15-103127 r Electrical
-City of rederal Way F,1L ..w Permit #: 15-103127-00-EL
Community&Econ.Dev.Services
33325 8th Ave S ,
Federal way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: VERIZON- SEA REDONDO
Project Address: 29205 18TH AVE S Parcel Number: 304020 0065
Project Description: Backup power Generator Installation
Owner Applicant Contractor
PUGET SOUND ENERGY/ELEC BECKY TODD EXPERT ELECTRIC
PO BOX 90868 LEXCOM EXPERE*932LG(6/7/15)
BELLEVUE WA 617 8TH AVE S 4619 PACIFIC AVE
98009 SEATTLE WA 98104 TACOMA WA 98408
• Additional Permit Information
Is this an Online or O.T.C.application? No Is Use Educational or Institutional? Yes
Service greater than 999 Amps? Yes
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
CONDITIONS:
A permanently installed generator is not allowed to be placed within required yards(setbacks). See Bulletin
#150 for placement details.
PERMIT EXPIRES Wednesday, April 27, 2016
Permit Issued on Friday, October 30, 2015
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us=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: to - 3o- i S
Ditr(4 t;oVGv I El r GovW.
t
THIS CARD IS TO IN ON-SITE
art!'OF Construction In ection Record -
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 15-103127-00-EL Address: 29205 18TH AVE S
Project: PUGET SOUND ENERGY/ELEC FEDERAL WAY, WA 98003-3826
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 LIFER Ground (4295) -( ( Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved "r Approved Approved to place concrete
By yy fj Date Ik 114--- By 1hf3 Date I l ('w(i By WA, Date l'1-1 3 1 1c-.
0 Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date Bc—:-Cr: Date 1_ 14_ ( 6
.❑ Feeders/Sub-panels(4045) * E Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
Final-Electrical(4055)
® Approved
By a� Date 1, ti____,.... _
® Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
L...._,-.,...,_ --, - 4
41)
RECEIVED •
ELECTRICAL
CITY OF JUL 0 6 2015
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER 1_ _ _ V / �� _ 0
_ _
SUITE/UNIT/SPACE#
SITE ADDRESS: 29205 18th Ave S.
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 105,000.00 3 0 4 0 2 0 - 0 0 6 5 Substation and unstaffed
— — wireless facility
PROJECT NAME SEA Redondo-Verizon
(Tenant or Homeowner Last Name)
Install new antenna array on existing monopole, consisting of 12 panel
antennas and appurtenances. New equipment cabinets on concrete pad at grade
PROJECT DESCRIPTION
Detailed description of work to within fenced area.
be included on this permit only
at..14Aio potAm- G}f i ''-- Le„rn}..i 1 yo u)
NAME PRIMARY PHONE
PROPERTY OWNER Puget Sound Energy ( ) -
MAILING ADDRESS E-MAIL
PO Box 90868 EST-06E
CITY STATE ZIP FAX
Bellevue WA 98009-0868 ( ) -
NAME PRIMARY PHONE
TBD ( ) _
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
Verizon Wireless(Becky Todd/Lexcom-representative) ( ) _
APPLICANT MAILING ADDRESS E-MAIL
c/o Lexcom Development,617 8th Ave S. becky.todd@lexcomcorp.com
CITY STATE ZIP FAX
Seattle WA 98104 ( )N
PROJECT CONTACT Becky Todd,Lexcom Development 206 ) P 313 0 Y 17913
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 of this application. 2.3)h
SIGNATURE: ® DATE CO /
PRINT NAME: �"3I.JL,
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application