04-104189 City of Federal Way Electrical Permit #: 04 - 104189 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Pb:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
7-
Project
Project Name: STONEHAVEN APARTMENTS,BLDG 15
Project Address: 1900 SW CAMPUS bi 1 5 Parcel Number: 132103 9103
Project Description: Repair work for units 202&302;lock box code AEH
Owner Applicant Contractor
Kenton Udr MADSEN ELECTRIC MADSEN ELECTRIC
1745 SHEA CENTER DR#200 3939 S ORCHARD ST 3939 S ORCHARD ST
HIGHLANDS RANCH CO TACOMA WA 98466 TACOMA WA 98466
80129-1540 \ (253)383-4546
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Alt.Serv./Feeder:0 to 200 amps-Mull 2
PERMIT EXPIRES April 11,2005.
Permit issued on October 13,2004
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 Was gton and
the City of Federal W.
Owner or a,
,i,� ��� _ Date: JO r' /3"
kld ��, _ off,
THIS CARD IS TO REMAIN ON-SITE '
CITY OF ACommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 04-104189-00-EL
Owner: KENTON UDR
Address: 1900 SW CAMPUS DR
FEDERAL WAY, WA 98023-6533
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
,
,El Rough Electrical(4225) s 0 Ceiling Cover(4020) at Final-Electrical(4055)
Approved Approved Approved
1/423.12C45, Date 7G.-/ By Date By e 4..>� Date't 1-1 p, Q ti
•❑ Under-slab groundwork(4 95)
Approved
By Date
CONSTRUC I ION PERMIT APPLICATION
CITY OF
....4011%.,_,,11.162--` APPLICATION NUMBER: D 4- 4 O f' _I if - eti)
Federal v vay APPLICATION NUMBER: -
1APPLICATION NUMBER: -
**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: / 940C) C
G✓ 414tfD U S W,,e ASSESSOR'S TAX/PARCEL #: _.1 -3`[O 7_ ?l_ t 63
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- ■ PROJECT INFORMATION _
TYPE OF PROJECT(This application): o BUILDING 0 PLUMBING o MECHANICAL 0 DEMOLITION
1CTRICAL a ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIP1 ON(Provide detailed description): -Q_p co r t.. i or t yes au Q 4-0
- t v`t? c iiV•it-, .-e 2UJA_t 1-S
PROJECT NAME: . .7® n •e_ - t,Qh
` _. 1 PEOPLE INFORMATION '
PROPERTY OWNER: NAME: : DAYTIME PHONE:
(
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
i
Q,� k C
CONTRACTOR: NAME: �i' /'`+ A �M+E�PHONNE�:Q�
cAm..-W..-.. �� v (,.33) tJ(.3 - 1/5-/6,
A MAILING ADDRESS(SIRE At DRESS;CITY.STATE.ZIP): I EVENING PHONE
CITY II FEDERAL WAY BUSSIIINEESSS�/UItC[ SE NUMBER: FAX NUMBER: �j 9(//p
CONTRACTORS REGISTRATION NUMBEi!" k 9 E7/ — — — — — cgc3 )56`/ -9447!Uv
///�,,�/� /� I PIRATION DATE:
(copy of card required) l it X—Ct-5 ee f Q 00-?E— — — 1 / /
APPLICANT: I NAME: DAYTIME PHONE
rd4P.IN
M NG ADORE EET AD RES STA I
ENING PHONE:
I
1/
RELA ON�P TO PRO ECT: \ j FAX NUMBER:
a ARCHITECT O TENANT ❑ OTHER( DESCRIBE): 1�r}Cp«A,l/V ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER O APPLICANT o CONTRACTOR
U DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VAL . ON $
P•OPOSED USE: PROPOSED VALUATION FOR I ' •OVEMENTS: $
SPR NKLERED BUIL• G? O YES ❑ NO FIRE SUPPRES •N SYSTEM PROPOSED/RE• IRED:❑ YES a NO
WAT • SERVIC •ROVIDER: O LAKEHAVEN O HIGH O TACOMA 0 PRIVATE(WELL)
SEWERS •VICE PROVIDER: ❑ LAKEHAVEN a HIGHLINE 0 PRIVATE(SEPTIC) '
/OCK (00)r G4f:)61-e A- FY
J
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOT:
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MA► DORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLI - UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S WOODSTOVE(S)
BOILER(S) PLACE INSERT(S) S) MISC.( )
COMPRESSOR(S) FURN•
DUCT(S) GAS PIPE OUTL HEAT SOURCE: ❑ ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER RAIN WATER SYS. VACUUM BREAKER(S) ❑ CTRIC o GAS
DRINKI c OUNTAIN(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 th f the formation 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(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,induding the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the dty,induding its officers and employees,upon the accuracy
of the Information suppli t4o e dty as a part of this application.
NAME/ P'E: `A„,RI"• Ai( j\Qi�`QI DATE: /O `l 3 -6) L/
r
❑ PROPEL •WNER o APPLICANT o CONTRACTOR
_.FOR.OFFICE.USE ONLY:=7:.
o' NEW*"o ADDITION M O ALTERATION r bnREPAIR TENANT IMPROVEMENT ,
+'CENSUS.`CODEt*4 `",r**r � -PZ'ktt LOT.SIZE
ZONINGT-.DESIGNATION: _ '4 ...(.- BUILDING 6HELL ONLY? *a YES' ,;o NO
COMP PLAN DESIGNATION , t BASIC PLAN? ❑YES .0 NO =
_SECTION � TOWNSHIP_ ` RANGE _ �, ,NEW%1UDRESS REQUIRED? :❑YES ❑.NO
PLATTED LOT? --:.CHANGE OF USE?. ase E d YES 'n NO s .04
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtyoffederalway.com