17-100724 Electrical
Community Develoopmeral nt Dept. Permit #:17-100724-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: FEDERAL WAY HIGH SCHOOL
Project Address: 30611 16TH AVE S Parcel Number:082104 9001
Project Description: Install(2)new 50A single phase receptacles
•
Owner Applicant Contractor
FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY PUBLIC SCHOOLS
33330 8TH AVE S 33330 8TH AVE S 33330 8TH AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application? Yes
n
Circuits-Commercial 2
PERMIT EXPIRES Wednesday,14 February,2018
Permit Issued on Tuesday,February 14,2017
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. r�
Owner or agent: Date: d "1Y—/ 7
FI NALED
MIli.
THIS CARD S TO REMAIN ON-SITE
��� Constructio Inspection Record
Federal Way INSPECTION QUESTS:(253)835-3050
PERMIT#: 17 100724 00 Address: $0611 16TH AVE S
Project: FEDERAL WAY PUBLIC SCHOOLS !FEDERAL WAY WA 98003-4903
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) Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
® Pool Bonding(4195) 0 Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) ® Rough Electrical(4225) t=t Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
By Date (
<. )
0 Rough Electrical El Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
CITY oFfFF ELECTRICAL
Federal Way PERMIT APPLICATION
FEB 14 2017
CITY OF FEDERAL WAY PERMIT NUMBER I V O -704- cc
CDS
SUITE/UNIT/SPACE#
SITE ADDRESS: o 6I
' ./61:11 Ago C
PROJECT VALUATION ASOZ ( O1yOO /
SOR'S TAX/PARCEL -L# CURRENT/PROPOSED USE
PROJECT NAME �"
(Tenant or Homeowner Last Name) F2e rr l /, o' Ji h SA�j I
PROJECT DESCRIPTION '1./1S'1-(I two he u) 50A 5,'r1, Ie pkias2 /eccP'fGcS
Detailed description of work to
be included on this permit only
NAME (� Sc_ PRIMARY PHONE
PROPERTY OWNER Fed era, (,U cud b1/4. ) L Jtoo l (c352)9Y5 - 5930
MAILING ADDRESS E-MAIL
3333c 3 Ave S c1/011.4•Cn-lan C-rliiOs-0/0
CITY STATE ZIP FAX
Tede.r...l Lucca
'0" lvt1 C/ oo3 (a53) 9ys - 5959
NAME PRIMARY PHONE
Own G,^ ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP
FAX
l ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
�.p PRIMARY PHONE
APPLICANT ' creel-"v (eZ.J)9`l5 -5930
MAILING
ADDRESS E-MAIL
1211 5. 33214 5T. S d,�Gac�h� ‘C-14164
ar
CITY STATE ZIP FAX d
Fedeirkl % )3 (053) qy5- S55I
NvePROJECT CONTACT PRIMARY PHONE
E
me.� k()LL-c man (J53 626 I - 5305
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 is application.
SIGNATURE• alkin5K DATE Ga'14/ -
PRINT NAME:
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application