96-103048 96. /a.�oyg
CITY OF FEDERAL WAY FIRE PROTE�TI�ON SYSTEM PERMIT PERMIT NO.: FP896-0042
33530 First Way South FIRE DEPARTMENT INSPECTION - 946-7318 ISSUED: 09/27/96
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 515 S 312TH ST
PARCEL NO.: 082104-9038
PROJECT DESCRIPTION: FPS — INSTALLATION OF UNDERGROUND SUPPLY LINE.
041NER CONTRACTOR LENDER
ST LUKE'S LUTHERAN CHURCH SMITH FIRE SYSTEMS
515 S 312TH ST 1106 54TH AVE E
FEDERAL WAY WA 98033 TACOMA WA 98424
839-0172 926-1880
SMITHFS1360T
SPRINKLERS?........:? HOOD & DUCT?.......:? FEES:
# ZONES..........: 0 OTHER.....: FPS PRMT ISSUANCE. $ 20.00
fIRE ALARM SYSTEM?.:? EXTENT OF WORK...:? FIRE DEPT FEE......* $ 19.00
# ZONES..........: 0
STANDPIPE?.........:?
UG FIRE SERVICE?...:?
FIXED SYSTEM?......:?
TOTAL FEES $ 39.00
INSPECTION RECORD
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT DATE � — � 7— ��
fps_prmt 07/01/92
a,,,� � _ . ,�.� City of Federal Way
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�`� � APPLICATION FOR BUILDING PERMIT
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°LEASE PR/NT �� ���`:s � �`��" APPL/CAT/ON #: Z
SITE LOCATION Add.ess ��S � -}-,,,
Tena�t (if known) �� / � �C Lot A� Assessor's Tax#
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Buiiding Owner Name Address
City State Zip Phone
Nature of Work (�{ N ��r- rU K / � `�
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APPLICANT
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Address
City State Zip
Contact Person Day Phone Other Phone Fax
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BUII,DING'CONTRACTOR
CompanyName /
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Address •
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City 4 c�y.�� State � Zip �f�
Co�tact Person '/� Pho�e Fax
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Contractor's �f (card must be presented) Expiration Date Verified ❑ Yes ❑ No
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ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
.EGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Hev 4!931
�`�"U�T� I ig Use / 1 osed Use / r- /
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Permit includes: ❑ Buildi�g Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential �New ❑ Remodel O Number of Units_ ❑ Deck
Commercial O Addition ❑ Garage ❑ Shed ❑ Othe�
Ente� tst Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basama�t sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability O On-Site Septic System Availability ❑ Project Valuation> S "�'<�"'
�;�
Zoning Lot Size s F�cisting Bldg Va(uation; $
_ _ _ _ _ _ __ _ __ __ _
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_ __ __ _ __ _ _ __ _.... ..
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Y;ENDER
Name Address
City State Zip
MECHEINTCAL.C�NTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
P1�11�IBING CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes O No
_ _ _ __
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_ _. _ __ _ _._ _ __ _ ___ ...
__. __.. _ _ _ _ __ __ __ .. ......
__. . _ _ __ __ __ _ _ _ __....._...
rLu�IIvc �ru� couNr > ;
Water Cfosets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fxture Cijunf
MECIIANICAL UNIT GOUNT
Fuel Type (electric/other) Gas Oryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Nood Boilers Above Ground
Conv Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons 7otal Unit CounL
DISCLAIMEA: I certify under penalty of perjury that the information furnished by me ie true and correct to the best of my knowledge a�d furthor thet 1 am euthorized by the owner
of tha ebova premises to perform the work for which permi[epplication is mede.I further egree to eave harmless the City of Federal Way as to any cleim(including costs,expe�ses,
end ettorneys'fees incurred in investigation and defe�se of such claim�,which may be made by any person,includi�g the undersigned,and filed against the City of Federal Way,
but only where suc claim erises out of the refiance of the City, including itc officers a�d employees,upon the eccurecy of the i�formation supplied to the City es e part of this
application.
OwnedAgent Date: _ � `C ^ �� ._