HomeMy WebLinkAbout15-106187 KGS. vw
• 4114 ._„
DEC 07 2015
CITY OF CITY OF FEDERAL WAY ELECTRICAL
Federal Way CDS PERMIT APPLICATION
PERMIT NUMBER / 5 _ / 0 , / g. 7-
SUITE/UNIT/SPACE
#
SITE ADDRESS:
3Z /CD PC{_ Hwy 5 .
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
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PROJECT NAME
(Tenant or Homeowner Last Name) CiAc( f,c,- y,-) Je c,
PROJECT DESCRIPTION (2eia),IV, (n '-{moi" -f-c Win(, ( Cc.L.J,Te_S )
Detailed description of work to
be included on this permit only
NAME sem, PRIMARY PHONE
PROPERTY OWNER � -e.r'-c,�^e-�r'l (-_,/,:.-c-
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MAILIN DRESS E-MAIL
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CITY /STATE ZIP FAX
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NAMEPRIMARY PHONE
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MAILING ADDRESS E-MAIL
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CONTRACTOR CITY / STATE ZIP FAX
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WA STATE CONTACTOR'S CENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME1 PRIMARY PHONE
APPLICANT IraS r\ (LCE-16:I'Z lig ( :'-)5)64 3 f? a) `)-
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
PROJECT CONTACT a (?6 )( faeZ
I certify under penalty of perjury 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 of such claim), which may be made by any person,including the undersigned,and filed against the city,
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.
SIGNATURE: DATE /7- -/s
J
PRINT NAME: 4A--6,7) 0=rl' :r-I GN-.„
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application
0 • Electrical
City of FedEcoeralway Permit #: 15-106187-00-EL
Community&Econ.Dev.Services
33325 8th Ave SF I I_E
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: EVERGREEN SALES
Project Address: 33216 PACIFIC HWY S Parcel Number: 797820 0010
Project Description: Repair meter to panel.
`
Owner Applicant Contractor
JOHN TSAKONAS AYSHA PIKO D&A ELECTRIC LLC
EVERGREEN SALES&LEASE INC D&A ELECTRIC LLC DELEC*E897D5(4/5/17)
PO BOX 3350 11909 VICKERY AVE E 33410 30TH AVE SW
FEDERAL WAY WA 98063 TACOMA WA 98446 FEDERAL WAY WA 98023
Additional Permit Information
Electrical Work Valuation? 600 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? • No Service greater than 999 Amps? No
Electrical Fixtures
Mast or Meter Repair(Commercia 1
PERMIT EXPIRES Saturday, June 4, 2016
r,r.f-ri'VriAlThsued on Monday, December 7, 2015
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: /7- 7/i
1-fVf4
THIS CARD IS T MAIN ON-SITE -
.
CITY OF ' h�
Federal WayConstruction In ection Record
INSPECTION REQU TS: (253) 835-3050
PERMIT#: 15-106187-00-EL Address: 33216 PACIFIC HWY S
Project: JOHN TSAKONAS FEDERAL WAY, WA 98003-6438
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) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) CI Service(4235)
Approved Approved Approved
By Date By Date By Date
/
El Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
o Final-Electrical(4055)
Approved
By Vwj Date tL l yl f 1-
c la 14' i 4 V' tkev
J Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
