01-103835 at of Federal Way
Community Development Services Electrical Permit #:01 - 103835 - 00 - EL
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: ALBERTSON'S
Project Address: 31009 PACIFIC IL.NWy$ Parcel Number: 082104 9062
Project Description: ELE-Installing L/V fire alarm system in portion of grocery store
Owner Applicant • Contractor
AMERICAN STORES PROPERTIE S&S SECURITY SYSTEMS INC S&S SECURITY SYSTEMS INC
S&S SECURITY SYSTEMS INC S&S SECURITY SYSTEMS INC
11823RD ST SE 11823RD ST SE
PUYALLUP WA 98372 (253)845-8665
Electrical Fixtures
Description oil:(Quantity] Description (Quantity :;:aDescription (Quantity
Low Voltage Fire Alarm-Commercia 33600
PERMIT EXPIRES March 30,2002,IF NO WORK IS STARTED.
Permit issued on October 1,2001
•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: O ��� Date: l b/( /01
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«.,f <- RECEIVED BY
� ..CONSTRUCTION PERMIT APPLICATION
rntnaUNITY DEVELOPMENT DEP V F APPLICATION NUMBER: L 4'&kOCT 0 12001 appLICA'IflNNMBER >_»:
**ThedoNowing is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
CIO
9 /1 ',■ PROPERTY INFORMATION �7
SITE ADDRESS: . ! CV J2 (�(f'/( / J.V $ ASSESSOR'S TAX/PARCEL#: Q X0L 1 Q - 1e) z
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑MECHANICAL ❑ DEMOLITION
ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
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S1/517731 IN Pogfiati or ecav / $7Z3 e-
PROJECT NAME:
U PEOPLE INFORMATION
PROPERTY OWNER: NAME: , DAYTIME PHONE:
fit j727-5 A)s #li90 (153 )$S 9 - 4723
MAILING ADDRESS(STREET ADDI SS;CITY,STATE,ZIP):
CONTRACTOR: NAME: DAYTIME PHONE:
S # 5e 1y Sy5/tm s iu ( )8115 -g2(65
MAILING ADDRESS(STREET DRESS;CITY,STATE,ZIP): EVENING PHONE:
,iso &K 159 Pttok i 9839/ (I )
CTTY OF FEDERAL WAY BUSINESS UCENSE NUMBER: FAX NUMBER:
�q112ILg55 - 0 050V81/5go?
CONTRACTOR'S REGISTRATION NUMBER: """ ^��• T /� EXPI DATE:: /�
(copy of card required) 5 SI. E l SX 11 2 2 C[P `7 1 /i / CJ p2._,
APPLICANT: NAME: Ir5DAYTIME PHONE:
141)1
MAIUNG ADDR (STREET ADD ;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 ARCHITECT ❑TENANT ❑OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑APPLICANT CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 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 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 BREAKERS) ❑ 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(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 c as a part of is applicatioon/.'r� ,�' C� �J/n f!
NAME/TITLE: �I ^ , 1 (lll ,1Wh(I'[ak�k DATE: ! ' (' (! I'
❑ PROPERTY OWNER APPLICANT ,CONTRACTOR
FOR OFFICE:USE:ONLY::>::
❑ NEV1l . ......::a.ADDITION ❑:.ALTERATION ............❑.REPAIR..:...:. ::'of:TENANT:IMPROVEMENT:......... :::
':ZONING DESIGNATION <:'.BUILDINGSHELL.ONLY:::::>a3:.YES:::• o:.MO...:.:. :::::: ': ::
>COMP PLAN DESIGNATION
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COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129