15-102519 R ii
• •
f• Erectrical
City of Federal Way
Community&Econ.Dev.ServicesFIPermit #: 15-102519-00-EL33325 8th Ave S
Federal Way,WA 98003 I
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: TOWN SQUARE PARK
Project Address: 31600 20TH AVE S Parcel Number: 092104 9021
Project Description: In conjunction with irrigation trenching,install 3"in-ground electrical conduit only for
future parking lot lighting.
,
Owner Applicant Contractor
CITY OF FEDERAL WAY STEVE IKERD OWNER IS CONTRACTOR
33325 8TH AVE S CITY OF FEDERAL WAY-PARKS
FEDERAL WAY WA 98063-9718 33325 8TH AVE S
FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional9 No
Service greater than 999 Amps9 No
Electrical Fixtures',
Circuits-Commercial 1
PERMIT EXPIRES Monday, November 23, 2015
Permit Issued on Wednesday, May 27, 2015
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 accor, - - - with the laws, rules and regulations of the State of Washington
- - City of Federal Way.
Owner or agent: e / < 4 1 Date: 5 21 . 1 5
THIS CARD IS TO MAIN ON-SITE +�� I ,
CITY OF • Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 15-102519-00-EL Address: 31600 20TH AVE S
Project: CITY OF FEDERAL WAY FEDERAL WAY, WA 98003-5426
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.
0 UFER Ground (4295) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date t. `3-t . By Date
El Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
,By e Date 1.. -3-1.7
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
,
►• E&C'TRICAI.
CITY OF n„< MAY 2 6 2015
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS
PERMIT NUMBER / _ /O
SUITE/UNIT/SPACE#
SITE ADDRESS: 31600 Z d Akf(�. S.
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ I 00 0 9 1 C> 1-{ - 9 U 2. 1 Park—
PROJECT NAME T A S wart. -r
(Tenant or Homeowner Last Name) Park-d6 .1�1�'�f�l�rGvV1�,
insi�atla w , of a 3” €te-ckrLeal raLUA( - c.,csinluA
PROJECT DESCRIPTIONfa( `rfv P 144%" u 1 to -. G3in� � 5cGG-4- an l sta(Ial
Detailed description of work to ((jam vJM%\ft ‘rrt ya,•kar -�-rru�c-htt' 0ccur t
be included on this permit only J
NAME f PRIMARY PHONE
PROPERTY OWNER C1i� Cc [7GC1[GC1 1))aJ► ( ) -
MAILING ADD�SS � �� .
J E-MAIL
CITY STATE ZIP FAX
4-( 4 VV WA 9f50°j ( ) -
NAME PRIMARY PHONE
Fade- Sk-aC ' . ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME(' PRIMARY PHONE
APPLICANT `"Ta t, (Z5 ) S - b911
MAILING ADDRESS E-MAIL
3'J?*5LS C6 ' S . rme.tit d@ CA,•STA -
kWTk E ZC$W ( )IP FAX
NAME PRIMARY PHONE
PROJECT CONTACT S- - t 1Z- i4-.> (2Sj) S, ( t l l
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 supplied to the city as a p• o his application.
SIGNATURE: /
.— ` ' DATE J 26 `
S 1 L V �
PRINT NAME: e. ` * R:c>
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application