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18-103849Electrical Oty of Federid Way Permit #:18 -103849 -00 -EL Community Development Dept. 33325 8th Ave S Federal Way, WA 98003 Inspection Request Line: (253) 835-3050 Ph: (253) 835.2607 Fax (253) 8352609 FILE Project Name: PANTHER LAKE TRAIL Project Address: 550 SW CAMPUS DR Parcel Number: 192104 9003 Project Description: Provide meter pedestal and service for site lighting Owner Applicant Contractor CITY OF FEDERAL WAY - DUMAS BAY WORF ELECTRIC WORF ELECTRIC CENTRE 5124 E BROCKDALE RD WORFEEI895C5 (1/23/20) 3200 SW DASH POINT RD SHELTON WA 98584 5124 E BROCKDALE RD FEDERAL WAY WA 98023 SHELTON WA 98584 Additional Permit Information Is this an Online or O.T.C. application? .................. Yes Alt. Srvc / Feeder 0 to 200 aml 1 Mast or Meter Repair (Comore 1 PERMIT EXPIRES Thursday, 22 August, 2019 Permit Issued on Wednesday, August 22, 2018 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy andJoe use will be in accordance with the laws, rules and regulations of the State of W shington and the City of Federal Way. Owner or agent: Date: �i -�- -X^�- i . 0, MY cf '4 Federal Way PERNM #: 18103849 00 THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record INSPECTION REQUESTS: (253) 835-3050 Address: 550 SW CAMPUS DR r Project: CITY OF FEDERAL WAY - DUMAS FEDERAL WAY WA 98023-8425 Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card. El UFER Ground (4295) 2 Ditch cover (4030) ® Slab/Concrete Floor (4253) © Approved Approved Approved Approved to place concrete By Date Date -'7 -'7 -: By Date ® Pool Bonding (4195) ® ® Temporary Power (4275) © Service (4235) -7 Approved IBY Approved Approved IBY Approved By Approved By Date By By Date By Date 1 7❑ Feeders/Sub-panels (4045) ® Rough Electrical (4225) ® Ceiling Cover (4020) Approved IBY Approved IBY Approved By Date Date By Date Final - Electrical (4055) Approved By Date k —Zj, �g Rough Electrical Final Electrical- Right of Way Approved Approved Approved By Date By Date By Date CITY OF 4A Federal Way RECEIVED ELECTRICAL AUG 22 2018 PERMIT APPLICATION CITY OF FEDERAL WAY COMMUNITf DEVELOPMEhti PERMIT NUMBER ( � I O OD - r,%:> SITE ADDRESS: Cf &) &1WqP ;f SUITE/UNIT/SPACE # P OJjV vECT VALUATION l0 Com% ASSESSOR'S TAX�RCEL # Q - —1 � 11/1 � 'V) O- CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeowner Last Name) �" L PROJECT DESCRIPTION Detailed description of work to be included on this permit only _ j Ll PROPERTY OWNER NAME d L ,& PRIMARY PHONE ( ) - MAILING ADIJRESS E-MAIL CITY STATE I ZIP ( PAX 1 ) - ELECTRICAL CONTRACTOR NAME�j� P Y PHONE (?r-)� MAILING ADDRESS /j 0- �/ l ¢S � � E-MAIL si,- lC , ( n Tj CITY ST TE ZIP FAX ( ) - WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE 20NAME FEDERAL WAY BUSINESS LICENSE # APPLICANT PRIMARY PHONE ( ) - MAILING ADDRESS E-MAIL CITY STATE ZIP FAX PROJECT CONTACT NAME PRIMARY PHONE ( ) I certify under penalty of pequry that I am the property owner or authorized agent of the property owner. I certify that to the best Of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. 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 o such claim), which may be made by any person, including the undersigned, and filed against the city, but only where such claim ses out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the ty as apart of this application. SIGNATURE: PRINT NAME: Bulletin 4160 — April 14, 2016 Page I of 1 Ul-landouts\Electrical Permit Application iM