14-103950Project Name: ADELAIDE ELEMENTARY SPEED ZONE
Project Address:
0 C 'Electrical
Permit #: 14 -103950 -00 -EL
Inspection Request Line: (253) 835-3050
2!
Parcel Number: CITY WIDE
Project Description: Installation of 100 -amp pedestal service for flashing speed zone signs. LOCATION: SW
Corner of 16th Avenue SW & SW 306th Street, W side.
Owner
Applican
Contractor
RICK PEREZ
City of Federal Way
OWNER IS CONTRACTOR
Community & Econ. Dev. Services
KING COUNTY DOT
33325 8th Ave S
Federal Way, WA 98003
33325 8TH AVE S
Ph: (253) 835-2607 Fax: (253) 835-2609
-
Project Name: ADELAIDE ELEMENTARY SPEED ZONE
Project Address:
0 C 'Electrical
Permit #: 14 -103950 -00 -EL
Inspection Request Line: (253) 835-3050
2!
Parcel Number: CITY WIDE
Project Description: Installation of 100 -amp pedestal service for flashing speed zone signs. LOCATION: SW
Corner of 16th Avenue SW & SW 306th Street, W side.
Owner
Applican
Contractor
RICK PEREZ
DOUG NEIGEL
OWNER IS CONTRACTOR
CITY OF FEDERAL WAY - PW
KING COUNTY DOT
33325 8TH AVE S
155 MONROE AVE
FEDERAL WAY WA 98003
FEDERAL WAY WA
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 Monday, February 2, 2015
Permit Issued on Wednesday, August 6, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy a h;use ill be ' accordance with the laws, rules and regulations of the State of Washington
artj the City of Federal Way. CC,,
Owner or agent: Date: �S �(
CITY OF V& 0
Federal Way
PERMIT #: 14 -103950 -00 -EL
Project: RICK PEREZ
THIS CARD IS TO 'MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
Address:
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.
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
0 Service (4235)
Approved
By Date
UFER Ground (4295)
Ditch cover (4030)Slab/Concrete
Rough Electrical (4225)
Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
0 Service (4235)
Approved
By Date
11 Final - Electrical (4055)
Approved
Bye Date �
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
Bye Date �
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
m ELEC'T'RICAL
AUG 0 6 2014 PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER _ / b 9S -
SITE ADDRESS: A
�t I�r� . ,
+ l6
c
ve
SUITE/UNIT/SPACE #
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL #
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
a' le C
Q DO
11 r1
L e C One' F 1 &A e (-S
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
o�) or C : o� Feder u1w
a C', Roel
S� 1� ;5 �� r%r"Q r 1
6C�00 1 59zeck Zone
;� n
PROPERTY OWNER
NAME `
C i O FQd e� �.,
W 4,�
PRIMARY PHONE
(Q,53) 9 3 -,-2 7 y0
MAILINGAbDRESS
3-33,25 S Ave S.
E-MAIL
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME IPRIMARY
,V\cou.'J D.C>-T—
PHONE
Q66 -x'/53
MAILING AD RESS
1-55 Inc) r) gyve N�
E-MAII.
CITY
STATE
ZIP
FAR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
)
MAILING ADDRESS
EMAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
NAP \Q e
PRIMARY PHONE
Ss - 6
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 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 suppUeEi to the city as apart of this application.
SIGNATURE:
PRINT NAME:
Bulletin # 160 —January 1, 2013 Pagel of 2 k:\F3andouts\Electrical Permit Application