14-106429i
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
0
F Ird I
IL&.
Project Name: LAKEHAVEN UTIIdTY DISTRICT
Project Address: 3203 SW DASH POINT RD
0 "'Flehrical
Permit #: 14 -106429 -00 -EL
Project Description: Replace failed UFD with a new UFD control panel.
Inspection Request Line: (253) 835-3050
Parcel Number: 122163 9105
Owner
LAKEHAVEN UTILITY DISTRICT
Aonlicant
HOWARD MORELAND
Contractor
LAKEHAVEN UTILITY DISTRICT
PO BOX 4249
LAKEHAVEN UTILITY DISTRICT
PO BOX 4249
FEDERAL WAY WA 98063
3203 SW DASH POINT RI}
FEDERAL WAY WA 98063
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Service greater than 999 Amps? .............................No
Electrical Fixtures
Alt. Srvc / Feeder 0 to 200 amps (C 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Tuesday, June 16, 2015
Permit Issued on Thursday, December 18, 2014
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:
THIS CARD IS TO MAIN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 14 -106429 -00 -EL Address: 3203 SW DASH POINT RD
Project: LAKEHAVEN UTILITY DISTRICT FEDERAL WAY, WA 98023-2340
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.
Feeders/Sub-panels (4045) 0 Rough Electrical (4225) E] Ceiling Cover (4020)
Approved Approved Approved
By Date By Date By Date
Final - Electrical (4055)
Approved
Byj!y Date I_3t_ 1
Ditch cover (4030)
❑
Slab/Concrete Floor (4255)Service
Final Electrical
Approved
(4235)
Approved
By
Approved to place concrete
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045) 0 Rough Electrical (4225) E] Ceiling Cover (4020)
Approved Approved Approved
By Date By Date By Date
Final - Electrical (4055)
Approved
Byj!y Date I_3t_ 1
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
OEC 17 2014
cirY of
Federal Way cmr cF EDERAL WAYCDS
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER
SITE ADDRESS: 5�
SUITRIUNIT/SPACE iF
C
PROJECT VALUATION
ODDt 00-
ASSESSOR'S TAX/PARCEL /
CURRENT/PROPOSED USE
fi../
— — —
PROJECT NAME
(Tenant or Homeowner Last Name)
}-- -
1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
N ME
t��
PRIMARY. PHONE'.
�P -
T>76.ADD S
E-b{AiL
CITY STATE
ZIP
FAX
NAME �-{j'
•may PRIMARY PHONE
ELECTRICAL
`LFG DRSSS
s 0 ) ,F
EMAIL
CONTRACTOR
c
rQ
STATEPAR
ZIP
` Y 4
WA STATE CONTRACTOR'S LICM N EXPIRATION DATE
FEDERAL WAY BUSINESS 'CENSE!
rpm
kinVv
PRIMARY PHONE
APPLICANT
) -
&ftI(6ADDRESS K
1yrrMAIL
«-
j(``ST��ATE
(ZIP
FAX
PROJECT CONTACT
NAME...
tr
PRIMARY PHONE
I certify under penalty of pe{jury that I am the property owner or authorized agent of the property owner. I cert{ fy that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I wilt 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 Iaws.
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 c" as a part of this application.
SIGNAT
PRINT NAME:
Bulletin #160 —January 1, 2013 Page 1 of 2 k: 11andoutsTlectrical Permit Application