02-102324R
City on FederalElectrical Permit #: 02 - 102324 - 00 - EL
ty Development t Services
Communityty
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: NORTHWEST CHURCH 6 A oZ
Project Address: 34800 21ST SW Parcel Number: 542350 0630
Project Description: ELE - Install low voltage security alarm and access control; also includes conduit work A1016, �LARAj
o
Owner
Applicant
Contractor
NORTHWEST CHURCH *NORTHWEST CHt
MODERN SECURITY SYSTEMS INC
MODERN SECURITY SYSTEMS INC
PO BOX 25110
PO BOX 98042
PO BOX 98042
FEDERAL WAY WA 98093-2110
TACOMA WA 98498-0042
TACOMA WA 98498-0042
(253) 584-1879
PERMIT EXPIRES December 2, 2002, IF NO WORK IS STARTED.
Permit issued on June 5, 2002
•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. r� ,,
Owner or agent: �` Date:' 0�KllaiG� �—
t _ W A If L Q� L E �!� Ca v Gel ` S ►� /L i�u �l Y—
4 01J 4 �2� +D 3, - 25-
01 ee
ti Cey vc4 M �t'� N C Fi�lts
0
c CPS 62,21 D 11'r i —2-C —0 Z- -'e?o
City unity Development Services Federal Way
Community Electrical Permit #:02 -102324 - 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: NORTHWEST CHURCH
Project Address: 34800 21ST SW Parcel Number: 542350 0630
Project Description: ELE - Install low voltage security alarm and access control
Owner
Applicant
Contractor
NORTHWEST CHURCH *NORTHWEST CHL
MODERN SECURITY SYSTEMS INC
MODERN SECURITY SYSTEMS INC
PO BOX 25110
PO BOX 98042
PO BOX 98042
FEDERAL WAY WA 98093-2110
TACOMA WA 98498-0042
TACOMA WA 98498-0042
(253) 584-1879
Electrical Fixtures
Low Voltage Burglar Alarm - Comm 45356
PERMIT EXPIRES December 2, 2002, IF NO WORK IS STARTED.
Permit issued on June 5, 2002
• 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:
0
iDEPAR nwm of ComKlnvrry DEvn omni r SERVICES
33534 First Way South
dI1'�ON"
PO Box 9718
• VISION DATE Federal Way WA 98863.9f18
253-661-4000; Fax 253-661.4129
JuN' ' wwwAlederal-wuy.waus -
4
APPLICATION FOR BUILDING RE'VISI'ON
}
Original Permit Number:. 0 A ' 10 rZk;� `t
Site Address: c,l �-QQ "d►� / S �' �GCJ
Building OwnerfFenant: ,1y itf/l a"f C /4UAC.Al
Contact Person: %%C Phone: a.f'3 , s rY 7f
Nature of Revision(s): j"/14
Revision Valuation: 1—
Owner/Agent:. Date: B 6A-11-9p—az
Bulletin #I I Z - April 6, 2001 Page I of 1 k-Mandouts — Revisedlhpplicatimi for BW$ Revision
RECEIVED
;°� G CONSTRUCTION PERMIT APPLICATION
> A-0 JUN Q 5 2002 APPLICATION NUMBER: 0 - J
CITY OF FEDERAL WAY
APPLICATION NUMBER: _ _ -
APPLICATION NUMBER:
BUILDING DEPT. - --- - - - - _ _ - _ _
**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.
SITE ADDRESS: 3 70EN ''pZ 5 ►W ASSESSOR'S TAX/PARCEL #: 5
_dG 3 o
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
I" L ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
PROJECT NAME: -fiAgn wi� 51-
■ PEOPLE INFORMATION
-PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
7
NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS, CITY, STATE, IIP).
wq 9gcb?3
NAME:
5�rtcrG t s � M
�,
OAYIIME PHONE:
053 )5(9V
-1�?9
MAILING ADDRESS (STREET ADDRESS; STA ZIP):
' �iSo� l� Iwl�vd
984�Q��o�l
EVENING PHONE:
(�s38Y
-� z
OF FEDERAL WAY BUSINESS LICENSE NUM)R:
-53
FAX NUMBER:
)�8y
-:,y3�'
CONTRACTOR'S REGISTRATION NUMBER:
(copy of card regLdred) m o o 2Si .S
1� 6�
EXPIRATION DATE:
O3 /03
/ 3
-J-D X53 )59 -1879
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
P,O, (Z3 )5A/
RELATIONSHIP TO PROJECT. FAX NUMBER:
❑ ARCHITECT ❑ TENANT NfOTHER ( DESCRIBE):
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: 11 PROPERTY OWNER 11 APPLICANT CONTRACTOR pfCdP"mUu6c�r t�>,► S•
DETAILED BUILDING INFORMATION
EXISTING USE:
PROPOSED USE:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? ,04YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 11 HIGHLINE 11 PRIVATE (SEPTIC)
f
**NEW RESIDENTIAL CONSTRUCTION ONLY"
NUMBER OF BEDROOMS:
ESTIMATED SELLING PRICE:
■ PR03ECT 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)
DUCTS) 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 r
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUMP(S)
•BLOCK
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 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 (including costs, expenses, and attorneys' fees incurred in the
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 arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information supplied to the city as a part of
this application.
NAME/TITLE: •- '-C- S� G:I�� DATE:
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
CDMMUNnY DEVELOPMEW SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 2S3-66111129
www.ctyoffedmlway.com