10-102682City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: KING COUNTY REGIONAL LIBRARY
Project Address: 34200 1ST WAYS
Project Description: ADD (1) ISA 120v DUPLEX RECEPTACLE.
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•. Electrical
Permit #: 10- 102682 -00 -EL
Inspection Request Line: (253) 835 -3050
Parcel Number: 202104 9058
Owner
Applicant
Contractor
KING COUNTY LIBRARY SYSTEM
KIRBY ELECTRIC INC
KIRBY ELECTRIC INC
960 NEWPORT WAY NW
4826 "B" ST NW SUITE 101
KIRBYEI077BN (1/13/11)
ISSAQUAH, WA 98027 -2702
AUBURN WA 98001
4826'B" ST NW SUITE 101
AUBURN WA 98001
Is Use Educational or Institutional ? .......................No Service greater than 999 Amps? ............................. No
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P;118 I . 1
THIS CARD IS TO MAIN ON -SITE
cffy OF Construction In ection Record
Federal Way INSPECTION REQU TS: (253) 835 -3050
PERMIT #: 10- 102682 -00 -EL Address: 34200 1 ST WAY S
Owner: KING COUNTY LIBRARY SYSTEM FEDERAL WAY, WA 98003
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.
Final - Electrical (4055)
Approved
Dat
FJ
UFER Ground (4295)
Ditch cover (4030)
Temporary Power (4275)
Slab /Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Dat
FJ
Pool Bonding (4195)
❑
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
By
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
Final - Electrical (4055)
Approved
Dat
FJ
Rough Electrical
Approved
0
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
I cert(fy under penalty of perjury that I am the property owner or authorised agent of the property owner. I oertVy that to the best
of my knowledge, the iBformation submitted in support of this permit application is true and correct. I certjfy that I will Comply with
all applicable City of Feral Way regulations pertaining to the work authorized by the issuance 4f 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 Feral 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 iled 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
Wormation supplied to the city as a part of this application.
SIGNATURE:
PRINT NAME:
d - ?--5-- 16
33325 8th Avenue South ♦ PO Box 9718 ♦ Federal Way ♦ WA ♦ 98063 -9718 ♦ 253- 835 -2607 ♦ fax: 253- 835 -2609 ♦ www.cityoffederalway.com
Bulletin #160 — April 9, 2010 Page 1 of 2 k:\Handouts\Electrical Pennit Application
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