10-104344City of Federal Way Electrical
Community Deveropment Services Permit #. 10-104344-00-E L
P O Box 9718
Federal Way, WA 98063-9718
Ph: (253) 635-2607 Fax: (253) 835-2609 &Lr
Inspection Request Line: (263) 835-3050
Project Name: CAMELOT SQUARE MHP - SPACE 179
Project Address: 3001 S 288TH ST Space 179
Project Description: Replace mobile home disconnect Parcel Number: 042104 9222
Owner
A091san
CAMELOT SQUARE INC
LEROY HARRINGTON
Contractor
3001 S 288TH ST
FEDERAL WAY WA 98003-8019
HARRINGTON ELECTRIC
20312 E 46 AVE
HARRINGTON ELECTRIC INC
HARRIEI012RO (12/20/11)
SPANAWAY WA 98387
20312 46TH AVE E
SPANAWAY WA 98387
Additional Permit Information
Is Use Educational or Institutional?... ........ ... No
Electrical Fixtures
Service or Feeder - Manu./ M.H. P 1
PERMIT EXPIRES Friday, October 14, 2011
Permit Issued on Thursday, October 14, 2090
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: AMO� �Y 14 /tO
Date:
FINALED 10/to/lo
THIS CARD IS TO REMAIN ON-SITE
ury or - .
Federal Way Construction Insaction Record
INSPECTION REQUE_ TS: (253) $35-3050
PERMIT #: 10 -104344 -00 -EL
Address: 3001 S 288TH ST Space 179
Owner: CAMELOT SQUARE INC
Schefi�le.i ,n�.,o�.:.._� ____ ,_ � FEDERAL WAY, WA 98003
• eft to • i ht, uc t bot a trits card isnot on-site. [? �' O l Tl il5 (_:� 121} 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.
n Slal,tlConcrete lour [4255} Final -Electrical (4 S5}
Approved to place concrete
Approved
By Date
By Date %D v
FILE
Hough Electrical ❑
Approved Final Electrical
Approved Mikllt Of u'.iy'
By Date Approved
BY Date
By Date
CITY OF .
Federal tiJVaFGF1VD PERMIT':
cv�AfuNrirnsv>31OU"I.poB ,9;,j JF MF CO ME EL PL DE EN FP
33325-&r-,4 VSARIB 38f/TP! • PD IIDX 9716
5383' oTYAX2s�. g7gja 5 2097APPLICATION TO
Nlnu�,cilemllEe}emlMum '
Thefollowing(Ui RAL W1
50 - an incomplete application will not be accepted. Please print legibly (in ink) or. type.
SITE ADDRESS
ASSESSOR'S TAX/PARCEL # SUITE/UNIT # Q� � � [] �L _ c� Z � �
-� - — LOT.SIZE (s�
LEGAL DESCRIPTION (e.g. Acme Estates, Lot IJ L� W] �]
(Attach aeparafe page%r 1119ft 1ega1 deacTW n) f 1 r 1
TYPE OF PERMIT 0-I3UILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑FIRE PREVENTION SYSTEM
ption of work iilcluded.on this ermit
PROJECT DESCRIPTION (Provide detailed descri
PROJECT NAME (Name of Business or Owner Last Name)
PROPERTY
OWNER
CONTRACTOR
of
With h
With eec eypllee
APPLICANT
PROJECT
CQNTACT
LENDER
-*le:l'1 C17Y..
T-- 00 1- -r_� IM,
SREGISTIIATION IIUMBER
�l /-. r)o4 V
❑ Architect ❑ Tenant ent ❑ Other
OR
ZIP ()
EXPIRATAON DAT
� 2 DAT
/
�7f
ExPI 10�No TE
-!, 70
3 2
P�rIiCW 28,x7.098;
Lender (rI jarm�Hnrt is required If
�3) 1.7 l —
TAX R -
.. w. rnusv es -
FAX HUMBETt
t value exceeds ,$5,000
rPHQNE
1 ) -
EXISTING USE
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE k
VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? O YES �"O FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES
WATER SERVICE PROVIDER �LAHEHAVEN 11HIGHLINE O
SEWER SERVICE PROVIDER O TACOMA 13PRIVATE (WELL)
AKEHAVEN ❑HIGHLINE ❑ PRIVATE ISEPTICI
EXISTIN( PROPOSED TOTAL
AREA DESCR'
ON SO. FT: S . FT. SQ. -FT.
BASEMENT
FIRST
SECOND
THIRD
DECK (0 COVERED OR ❑ UNCOVERELM
GARAGE ❑ CARPORT ❑
PceOP°8�'° T°rAL 7arAGy�srrr,a ar
,j][Sg71N0
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF S BEDROOM
ESTIMATED SELLING PRICE $
ar
Indicate number of each type of facture to be installed or relocated as part of this prod
(NCECUAWCAL (A COPY OF BID -OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
Value of Mechanical Work
GAS PIPE OUTLETS WOODSTOVES
AIR HANDLING UNITS EVAPORATIVE COOLERS FANS MISC (Describe)
-OAS WATER HEATERS (
BBQS HOODS (comm
BOILERS erdal)
FIREPLACE INSERTS
FURNACES RANGES
COMPRESSORS REFRIG. SYSTEMS
DUCTS GAS LOG SETS
BATI-ITUBS (oriub/shower combo) LAVS patiroomsink-)
DISHWASHERSRAINWATER SYST
DRINKING FOUNTAINS SHOWERS
ELECTRIC WATER HEATERS SINKS
HOSE BIBBS SUMPS
URINALS
VACUUM BREAKERS
WATER CLOSETS ir-00
WASHING MACHINES
•.MISC (Describe)
dgep and
rther, Mut I
I eerthe the owtnerjof h above premisesmtoiion jurntshed by Me 43 true arid correct to thq best Of perform the work far which he permit applica ion isgm de.Iel further agree a hood
am authorizedy
a arson, im f lniing the undersigned, and filed against the City of Federal Way, but only where such claim
harmless the City of Federal Way as to any claim jlmcluding casts, rxpenses, and attorneys' fees incurred in the inurstigution and arse a
such claim), which may be made by any P
arlses out of the reliance of the city, including its of rs and employees, upon the accuracy of the !rtf°rmattan supplied to the city as a part Of
this application.
DATE
NAME/TITLE s grtstarel;Tit el
RELATIONSHIP TO PROJECT ❑ Owner gent ❑ Contractor [3Architect ❑ Other
o NEW o ADDITION
❑ ALTERATION
BUILDING SHELL ONLY?
❑ YES ONO
ZONING DESIGNATION
o NO
NEW ADDRESS REQUIRED?
❑ YES o NO
PLATTED LOT?
DYES o NO
o REPAIR o TENANT IMPROVEMENT.
BASIC PLAN? o YES
❑ NO
CHANGE OF USE? o YES
o NO
UP/ SEPA/ SU? o YES
o NO
DEMO PERMIT REQUIRED? o YES
❑ NO
Page 2 of 4 kll-Iarldouts\Pcrmit Application
Bulletin #100—January 1, 2007
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