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02-103420 ti '8 City of Federal Way Community Development Services Electrical Permit #:02 - 103420 - 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: BETHEL CHRIST CENTER Project Address: 103 MIRROR LAKE PARK Parcel Number: 072104 9003 Project Description: ELE-Low voltage TV and phone in residence.Home is located on church grounds at 414 SW 312TH ST. Owner Applicant Contractor BETHEL CHRISTIAN CENTER LINDSAY ELECTRIC LINDSAY ELECTRIC 414 SW 312TH ST LINDSAY ELECTRIC LINDSAY ELECTRIC FEDERAL WAY WA 98023 406 SW 312TH ST 406 SW 312TH ST FEDERAL WAY WA 98023 Electrical Fixtures Description ...; 3�% @escnptlon 4Quantity tw Low Voltage-Other Residential 1200 PERMIT EXPIRES February 5,2003,IF NO WORK IS STARTED. Permit issued on August 9,2002 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_•iii , Date: ca./ / 2_ 6- (z - z Z - Ai4-(y ,/4/ rcirf — p fro(c4 5 (,a-k\,o4 17-° 1•01, ‘16K-4D'S2C-- S 9` ;°„ CONSTRUCT I ION PERMIT APPLICATION VV FiY - APPLICATION NUMBER: 0 I o3 c(Z©- 6212 APPLICATION NUMBER: - APPLICATION NUMBER: - - **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. ' ' - ■ PROPERTY INFORMATION • SITE ADDRESS: Ion R\QROe. I.i. Pike_ ASSESSOR'S TAX/PARCEL#: - LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): d tJ CN v1/4P-C- Cw.Q-oLwas e_t+•vL .CN i S A-t /-1 l'-f SW ' 12.:4'. Sr : O) ==:- _=��--....- - - : .■ PROJECT INFORMATION - - -. . TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION PoELECTRICAL ❑ ENGINEERING CI FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): L\/ -T\I N.11) A .Q,,N� (N ;0 E PROJECT NAME: ■ PEOPLE INFORMATION , PROPERTY OWNER: NAM ' DAYTIME PHONE: - f,L ( -ç C rq (4S3 ) 939 -2Y$G MAILING ADDRESS(STREET ADDRESS;CITY,STATE,Il 1--(IL( -Svc) 3‘24''` S^ Fw 9302-3 CONTRACTOR: NAME: DAYTIME PHONE: . 1-I tv 9 gyp►'r' EL-CC-7 2 Lc_ ( ) MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: 4V(0 w '2112 6C- cv.) 98d2.-3 ( ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: ( ) CONTRACTOR'S REGISTRATION NUMBER:- ,L EXPIRATIONyDATE: 7 7, (copy of card required) 4 N 1 S. I4'. �T v a 1 J ©i / 2Y T/ / APPLICANT: NAME: DAYTIME PHONE: Pt4Ut0 Li.0054:r) ( ) - MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: ratJTR V ( ) - RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) - j E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: Cl PROPERTY OWNER ❑APPLICANT ❑ CONTRACTOR ■ DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES 0 NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTION ONLY** • NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PRO3ECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: .u- •....- . w.a.c,e+....� .-.•..?...:...ww�.. r. .SriC`e�.GY/'YJ. iCHIYL'1M`fAYNI�iFIAeURES'}tJ;r'YxNaY•.S'F�i-nW'+.f.M•r�,i�yj11.+icv;3tfiL"1i:aAiVy?rM Vi.:T�1(?„lv.�ki.4+p, 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) BOILER(S) 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) ■ '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,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 daim(induding costs,expenses,and attorneys'fees incurred in the investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE: DATE: g / 5/02- El / //O'L❑ PROPERTY OWN ❑ APP CANT ❑ CONTRACTOR FOR°OFFICE USE"ONLY:"=j NE gs,❑AD,pITIUN -?❑:ALTERATION ' ; ,REPAIR 4 B ENANL:IMPROVEMENT m ': =CE1!ISUS CODE: G €cx r:' W2ae Mgd-trK ;_ �OhIYNG..ESfGNATI'0 _ z BUILDING=SHELLOfVLY?rii+❑YEMC3WO, AF4=` COMPX1DESIGNATIO _ _-_, -3" `g S C lA ? _ � _ fS TI�OMO 4' ECTION TUWNSIII07- f,fd, ` -6 HADD ER�SS-REQl11RED?agri5.B EES"0` O f1O -- PLATTED a- _ri A sn: >..._� - LOT? D YES. O=N :-Efai GEOFUSE?.:, ;;;"7.7,-f.-.❑ E ::_s �.NO:.s.z` �Y COMMUNITY DEVELOPMENT SERVICES_•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.cityoffederalway.com