09-103626Eleci rical
City of Federal Way • Community Development Services Permit #: 09-103626-00-EL
P,O, Box 9718
Federal Way, WA 98063-9718 -a Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: PACIFIC HWY S @ S 320TH ST - PHOTO ENFORCEMENT
Project Address: Parcel Number: CITY WIDE
Project Description: Installation of photo enforcement cameras in school zone. Install cameras, wire, conduit, 2
camera poles and loops.
Owner Applicant
Contractor
CITY RIGHT-OF-WAY SIGNAL ELECTRIC INC
SIGNAL ELECTRIC INC
PO BOX 6209
SIGNAEI325K8 (7/31/1 1)
KENT WA 98064-6209
PO BOX 6209
KENT WA 98064-6209
Additional Permit Information
Is Use Educational or Institutional? .................... No
Service greater than 1000 Amps?..,,...........
Electrical Fixtures
New Service: 0 - 100 amps (Comm 1
CONDITIONS:
***UL SPEC LISTING TO BE ON SITE AT TIME OF INSPECTION***-- -- Vva.
PERMIT EXPIRES Saturday, September 18, 2010
Permit Issued on Friday, September 18, 2009
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.
�j
Owner or agent: Date:
THIS CARD IS TO -REMAIN ON -SITE
CITY OF - � Construction I k, ection Record
Fecieral Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 09-103626-00-EL Address:
Owner: CITY RIGHT-OF-WAY FEDERAL WAY, WA
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.
UFER Ground (4295)
❑ Ditch cover (4030)
Slab Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By^Date/vr-
By Date
By Date
El
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
El
Final - Electrical (4055)
Approved
By Date `e g 0
El
Electrical
Approved
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
Fed�%SCEIVr-n
V[iLOPSERVICES
PERMIT
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S1, IF CO M�EL PL DE EN FP
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. PROPERTY
SITE ADDRESS LJ , t - i A Y
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SUITEMNIT t ZONING
ASSESSOR'S TAR/PARCEL
NAME OF PROJECT
(Tenant or Homeowner Name)
12 ed— L i c h4 P'rn 0A-t 1 � ,L:. L � /� (�►'�
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION J4 ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
7n\s4 ,(( mt.-r-C". eS
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
C 5
PEOPLE -
PROPERTY OWNER
NAME
C-~ti•-( p� �2� e�c.lC,
PRMARY PHONE
( ) -
NAILING ADD , CITY, STATE, ZIP
E-MAIL
OWNER IS ALSO:
CONTRACTOR APPLICANT PROJECT CONTACT
NAME
PRIMARY PHONE
CONTRACTOR
MAILING ADDRESS, CITY, STATE, ZIP p
/'- � 0 0�'
fool 3�c1 /tvC S K�/�� l�/�. �2C7cf
FAx
253 �95 - Q$'S(o
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
51GNAF 132,5k� / i / to
NAME
'� ` `I-- (I
/(-9Ct•(o7Z7('e_Co-g.
PRID(ARYPHONE
6 -12- - ? -1 i 1
APPLICANT
MAILING ADDRESS, CITY, STATE, ZIP PO 13 O
FAX
/,co( ',rd Ase S. ►U`+ VC, 9&b(,Ll C72a�
(Z53 3ris-- 055(0
PROJECT CONTACT
NA31E
PRnrARY PHONE
-7
(The individual to receive and
l k M �„%
(251)S12 - i -t
respond to all correspondence
MAILING ADDRESS, CITY, STATE, ZIP too (O )e
FAX
concerning this application)
1 u D l 3 r 1. . Q-,n-F W fa . q to ( -J (,2 Dot
(2�3 �9 5 - 0 5 5 (o
ALTERNATE CONTACT NAME:
PRIMARY PHONE
E-MAD.
3n�� Jl'loq eY1Se
`dam ) Slo - 521q
01nA(elcc-(r"C'cc
PROJECT FINANCING
NAn�
r
S
OWNER -FINANCED
Required for projects urith
�
value of $5, 000 or more
MAHdNG ADDRESS, CITY, STATE, ZIP
PRIMARY PHONE
(RCW 19.27.095)
1 ¢
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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 MW as to any claim (including costs, expanses, and attorneys' fees insured
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 t the city as a part of this application,
C� c
SIGNATURE: DATE 9 _ 1
!
! L Q 0—cC.tn e,r
PRINT NAME:
Bulletin # 100 - 4/17/2009 Page 1 of 4 Ullandouts\Pennit Application