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• PERMIT 0°11,ir,HI 7-- FA *
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FIRE ALAR , ''': Rh/0Y A OPLI 0.1 TION '1' I'll
Job Address: Decatur High School, 2800 S.W. 320th Street, Federal Way, Wa. 98003
IStraeq Irar•rl IStetel MO ISu.te al
Owner: Federal Way School District �__ Tenant Name: Federal Way School District
Contractor: Sheppard & Nelson Electric-_ __ Tax Parcel ifi
Address: P.O. Box 3630, Kent, Wa. 98032-0210
Phone: 206-878-7333 Contractor License /l: SHEPPNE556JQ Expiration Date: 7-31-97
ICerA mace ba preeenteyl •--__
Owrwr'. Address: 31405 18th Ave. South, Federal Way, Wa. 98003Phone: 941-0100
-•- ---
Contact Person: Mike Carlisle
Phone: 839-9250
PLEASE SUBMIT THREE (3) SETS OF FIRE ALARM WIRING DIAGRAMS, DEVICE„ LOCATION PLANS AND CUT
SHEETS WITH THIS APPLICATION.
INCICATE NUMBER OF ZONES ON PANEL, INCLUDING SPRINKLER ZONES, Jr APPLICABLE: jr 4
MAXIMUM PLAN SIZE W 24" x 36"
If sill/® wr,70"!"'"°0141"1ewrwee "1000eq tarm Yr
I CERTIFY U1 DFR PEEVALTY OF PERJURY TWAT THE INE GRMAT$ON FUHNIb r
FIEU EY Mt:1 'TRUE Al1D:CORRECT`Td f{IC EtEe.7
OF MY F NOWLEDGE,AND F0RTHER THAT I AM AUTHCIR)Zeti 1W THE OWNER OF THE ABO PREMISES•TO PERFORM{THE
L.WORK FOR WHICH PERMIT APPLICATION IS DE.MAI.FURTIiER At REE•TO•SAVE HAIiMt ESS•THE CITY OF FEDERAL"WAY its
TO ANY C.I.ATM1INCLUDING COSTS EXPENSES AND AY TOANFYS'FEES INt.URREOIN INVttiTIGATION AND DEFENSE OF
SUCH,"CL\MJ WHICH MAYBE MADE BY ANY PERSON INCLU0ING.THL UNOERSIr;NED,AND FIL&..1 AGAINSFtIIE Ci'E'Y OF
FEDERr.' 1),tAY BUT ONLY WHERE SUCH CLAIM ARISES OUT:"'OF"1 HE'RELIANCC OF THE CITY:INCLUDING ITS OFFICERS AND
EMPLOYL t-5, UPON TNI ACCURACY;OF i'HC INFORMA1IQN SUPPLIED TO THTC CITY AS A PART OF THIS APPLICATION
i i‘ /Yc,, 4_,,,,,,,v,i,.212
Owner/Agent: / -y- 9A
Office Use Only fPlta.s ,do not Write below this lino) �,_— .
Remarks: .._._„_.,._._
Department of Labor and Industries _
Electrical Permit shall be pasted Permit-Fee (Includes First Zone) $30.00
at all fire alarm installations. ._ Additional Zones El $10.00 ea.
O Received Total Fees $
Route to: Fite Department_ - -�T- --.
Approved by:
C13049