05-103500 r
City of Federal Way Electrical Permit #: 05 - 103500 - 00 - EL
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax (253)835-2609 Inspection request line: (253) 835-305C
Project Name: UNDERHILL
Project Address: 30149 10THeyeAvei Parcel Number: 515320 0427
Project Description: Installing a new LN intrusion alarm
Owner Applicant Contractor
KEVIN T UNDERHILL BRINKS HOME SECURITY INC BRINKS HOME SECURITY INC
30149 10TH AVE SW 19115 WEST VALLEY HWY SUITE H-106 19115 WEST VALLEY HWY SUITE H-106
FEDERAL WAY WA 98023 KENT WA 98032 KENT WA 98032
(425)251-9727
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Low Voltage Burgler Alarm-Residen'I 1790
PERMIT EXPIRES January 15,2006.
Permit issued on July 19,2005
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 tate State of Washington and
the City of Federal Way.
Owner or agent: See Application Date: !c (0C
II
THIS CARD IS TO REMAIN ON-SITE - '
C, of •
ACommunity Development Inspection Record _
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-103500-00-EL
Owner: KEVIN T UNDERHILL
Address: 30149 10TH AVE SW
FEDERAL WAY, WA 98023-8208
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
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.
O Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) 0 Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
O Rough Electrical(4225) ❑ Ceiling Cover(4020) Final-Electrical(4055)
Approved Approved Approved
By Date By Date B Iwo Date 1 e
❑ Under-slab groundwork(4295)
Approved
By Date
i
' b06, 556 7 ° (� - I 0 0 0
`"YOF CEIVED BY � �
. Federal Way Y EVELOPMENT DEPARTME 77
P :'•�' ` bF MF CO M 0'1, DE EN
, COMMUNITY DEVELOPMENT SERVICES
33325 8711 AVENUESWATH• BOX 9718 APPLICATION?-005 TDFP
FEDERALL WAY,WA 98063-9718
• 253-835-2607•FAX 253-835-2609
www.cituoffedernlwau.com
The ollowi • is re•uired in ormation-an inco •lete a••lication will not be acce•ted. Please •rint •ibl in ink or • .
/^�1p t ' • PROPERTY✓ LINFORMATION
✓�
SITE ADDRESS `")V 4 q b /0 1, I (,�� SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# I ✓ LQ 0 - 0 ! 3 '7 LOT SIZE(sfl
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
❑ DEMOLITION X ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
.�rrr03iDr- elk? I
PROJECT NAME(Name of Business or Owner Last Name) w 1 n V nd r
• PEOPLE INFORMATION
PROPERTY NAME n �/� /�I)/// PRIMARY PHONE/J / •
��
OWNER I� ' )I 1 tide
�W l y ] /�^) S 7"7 - l 7
W II—1 DRS 11 /014.1aut.
_ ,,,x,7,
�1.�1 P it�((,{/ W!/ / S2'
CONTRACTOR /OMPANY NAME APPLICANT NAME 1 OFFICE PHONE
IP 5 iiia - . . 'J -0411 t Ajf17077 ( 9.2 .)- . --/- 97z7
MAILING
ZIP
CELL PHONE
1II1Jt/ ) � A �tL� Q�4�2
CITY OF FELUSI SSL NUMBER O EXPIRATION (AX NUMBER
c -' 19_-.92_- I a az g9_- OL ( )
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
brLfl 1 / g e_ / /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
( )
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
.l�• ( ) -
t RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect o Tenant ❑Agent ❑ Other(Describe) ( ) -
CONTACT I NAME I PRIMARY PHONE CL4
E-MAIL ADDRESS
LENDER Per RCW 19 7 095 L ender nform ion 1a'1 (AME ) �,required ffprx. ec#,value exceeds$5,000 --��
MAILING ADDRESS CITY,S ATE,- IP
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VAL • PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE S • . -1 ak.SION SYSTEM PROPOSED/REQUIRED? o YES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN : •IGHLINE o TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ L• . - ' 0 HIGHLINE o PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ. FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
-FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE [I CARPORT p
EXISTING PROPOSED TOTAL TOTAL EXISTING BF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHAIVICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE GAS LOGS REFRIG.SYSTEMS
COOLERS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower SHOWERS WATER CLOSETS MISC(Describe)
Combo) (Toilet)
DISHWASHERS SINKS DRINKING
FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
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 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. /� �j
NAME/TITLE 6�/70 c `�y�///// DATE / i ` (
(Signature)
(Title) I
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent frContractor 0 Architect ❑ Other
FOR Oi)'�k'ICE USE ONLY
o NEW o ADDITION ❑ALTERATION o REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? ❑YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES o NO
Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application