91-101750CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
5-0
BUILDING INSPECTION
661-4140
91-1717 FA NORTHWEST CHURCH 34800 21 AVE SW
PERMIT NO. OWNER'S NAME SITE ADDRESS
CONTRACTOR PORT ORCHARD ELECTRIC POB 1248 PORT ORCHARD 876-9799
ADDRESS CONT. PHONE
PORTOEI26207 15 -� 952-3498 SAME AS SITE
CONT. REG. NO. EXP. OWNER'S PHONE OWNER'S ADDRESS
TYPEJOB: NEW RESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS ) MULTI. ADD. SIGN GRADING OTHER FIRE ALARM IN PORTABLE
542350-0630
TAX ACCOUNT NO. LEGAL DESCRIPTION
SSUED BY ELIZABETH SNYDER DATE OF ISSUE DATE OF APPLICATION 12/9/91
BUILDING INFORMATION
ZONE -__ SET BACKS: FRONT SIDE REAR HEIGHT LIMIT
S
OCCUPANCY TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG. SQ. FT. __ STORIES _
PLUMBING NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS ELEC. HOT WATER HEATER _
GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS LAUNDRY DRAINS
FORCED AIR FURNACE DUCT WORK
SHOWERS URINALS
GAS HOT WATER HTR. _ AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
CONVERSION BURNER MISC.
SINKS _. MISC.
BBQ BASIC FEE
RETURNED
DISHWASHERS TOTAL FIXTURES NONE
DRYER TOTAL MECHANICAL NONE
AMOUNT NONE
$NONE
VALUATION
BLDG/FIRE DEPT APPROVAL = KEVIN ELLIS
PERMIT FEE $30.00
PLAN CHECK FEE
"CALL 661-4140 FOR INSPECTION!"
UMBING FEE
ECHANICAL FEE
PART P/C FEE
SEPA REVIEW
PUBLIC WORKS
S.B.C.C. FEE
15.00
FIRE FEE
DATE:
$45.00
OTHER FEES
AMOUNT:
$45-00
AMOUNT DUE
RECEIPT: -4
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET.
OWNER OR AGENT DATE
PERMIT #. I FA
Job Address: *3 Y Q0 21.5 %^ Aft 3i L, . f&EO�'A-L AA l . WA
tstreet) (City) ISi+te) (Zip) Isate I)
Owner: A10A j A1957— Ola,'A!�04- Tenant Name: 5A -AA
Contractor: PO4 &/c'cdAW fl t (_ Tax Parcel ' /� '� "` d 4.-T e>
—No.
�-�C l Z ►�0 2 d- C� LSF -A -r2 tt� lA 4 k 3 6
Address: --
Phone: 20C 76'Contractor License #b�to�a 6 oi0? _Expiration Dated
(Card mut be presented) _----------- / � 7 1
Owner's Address: f -/ f e Phone: 1751z- J yam%
Contact Person: -TyM f'ZA . - /11 i C Phone: 72 -
PLEASE SUBMIT THREE (3) SETS OF FIRE ALARM WIRING DIAGRAMS, DEVICE LOCATION PLANS AND CUT
SHEETS WITH THIS APPLICATION.
INDICATE NUMBER OF ZONES ON PANEL, INCLUDING SPRINKLER ZONES, IF APPLICABLE: A) ,4
MAXIMUM PLAN SIZE = 24" X 36"
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 1 AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE
WORK FOR WHICH PERMIT APPLICATION'IS MADE. 1 FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERALIWAY AS
TO ANY CLAIM. (INCLUDING COSTS, EXPENSES, AND ATTORNEYS' FEES INCURRED IN 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 ARISE; OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS OFFICERS AND
EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY ASA PART OF THIS APPLICATION.
Owner/Agent: �'� �_._ Date:
Office Use Only (Please do not write below this line/
Remarks:
Department of Labor and Industries
Electrical Permit shall be posted Permit Fee (Includes First Zone) $30.00
at all fire alarm installations. Additional Zones @ $10.00 ea. 0
F D 'F--42- e 7f�--
O Received Total Fees $ y5 -.y0
Route to: Fire Department
Approved by: Date: 1-2— r f 0
CD046t
CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
BUILDING INSPECTION
661-4140
PERMIT NO.
OWNER'S NAME SITE ADDRESS
CONTRACTOR
ADDRESS
CONT. PHONE
CONT. REG. NO.
EXP. OWNER'S PHONE OWNER'S ADDRESS
TYPEJOB: NEWRESIDENCE
ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD.
NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY
(UNITS ) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO.
LEGAL DESCRIPTION
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
NE
SET BACKS: FRONT SIDE REAR
HEIGHT LIMIT
OCCUPANCY
TYPE OF CONSTRUCTION CENSUS NO._ TYPE OF HEAT----- _- BLDG. SQ. FT.
STORIES
PLUMBING
NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS
LAUNDRY DRAINS
FORCED AIR FURNACE DUCT WORK
SHOWERS
URINALS
GAS HOT WATER HTR. AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
CONVERSION BURNER MISC.
RETURNED
SINKS
MISC.
BBQ BASIC FEE
DISHWASHERS
TOTAL FIXTURES
DRYER TOTAL MECHANICAL
AMOUNT
VALUATION
BLDCi/FIRE DEPT APPROAI L = KEVIIN ELL
PERMIT FEE
PLAN CHECK FEE
"CALL 661-414c rw� INSPT1:CTIO'_V I p
PLUMBING FEE
MECHANICAL FEE
RT P/C FEE
SEPA REVIEW
PUBLIC WORKS
S.B.C.C. FEE
FIRE FEE
DATE:
OTHER FEES
AMOUNT:
AMOUNT DUE
RECEIPT:
ALL PERMITS EXPIRE
180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE
INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET.
OWNER OR AGENT
DATE
SET BACKS AND FOOTINGS
DATE ..._- .._.. BY
PLUMBING ROUGH IN
DATE __ BY
O.K. TO ENCLOSE FRAMING
DATE __ BY
FINAL O.K. TO OCCUPY
DATE 1Z " .f. BY
_..
O.K TO POUR FOUNDATION WALLS
DATE _ -- __ BY .....
WATERLINE O.K.
GAS PIPING O.K. _......__.
INSULATION
DATE __ ._ BY
m •
PSD
PLUMBING GROUNDWORK
DATE BY
MECHANICAL INSPECTION
DATE _........__BY --........
WALL BOARD AND FIRE WALL
DATE _ _- BY
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