17-102014 Electrical
uniyteeontPermit #:17-102014-00-ELComntyDvlpm 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: S BLUE SKY LLC
Project Address: 33303 43RD AVE SW Parcel Number: 142103 9047
Project Description: Replace mast/meter base.
Owner Applicant Contractor
S BLUE SKY LLC S BLUE SKY LLC OWNER IS CONTRACTOR
33303 43RD AVE SW 33303 43RD AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
USA USA
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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Alt.Serv./Feeder:0 to 200 am] 1 Mast or Meter Repair(Resider. 1
PERMIT EXPIRES Thursday,3 May,2018
Permit Issued on Wednesday,May 3,2017
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 accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Owner or agent: Date: &' V-- / 2
r1110,‘
1 I
THIS CARD IS TO REMAIN ON-SITE
Federal Wa Construction Inspection Record
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 102014 00 Address: 33303 43RD AVE SW
Project: S BLUE SKY LLC FEDERAL WAY WA 98023-3202
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.
El UFER Ground(4295) Q Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
.By Date By Date By Date
•® Pool Bonding(4195) s❑ Temporary Power(4275) s '
p ry ❑ Service(4235)
Approved Approved Approved
By Date By Date By Pe Date slgf ii
•,
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
0 Final-Electrical(4055)
Approved
By PIS Date SIT':7
Rough Electrical ❑ Final ElectricalE3 Right of Way
Approved Approved Approved
By Date By Date By Date
CITY of A ELECTRICAL
Federal Way PERMIT APPLICATION
( RECEIVED
PERMIT NUMBER 1-1- - 1 1 4 - o _
� MAY 2017
03
SITE ADDRESS: e 33 o 3`/ `'A3 f4 Ave 5jJ
CI Y OF FEDERI SNIT/SPACE#
'-, GoMMUN(TY DEVELOPMENT
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
tirtr_rol,00o, r - ( 10
PROJECT NAME ,p,,� C
(Tenant or Homeowner Last Name) l�/1 �-«-
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME Gt PRIMARY PHONE
PROPERTY OWNER 5�U11 j i4)1144 (fob )693 -gin
MAILING ADDRESS U E-MAIL
33303 4,5i4 Ave 5 ()
CITY STATE ZIP FAX
pie( I
a, 1001 eoZ 3 )
NAME PRIMARY PHONE
(Ai ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME l�ry, PRIMARY PHONE
APPLICANT - " /' ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT ( )
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 part oJthis application.
SIGNATURE: DATE
-- 3—?Qr I/
PRINT NAME: /i1 i iVi .I A
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application