17-100305 Electrical
City of Federal Way Permit #:17-100305-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: SAGHALIE SPEED CAMERA-17TH AVENUE SW/SW CAMPUS DRIVE
Project Address: Parcel Number:CITY WIDE
Project Description: Installation of electrical service for automatic speed enforcement camera system.
Owner Applicant Contractor
CITY OF FEDERAL WAY WEST COAST SIGNAL INC WEST COAST SIGNAL INC
33325 8TH AVE S 20111 208TH AVE SE WESTCCS8928G(11/21/17)
FEDERAL WAY WA 98003 RENTON WA 98058 20111 208TH AVE SE
RENTON WA 98058
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Alt.Srvc/Feeder 0 to 200 am] 1
PERMIT EXPIRES Saturday,20 January,2018
Permit Issued on Friday,January 20,2017
I hereby certify that the a ormation is correct and that the construction on the above described property
and the occupan nd th se will be in accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Owner or ag t: �' �� Date:
FINAL
ED
..
, . _ .
THIS CARD IS TO REMAIN ON-SITE
CITY ,. ,
Of Construction Inspection Record
Federal Way INSPECTION REQUESTS :(253)835-3050
PERMIT#: 17 100305 00 Address:
Project: CITY OF FEDERAL WAY
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.
---------------17—'
® UFER Ground(4295) Ditch cover(4030) f® Slab/Concrete Floor(4255) ,
Approved Approved Approved to place concrete
B Date 2—I.G-- ) B� Date Z ( (o-(,�By Date
• I%
® Pool Bonding(4195) ® Temporary Power(4275) ® Service(4235)
Approved Approved Approved
B45.
0 Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
E Final-Electrical(4055)
Approved ��'
B3‹.. Dat E . � 7 �
•
0 Rough Electrical Cl Final Electrical G Right of Way
Approved Approved Approved
By Date By Date By Date
Ni.. ELECTRICAL
CITY OF
Federal Way PERMIT APPLICATION
JAN 2 0 2017
r.�,i e �IT NUMBER i _ / 6 0 3 O a
_ _
clip*
SITE ADDRESS: SUITE/UNIT/SPACE#
(7f S k) C itsOn e
PROJECT VALUATION ASS SSOR'S TAX/PARC # CURRENT/PROPOSED USE
O
PROJECT NAME A
/ c
(Tenant or Homeowner Last Name) 1 5 ; e e.Jt" frt (,i f e i iAeV L 6 e
51/lft- 1bA.. c-r el(, t-l� lctt( rJite 'fid
PROJECT DESCRIPTION e ei: A-V- t d15fick f( -A trF-1 G c-'4, 4'e r rtie_J<1
Detailed description of work to .et 1,4-1c„"
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNERa -
MAILINGDRESS a -E-MAIL
CITY STATE ZIP FAX
NAMEPRIMARY PHONE
c 1— (Da.51* C)NA,i ( ) -
MAILING ADDRESS .- E-MAIL
ELECTRICAL ' D(1 1 2 0 U C.' c3 i E '
CONTRACTOR ITY STATEZIP FAX
Re I/0 r) V1.. ) yw ' 5' ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAM4aAy, PRIMARY PHONE
APPLICANT MAIL ADDRE S ) E-MAIL
CITY STATE ZIP FAX
)
PROJECT CONTACT
NAM PRIMARY PHONE
K-01-?)-r- .-' 1(-C-C LnY0C.`,C k
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 defens such claim), which may be made by any person,including the undersigned,and filed against the city,
but only where such m ses out of the reliance of the cit -including its officers and employees, upon the accuracy of the
information suppli t t ity as a part oft plicatpn
F
SIGNATURE: ` ; DATE .7 1• 7
PRINT NAME:
(_)?„,(--- C-k. UC
Bulletin#160–April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application