04-101244 le 1
P
City of Federal Way
Community Development Services Electrical Permit #:04 - 101244 - 00 - EL
33530 Ist Way S
Federal Way,WA 98003-6210
Ph:253 661 4000 Fax 253.661.4129 Inspection request line: 253.835.3050
Project Name: CHRIST CHURCH
Project Address: 941 S DASH POINT Parcel Number: 052104 9092
Project Description: Install(7)thermostats and sensors
Owner Applicant Contractor
CHRISTS CHURCH AT FED WAY AIR SYSTEMS ENGINEERING INC AIR SYSTEMS ENGINEERING INC
941 S DASH POINT RD 3602 S PINE ST 3602 S PINE ST
FEDERAL WAY WA TACOMA,WA 98409 TACOMA,WA 98409
98003-3795 (253)572-9484
Electrical Fixtures
T Description Quantity Description Quantity Description Quantity
Thermostat 7 1
PERMIT EXPIRES October 2,2004.
Permit issued on April 5,2004
I hereby certify that t- above inf. ;on;` correct a a at the construction on the above described property and
the occupancy and th i .e , ' .e m ac • dance `' 1 li laws,rules and regulations of the State of Washington and
the City of Federal WA.
Owner or agent: A NA A
_, fi7...n. Date: q- V - y
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INSPECTION LOG ytt-
DATE INSPECTOR OK CORR/REJ AREA AND TYPE OF INSPECTION
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Fed11eral Way PERMIT
COMMUNr1YDEVELOPMENrSERVICES SF MF- CO MF EI PL DE EN FP
33530 FIRSTDEKA WAY SOFA • 6 BOX 9718 A p p L I C A T I O �P R® 1
FEDERAL WAY, FAX
53-63-9718
253-6614115• FAX 253�b61-9129
www.titvoJTederdwav rom
TY OF FEDE
The oliourin is required information - an fncom Tete a iication iT , �dT Please -int ie ibi (in in11or
PROPERTY1• • •
SITE ADDRESS �j C J . SUITE/UNIT N
ASSESSOR'S TAX/PARCEL 1 0 3 0 '�f 0 - O Q J ()_ LOT SIZE (sJ)
LEGAL DESCRIPTION (e.g. AcmeMes, Lot 1)
(Attach upasate page[ lengthy legd d—p.-)
PROJECT1 • - t t •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed des tion of work included on this Der7ntt on1
t( -P ��nt PC'C (Orl n -enol L�✓I�Q�CI(-C)Cr�
�-
PROJECT NAME (Name of Business or Owner Last Name)
PEOPLE1 •R •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
NAME PRIMARY PHONE
/�G`��"cl In SQ `1UC.c (Y -, l cry ` (`L ) 1 -Lk 1,51
MAILING ADDRESS CITY, STATE, ZlP
qjo Cel
COMPANY NAME APPLICANT NAME
0�' c3cv- w
OFFICE PHONE
(Z�"3) G�3
ICA f
i
MAILING ADDRESS CITY, STATE, ZIP
\c�3 N,- S� A K)
CELL PHONE
t2rnGG
- Gi3C
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
a -�_ �_ -k o_ t '_� S -] -l2 / 3 I C)q
FAX NUMBER
(2 53) P63
- 13-19
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application)
_ C�'T'� L�� 34 4 6 U
EXPIRATION DATE
7 /7i / 05-
C PANY NAME
\ C C) �?,n c
APPLICANT NAME
l� r -,� c.�1
OFFICE PHONE
2S3) -o4s4
MAILING ADDRESS
1L 2
CI+TY, STATE, ZIPCELL
Jc n�,r)QrC,�• �i � SRC)
PHONE
(q?," 76C -C>\-36
RELATIONSHIP TO PROJECT \\ \\ \
❑ Architect 11Tenant El Agent Other (Describe) SU'XG�C C -t-
FAX NUMBER
(2 M) X3 - i3 -
P
YHON -
LENDER Per RCW 19.27.095:Lender information is NAME
required ifproject value exceeds $,000
MAILING ADDRESS CITY, STATE,
EXISTING USE
EXISTING ASSESSED/APPRAISED VALUE $
DETAILED BUILDING INFORMATION
PROPOSED USE
VALUE OF PROPOSED WORK $
E-MAIL ADDRESS
parcl roc, I Q l(Ja�l . rle-
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE (SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
o ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
FIRST
BASIC PLAN? o YES
o NO
ZONING DESIGNATION
SECOND
CHANGE OF USE? o YES
o NO
NEW ADDRESS REQUIRED? o YES ❑ NO
THIRD
o NO
PLATTED LOT? ❑ YES o NO
DEMO PERMIT REQUIRED? ❑ YES
FOURTH
ADDITIONAL FLOORS (DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
TOTAL L'XiS TING
TOTAL PROPOSED
TOTAL EXISTDIG AND PROPOSED
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS(., T�b/Sh— combo)
DISHWASHERS
GAS PIPE OUTLETS
WASHING MACHINES
EVAPORATIVE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS
RANGES
GAS WATER HEATERS
WATER CLOSETS (rode, _
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
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 relianceo e ejty�incjing itspfficers and employees, upon the accuracy of the information supplied to the city as a part of
this application. l�Q
NAME/TITLE _ (�4 / -' 62
(Signature)
RELATIONSHIP TO PROJECT ❑ Owner
(Title)
❑ Agent ❑ Contractor ❑ Architect
DATE
N(Other
FOR OFFICE USE ONLY
o NEW o ADDITION
o ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES c NO
BASIC PLAN? o YES
o NO
ZONING DESIGNATION
CHANGE OF USE? o YES
o NO
NEW ADDRESS REQUIRED? o YES ❑ NO
UP/SEPA/SU? o YES
o NO
PLATTED LOT? ❑ YES o NO
DEMO PERMIT REQUIRED? ❑ YES
o NO
Bulletin #100 — March 30, 2004 Page 2 of 4 k\Flandouts — Revised\Pennit Application