01-102042 City of Federal Way -
Community Development Services Electrical Permit #:01 - 102042 - 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: GRACE CHURCH
Project Address: 1232 SW DASH POINT R a Parcel Number: 515320 0625
Project Description: ELE-Add(1)circuit for new gas furnace in accessory building of church.
Owner Applicant Contractor
Grace Ministries Northwest*Grace Ministries N GRACE CHURCH GRACE CHURCH
PO BOX 24000 1232 SW DASH POINT RD 1232 SW DASH POINT RD
FEDERAL WAY WA 98093-1000 FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
(253)893-5011
Electrical Fixtures
Description Quantity , "A" 'NLDescription.;I ;11,,1'''',, ° ,jQuantity1 Description Quantity
Circuits- Commercial 1
PERMIT EXPIRES November 19,2001,IF NO WORK IS STARTED.
Permit issued on May 23,2001
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. 2
Owner or agent: //�f//._f_ Date: Kr- /
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CONSTRUCTION PERMIT APPLICATION
RECEIVED APPLICATION NUMBER: aL - / Z 0�2 -00-a(_
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NUMBER: - -
MAY2 APPLICATION NUMBER: - -
**Th�tstip trntr� wAnformation-Please print(in ink)or type**
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Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
1 PROPERTY INFORMATION
SITE ADDRESS: /2. 2- 54) 44;41 J( 44 ASSESSOR'S TAX/PARCEL #:� /5 3 2{/ -0‘,25--
LEGAL
.2LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
M PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING V MBING ❑ MEC ❑ DEMOL ON
ELECTRICAL I NEERI LI FIRE • ' • •N SYSTE
PROJECT DESCRIPTI• . Provid• etailed •escription): `a• ' 'i' , "��t! A
Am a. AIL I ' ♦ • '.
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PROJECT NAME. 0a`_. a - � ..EI11113k
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��'�`1�f' '7-. ).
0, PEOPLE INFORMATION
'-111 IIIMM=L/� /, =ate 1. 1
PROPERTY OWNER: Nor, /I !/ i �� .� �•_ 21I � I A �l� 1
� ADDRESS( RE ADDR SS;C - ATE,Z P):
i: = r,o a-2FAVAPSiii-a' ' %WCONTRACTOR: � Tt` ri , Mi / / ilkDAYTIME PHONE,:,
AILING A.D• . STREET ADS•ES ;CITY, kiiiiipr,; i EEVENING PHONE:
441!‘„.) 411)6. , ` )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER:— — MAMIE.=
FAX NUMBER: -
( )
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) / /
APPLICANT: NAME: DAYTIME PHONE:
NC) ( )
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( ) -
RELATIONSHIP TO PROJECT: FAX NUMBER:
El ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: II •ROPERTY 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:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE Cl TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PRO]ECT 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) RANGES) 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) MP(S)
` N 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 s p1i to e city as part of this application.
NAME/TITLE: A5���2�G�o�t/K,0,4/'C� DATE: �e'3 07)PROPERTY OWNER ❑ APPLICANT ❑ CONTRA 1
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129