01-101635 City of Federal Way
community Development Services Electrical Permit #:01 - 101635 - 00 - EL
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: TERRY JENSEN CONSTRUCTION
Project Address: 443 SW 297TH Parcel Number: 720520 0100
Project Description: ELE-Service for new single family residence
Owner Applicant Contractor
TERRY JENSEN CONSTRUCTION CORP ADVANCED ELEC&SECURITY INC ADVANCED ELEC&SECURITY INC
TERRY JENSEN CONSTRUCTION CORP 3217 MERIDIAN AVE E 3217 MERIDIAN AVE E
P.O.BOX 1326 PUYALLUP WA 98371 PUYALLUP WA 98371
ISSAQUAH WA 98027-0058 (253)848-8706
Electrical Fixtures
Description -,Quantity Description Quantity Description Quantity
Service: -Residential , 3416
PERMIT EXPIRES October 22,2001,IF NO WORK IS STARTED.
Permit issued on April 25,2001
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. -
Owner or agent: Date: G y 2 Vo
MP ......
�� ��zRL ����'��® CONSTRUCTION PERMIT APPLICATI�
--� APPLICATION NUMBER: �i ( - ( 2 L i.C20
N>N> FIY APPLICATION NUMBER: _ _ - _ 5- - _
APR 2 APPLICATION NUMBER: _ _ - _ -
**The followi i ated information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
1
= • • . • _ " PROPERTY INFORMATION •-
SITE ADDRESS: Lit-13 3/A.) 2 r 5� ASSESSOR'S TAX/PARCEL#: 7z '- - �1 vO
— LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
. - 2.PROJECT INFORMATION - - .
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
• ELECTRICAL ❑ ENGINEERING❑ Fl PREVENTION SYSTEM
PRO. DESCRIPTION(Provide detailed . 'ption): IV" 1 i t. 1 —A—Al1 ' 0 _c
sichn.p.L2 IV
Il
PROJECT NAME: 1 0~ C�
I= - - _ _ :6 PEOPLEINFORMATION - . . -.
PROPERTY OWNER: NAME: DAYTIME PHONE
I— i '\ I Sell- i ‘i .ff (125--) -5-7 -cit-55-3
,___ MAI I. .c .•.;CITY.STATE.ZIP):
?X 72-6,0 S S• i . ' '9- ' 6? 7
CO CTO • NAME: 4 DAYTIME PHONE:
A�,►. (la , ec ` 'C 6 ( z 3) gqg -,97/6
MAILING ADDRESS(STREET •STATES A EVENING PHONE
X2/7 444));)); in— - 6 .ei..ozd ??371 �-S3) 3c/� -/q/O
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: c/FAX NUMBER: .?
L I ('LL 6- 3 `ZZ 25"3 ��8 g
CONTRACTORS REQSTRATI• UMBER: EXPIRA ON DATE:
a / _ Yile_ aoga ,07 / 7 /0/
APPLICANT: NAM DAYTIME PHONE
Ac cL rte.* Elf '& g• 5ec�til r` -y ' c • (75-3)3L/ -57a)
MAILING ADDRES$-(TTREET i i•s CITY,STA ZIP): EVENING PHONE
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT 0 TENANT O �-THER(DESCRIBE): FieCT/1Ca ( j) ;34t - / /o
C 6Y1Tli Y(!Y-E l4AIL ADDRESS:
III CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER \APPLICANT / CONTRACTOR
• • _ • : DINI ORM• • .
`I EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES C
1
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) .
SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
lNUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
- • ■ PROSECT FLOOR AREAS • • •
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
•
FIRST
SECOND -
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
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)
BOILERS) 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)
'10. .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,an
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 th
investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City o
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accurac
of the information suppli to the a as a part of this application.
NAME/TITLE: _ i DATE: / Z 5 1 �'
❑ PROPERTY OWNER ❑ APPLICANT L CONTRACTOR
J OR1FF10E1ISE ONL i
(YE7N §ADDITIONN ILTERAiION. lREPAIR NANT MPROVFME t u—
-1ENSUS CODE: _ =3
ONING DESIGNATION� � MilinirSfiEtfeRM ZIWA NO S -
=OOMP PUIN p SIGNA7ION +1f BASXC LPN? ® (ES 3 V0
ECTION - T WNSHIPF,-°;#;ANGE °a _� f ESQ=
�� _ � �,,, �1bDRESS�LEQUIRED � �
PLATT—T.6ri rES -0 NO tcHANGE OF SE?
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718.253-661-4000•FAX:253-661-4129