16-100661 '*- -- A. 0 0 Electrical'
City of Federal Way
Community&Econ.Dev.Services Permit #: 16-100661-00-EL
33325 8th Ave S
Federal Way,WA 98003F ILE Request Line: 253
Ph:(253)835-2807 Fax (253)835-2609 Inspectionq � )835-3050
Project Name: SOUTH 352ND ST EXTENSION(STATE ROUTE 161 TO STATE ROUTE 99)
Project Address: 35200 PACIFIC HWY S Parcel Number: 292104 9048
Project Description: Install(1)new 100A 120/240V electrical service for new traffic signal and street lighting in
right of way on southeast corner of S 352nd Street
Owner Applicant Contractor
YOUNGSPRING LLC ROGER SHERWOOD WEST COAST SIGNAL INC
813 LONNA LN WEST COAST SIGNAL INC WESTCCS8928G(11/21/17)
CUPERTINO,CA 95014 20111 208TH AVE SE 20111 208TH AVE SE
RENTON WA 98058 RENTON WA 98058
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
New Service:0- 100 amps(Comm 1
PERMIT EXPIRES Friday, February 3,.2017
Permit Issued on Thursday, February 4, 2016
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the . - hill be in accordance with the laws, rules and regulations of the State of Washington
e.-, and the C�of,Federal Way.
--Z----Owner or a• /
Date: / 16
r
r THIS CARD IS TO MAIN ON-SITE 4
c ri OF - • Construction In ection Record +
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 16-100661-00-EL Address: 35200 PACIFIC HWY S
Project: YOUNGSPRING LLC FEDERAL WAY, WA 98003-8319
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 By Date By Date
❑ Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
Q Feeders/Sub-panels(4045) E Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
ID Final-Electrical(4055)
Approved
By M Date /4-1 24-I ( ,
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
110
ELECTRICAL
CITY OF
Federal Way PERMIT APPI4FcigffeT
PERMIT NUMBER \ ' 0 0 0 I _ � ' FEB 0 4 2016
CITY OF FEDERAL WAY
SUITE/UNIT/8 /
SITE ADDRESS: 35200 Pacific Highway South Federal Way, WA
PROJECT VALUATION ASSESSOR'S TAX/PARCELS CURRENT/PROPOSED USE
$ 4500.00 2 9 2 1 0 4 - 9 0 4 8 R/W Improvements
PROJECT NAME
(Tenant orHomeowner Last Name) South 352nd St Extension SR161 to SR99-Federal Way
Install new 100A 120/240V electrical service for new traffic signal and street lighting in right of way
PROJECT DESCRIPTION on southeast corner of S.352nd St.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER City of Federal Way ( 253) 835 - 2700
MAILING ADDRESS E-MAIL
33325 8th Ave S
CITY STATE ZIP FAX
Federal Way WA 98003 ( ) -
N AME PRIMARY PRONE
West Coast Signal, Inc. ( 206 ) 595 _ 6656
MAILING ADDRESS E-MAIL
ELECTRICAL 20111 208th Ave SE moge@westcoastsignal.com
CONTRACTOR CITY STATE ESP FAX
Renton WA 98058 ( N/A ) -
WA STATE CONTRACTOR'S LICENSE a EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
WESTCCS8928G 11 / 21 / 17 20-12-100610-00-BL
NAME PRIMARY PRONE
APPLICANT West Coast Signal, Inc. ( 206 ) 595 - 6656
MAILING ADDRESS E-MAIL
20111 208th Ave SE moge@westcoastsignal.com
CITY STATE ZIP FAX
Renton WA 98058 ( N/A)
NAME PRIMARY PRONE
PROJECT CONTACT Jon Mogensen ( 206 ) 595 _ 6656
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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
injbrmation s -•• • to the city as a part of his application.
SIGNATURE: i/ , DATE 1/20/2016
PRINT NAME: :ecky Moge en
-- I 71 ,C,% U � '
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