13-103001-00Electrical
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Permit #: 13-103001-00-EL
Inspection Request Line: (253) 835-3050
Project Name: CENTURY LINK FTTN SITE
Project Address: 1ST AVE S Parcel Number:
Project Description: Installing a new 100 amp 120/240 V service, ground grid, and two 15 amp 120V receptacle
circuits.
** LOCATION OF WORK: On ROW at SW corner of intersection at 1st Avenue S and
SW 304th Street. **
Owner Applicant Contractor
CITY OF FEDERAL WAY THOMPSON ELECTRICAL CONSTRUCTORS THOMPSON ELECTRICAL
33325 8TH AVE S INC CONSTRUCTORS INC
FEDERAL WAY WA 98023 PO BOX 45260 THOWECO08CW (2/16/14)
TACOMA WA 98445 PO BOX 45260
TACOMA WA 98445
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Service greater than 999 Amps? .............................No
Electrical Fixtures
Circuits - Commercial.. . ............. -- 2 New Service: 0 - 100 amps (Comm 1
PERMIT EXPIRES Saturday, January 4, 2014
Permit Issued on Monday, July 8, 2013
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: �iZEc� E� Date: 3
THIS CARD IS TO R> MAIN ON -SITE
Federal Wa Construction Ins ection Record
y INSPECTION REQQUEVTS: (253) 835-3050
PERMIT #: 13-103001-00-EL Address: 1 STAVE S
Project: CITY OF FEDERAL WAY FEDERAL WAY, WA
Scheduled inspections may be failed ifthis card is not on -site. DO N T LOSE 1'HI5 CARD- Inspections are listed as close to sequential order as
possibie (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.
❑ UFERAGp rouno ed d (4295) ❑ Ditch cover (4030) 1-3Service (4235)
Approved Approved
By Date By G:, Date �B Y Date
❑ Feeders/Sub-panels (4045) ❑ Rough Electrical (4225) ❑ Final -Electrical (4055)
Approved Approved Approved
By Date By Date By Date
❑ Rough Electrical Final Electrical
Approved ❑ ❑ Right Way
Approved Approved
By Date By Date
BY Date
CWT 0, A, RECEIVE®
Federal Way JUL 0 8 2013
ELECTRICAL
PERMIT APPLICATION
CITY OF FEDERAL WAY
FZPMT Nom"M 0 1� 0 71`5' 1 - La
SITE ADDRESS: 3 y
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PRDJI= VALUATION
$ SoC)7, ao
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
ELECTRICAL
CONTRACTOR
APPLICANT
PROJECT CONTACT
_ `.399976
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SUITE/.UNIT/SPACE #
ASSESSOR'S TAX/PARCEL #
CURREI:f/PROPOSED USE
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PRIMARY PHONE
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FAX
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WA STATE CONTRACTORS LICF/iBE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
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PRnIART PHONE
MATING ADDRESS
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I certify under perxalty of perjury that I am the property owner or authorized agent of the property Owner. I certify that to the best
of my kaotvZedge, the Warrnation submitted in support of this permit application is true and correct. I certify that I will aremply With
all applicable City of Federal Way regulations pertaaning to the work authorised by the issuance of a permit I understand that the
issuance of this permit does not remove the owner's nesponmbilbty for compliance with lo,=4 slaty or federal laws regulating
construction or environmental laws.
I further agrce to hold harmless the City of Federal Way as to. any claim (including costs, expenses, and attorneys' fees incurred in
the iawestigatoion and defense of such claimJ, which may be made by any person, including the undersigned, and f led against the city,
but anly Cohere such cUdm arises out of the reliance of the city, including its offleem and employees, upon the accuracy of the
information supplied to the city as a part of this application_ I -
�P I
SIGNATURE: DATE
PRINT NAME:
Bulletin #160 -January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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