c `
7 ..21,a i r
PROJECT NAME(Name of Business or Owner Last Name) 40(( 4K Vtorewf 5
II PEOPLE IINFORMATION
PROPERTY NAME
if
PRIMARY PHONE
OWNER
MAILING ADDRESS A K0 CGt� 5�GI el' (-SS ) R3T-C7J -
CITY,STATE,ZIP
�S3o $'_ .3-i. sf-. 1 reit ( We 7, W4 ' W'3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
1.11( IZill NOcek+s- ( ) -
NO D CITY,STATE,ZIP CELL PHONE
( , ) r.
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER _ EXPIRATION DATE FAX NUMBER
- - sty / ( ) -
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application( EXPIRATION DATE
I /
APPLICANT COrPQNY NAME APPLICANT NAME OFFICE PHONE
oJyR rlslOceh �s . ( ) -
MAILING MA,°' CITY,STATE,ZIP _ CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
a Architect a Tenant ❑Agent ❑ Other(Describe) ( ) _
CONTACT NAM PRIMARY PHONE E-MAIL ADDRESS
Ylcti 1rf, aK1 -'q ( (gcn Sal - D7 .
LENDER
MAILING ADDRESS CITY,STATE,ZIP
■ DETAILED BUILDING INFORIMMATION
EXISTING Z-E P• •POSED USE
EXISTING - ES` D/APPRAISED • $ VALUE • PROPOSED W• • $
SPRINKLE' D :UILDING? a • = 0 :• SUPPRESSION SYSTEM P•4• . - D/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER a LAKEHA'bit a HIGHLINE a TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑HIGHLINE . a 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
stasrma soros= AL , ,_r N. , (i:R '3►;k , si
NUMBER OF FLOORS
'*NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to • installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS O LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
• COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BA ' :S(or Tub/shower combo) SHOWERS WATER CLOSETS/Toilet) MISC(Describe)
SHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS mailroom stoic.) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the ormation furnished by me is true and correct to the best of my knowledge,and further,t
am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to ho
harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense
such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,but only where such cla
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 o
this application.
NAME/TITLElig24/11.4 21/, .,/,•• 3— I/rettQ/./A W DATE /`/
/S
(Signature( (Title)
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent 0 Contractor ❑Architect Other
!tY)
'PM/ .t)o-l'O.('3.1 al0:4v4,4i t;ii.);lePAD)
t,tst(ePf ej: Oj:_ :.- gam. .lot.
& f o-.fZi ;dyo)trita 7 's fei (,it;l .... 'ty -(:rr'
tiO.•- t.,til - ',(04 iifbi--4 ,;( t-s Ti .. •,
Bulletin#100—Januaiy 7,2005 Page 2 of 4 k\Handouts\Permit Application