09-102428 City of Federal Way • Electrical(�
Community Development Services Permit #: 09-102428-00-EL
P.O.Box 9718
Federal Way, Fax 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax'(253)835-2609 p q ( �
Project Name: QWEST DSL SITE
Project Address: 1900 S 288TH ST Parcel Number: 332204 9159
Project Description: 100-amp underground service for DSL installation in ROW at SW corner of this site.
Owner Applicant Contractor
QWEST COMMUNICATIONS KEN BOBKO ELECTRIC CO INC KEN BOBKO ELECTRIC CO INC
1801 CALIFORNIA ST#4600 PO BOX 7009 KENBOEC066BA( 1/1/10)
DENVER CO TACOMA WA 98406-0009 PO BOX 7009
80202-2658 TACOMA WA 98406-0009
Additional Permit Information
Is Use Educational or lnstitutional9 No Service greater than 1000 Amps9 No
Electrical Fixtures
New Service: 0- 100 amps(Comm 1
PERMIT EXPIRES Saturday, June 26, 2010
Permit Issued on Friday, June 26, 2009
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us will be • acco da e with e laws, rules and regulations of the State f Was ; gton
dthe of I Way. 2‘'Owner or agent: ` , Date. /
THIS CARD IS T EMAIN ON-SITE •
CITY OF • Construction I ection Record - ,
. Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 09-102428-00-EL Address: 1900 S 288TH ST
Owner: FEDERAL WAY, WA 98003-3227
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 B1C Date6-z,q-c9 • By Date
0 Pool Bonding(4195) Temporary Power(4275) Service(4235)
Approved Approved Approved
By Date By Date B Date
o Feeders/Sub-panels(4045) Rough Electrical(4225) ❑ Ceiling Cover(4020)
_ Approved Approved Approved
By Date By Date By Date
Final-Electrical(4055)
Approved
By � Date 2-7f4,5
•
•
• _ For inspector reference only
1 ❑ Rough Electrical ❑ FINAL-Electrical
Approved Approved
By Date By Date
. „A
tqr"--"1 4/ _ - o a y,, 8
Federal WR(E. PERMIT
COMMUNDYDEVELOPMERT SERVICES F MF CO ME 411j11, DE EN FP
33325 8*H AVENUE SOUTH•PO BOX 9718 iN L► V Inc�On p TT I C AT I O N
FEDERAL WAY,FWA AX 98063-9718-8 -260 �J TD
253-835-2607.FAX 253-835-2609 `��V
(--- / -1_________.)
www.cittpfedemlwau.com DE 11(4'
The foilowink utred i t on-an inc. np application�>w�l 'Ito dc'ce' t d. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS_ SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# -,_- __ __ LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description) ok y/ I
NI PROJECT INFORMATION ( (�
TYPE OF PERMIT ❑BUILDING 0 PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT ES/C/RIPTION e detaileds tion of work included on this permit onilij I
PROJECT NAME(Name of Business or Owner Last Name)
1 II PEOPLE INFORMATION
PROPERTY ME PRIMARY PHONE
OWNER ` Lk,t-1,57.4.• ( ) -
MAILING ADRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME _ APPLIC NT NAME OFFICE PHONE ^
/c1C:yi ) 0 1 5' , �,c(C 14c ( IcLelt keel /1.�` A A A ( S ? ) E - 6 r�
1'C)t L-_ADDRESS c c 7 //c/Ccfn,4 Pizio � e-‹.,(....7 CELL PHONE/ -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER RATION DATE FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
CY1 R6 0(.16614 / /1 ( /c )
APPLICANT COMPANY NAME /) APPLICANT NAME OFFICE PHONE
MAILING_ `� � -c CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑Agent ❑ Other ( ) -
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ( ) -
LENDER NAa\`---- - Per RCW 19.27.095:
Lender information is required If project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
a DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL=WINO sr TOTAL.PROPOSED Sr TOTAL Sr
**NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or-rah/shower combo) LAVS(Bathroom sinlw) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roitet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 nay be ade by any person, including the undersigned, and filed against the city, but only
where such claim arts -t of t reli a of city, lu its officers and employees, upon the accuracy oft info • •on supplied to
the city as a part of pile on. '
SIGNATURE: — / r / DATE I 40,• �
Prope Owner d/or uthorized Agent
• SS :f
a NEW a ADDITION a ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? o YES o NO
• PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application