03-103200 City of Federal Way
Community Development Services Electrical Permit #:03 - 103200 - 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: DACE
Project Address: 102 SW 301ST 5fi Parcel Number: 662080 0010
Project Description: Intrusion alarm
Owner Applicant Contractor
W Dean Dace &Darlene F Dace BRINKS HOME SECURITY INC BRINKS HOME SECURITY INC
102 SW 301ST ST 19115 WEST VALLEY HWY SUITE H-106 19115 WEST VALLEY HWY SUITE H-106
FEDERAL WAY WA KENT WA 98032 KENT WA 98032
98023-3562 (425)251-9727
Electrical Fixtures
� . . .. ;" .1I 1, ... VVI,f..� „.1 pion yA, Wittifki rafk ,Qesc1.tptiQl ..,.._
Low Voltage Burgler Alarm-Residen 3650
PERMIT EXPIRES January 31,:2004.
Permit issued on August 4,2003
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: SE 17p •0-7/1 Date:_WWI) 3
I----)AAQ \4___
al .o c, p 9 &Ada
ELLtrj
•
CdMMU RE
41111144t ^'nyo�[/FC (11 Py CONSTRUCTION PERMIT APPLICATION
CITY OF
,�.ICATIONNUMBER: 03 - IQ3oZOa -
FeWay deralAUG ` zoo,. 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: 102 SW 301ST STREET ASSESSOR'S TAX/PARCEL 662080-0010
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING o PLUMBING o MECHANICAL ❑ DEMOLITION
XX ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): INTRUSION ALARM
PROJECT NAME:
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
W.D.DACE ( 253 ) 941-0385
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
102 SW 301ST STREET,FEDERAL WAY,WA 98023
CONTRACTOR: NAME: DAYTIME PHONE:
BRINK'S HOME SECURITY ( 425 ) 251 - 9727
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
19115 W VALLEY HWY#H106, KENT,WA 98032 ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
19-98-105789-00-BL ( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) BRINK HS L48 LE
APPLICANT: NAME: DAYTIME PHONE:
( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT o TENANT o OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑APPLICANT o CONTRACTOR
• PROJECT INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES ❑ NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
• FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING EVAPORATIVE GAS LOG(S) REFRIG.SYSTEM(S)
UNITS) COOLER(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 o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER VACUUM BREAKER(S) ❑ ELECTRIC o GAS
SYS.
DRINKING SHOWER(S) WASH MACHINE
FOUNTAINS) 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 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.
il
NAME/TITLE: 4 l.r c�Z� � (�1 //•// %./i/ DATE:
❑ PROPERTY OWNER o APPLICANT ,CONTRACTOR
FOR OFFICE USE ONLY:
o NEW o ADDITION o ALTERATION ❑ REPAIR o TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? o YES o NO
COMP PLAN DESIGNATION BASIC PLAN? 0 YES 0 NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? o YES ❑ NO
PLATTED LOT? 0 YES o NO CHANGE OF USE? ❑ YES o NO