01-101154_ DECEIVE[ CONSTRUCTION PERMIT APPLICATION
uV FT)-"El�L MAR Z %O�i PPLICATION NUMBER:
PPLICATION NUMBER: - - _
G►tY OF FEDERAL WAY APPLICATION NUMBER: -
BUILDING DEPT. — — — — — —
**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: / ! % S.> l �fh /" /4�� ASSESSOR'S TAX/PARCEL #: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
TYPE OF PROJECT (This application)
PROJECT DESC
PROJECT NAME:
CONTRACTOR:`
APPLICANT:
N
DAYTIME PHONE: !
(206 ) 66U *'780
AILING ADDRESS VREET AD ESS; CITY, STATE,
EVENINGG PHONE:
(J&G) &A-0 ��'Ox U
F FEDERAL WAY BUSINESS N ER:
FAX NUMBER:
7
CONTRACTOR'S REGISTRATION BER:
EXPIRATION DATE:
/�/ �[ ff y/�
(copy of card required) / i r _ `L a /� / �
%
NAME: DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
EXISTING USE:
PROPOSED USE:
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED VALUATION FOR IMPROVEMENTS: $
❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
❑ NO
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS` I
FLOOR
EXISTING S . FT.
PROPOSED S . T.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAINS)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERT(S) RANGE(S) MISC. ( )
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINAL(S) WATER HEATER(S)
RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINK(S) WATER CLOSET(S) MISC. ( )
SUMP(S)
'%=rtATMER/STGNATURE BLC
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.
NAME/TITLE: h ek_ DATE: 03 - 2 7 -® 1
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
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
C(IMMI IN ITY nFVFI (1PMFNT SFRVIFFS - 33530 FIR CT WAY MIMI . P () RC)Y 9718 - FFDFRAI. WAY. WA 98063-9718 - 2S3-661-4000 -FAY* 2;"1-(,61-4129
City of Federal Way
Community Development Services Electrical Permit #:01 - 101154 - 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: TRINITY BROADCASTING OF WASHINGTON
Project Address: 1909 S 341ST Parcel Number: 390380 0030
Project Description: EL-Install feeder for emergency generator.
Owner Applicant Contractor
TRINITY BROADCASTING NETWORK*Bro; TRINITY BROADCASTING OF WA INTEGRITY ELECTRIC
1909 S 341ST PL 1909 S 341ST PL 5131 S 291ST ST
FEDERAL WAY WA FEDERAL WAY WA 98003 AUBURN WA 98001
98003-6006 (206)660-8780
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Alt.Sett'./Feeder up to 200 amps-Co 1
PERMIT EXPIRES September 23,2001,IF NO WORK IS STARTED.
Permit issued on March 27,2001
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: - Date: 2 - Q /
G/ /I4,./ 0-1 5,e"7
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