16-102653 •
�( Electrical
City of FederalWay P 16-102653-00-EL
Community&Econ.D #:
Permit Dev.Services •
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: CHRISTIAN FAITH CENTER
Project Address: 33645 20TH AVE S Parcel Number: 212104 9004
Project Description: Extend 120v to new LED wall mounted sign
Owner Applicant Contractor
CHRISTIAN FAITH CENTER CANNON CONSTRUCTION(GENERAL) CANNON CONSTRUCTION(ELECTRICAL
33645 20TH AVE S 406 PORTER WAY 01)
FEDERAL WAY WA 98003 MILTON WA 98354 CANNOCI873CL(2/13/17)
406 PORTER WAY
MILTON WA 98354
Additional Permit information
Electrical Work Valuation? 1100.00 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures
Circuits-Commercial 1 Sign 1
PERMIT EXPIRES Thursday, June 1, 2017
Permit Issued on Wednesday, June 1, 2016
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
the City of Federal Way.
Owner or agent: Date: - 1 - /L
TIAs CARD IS TO ON-SITE ,.«� Construction In ection Record
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT#: 16-102653-00-EL Address: 33645 20TH AVE S
Project: CHRISTIAN FAITH CENTER FEDERAL WAY, WA 98003
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 UFER Ground(4295) ❑ Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) ❑ Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
'❑ Feeders/Sub-panels(4045) CI Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By s Date c,......-0..... I By Date •
El Final-Electrical(4055)
Approved
B ? Date C./ �l/ 6
3 .10 )1 i)mu)
r Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
ilk
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•
Rel. .E
ary OF
: �" ELECTRICAL
JUN 01 zoos
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS
PERa /( 1 - /0zc53 _ C/0
�'c xDARSER
SUITE/UNIT/SPACE#
SITE ADDRESS: 31, 4 S a oT
Rve_. S
PROJECT VALUATION ASSESSOR'S'TAX/PARCEL S CURRENT/PROPOSED USE
$ I, 100.00 a 1A 1 o y - 9 o o 9
PROJECT NAME L 1
(Tenant or Homeowner Last Name) C t S 1_�'V, E-'Q,•
L 1t {fy, c
PROJECT DESCRIPTION x Lt'y" r?-0 0 n c..r.J L E t7 i q►r+
Detailed description of work to J
be included on this permit only
NAME ) /' PRIMARY PHONE
PROPERTY OWNER ( 1 t� r i La 1 a•v, A/ �-1-- (..,.c,,,-L c,< (ao G ) //L - /00-
MAILING ADDRESS E-MAIL
33L1-Is- aor` Ape. S.
CITY STATE ZIP FAX
Fe-Acrai way W� (y8do3 ( ) -
NAME PRIMARY PHONE
Cv, r vy,c1. -1-AI&. ( ) -
MAILING ADDRESS EMAIL
ELECTRICAL L/O to 'Por-ler (.00i
CONTRACTOR CITY TE ZIP FAX
WI', tLrsn 4.5 a. 98 3 S'4 (.25-3 )VA- says
WA STATE CONTRACTOR'S LICENSES EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
c CaN 1 . GL„,.. & 13/17- . 0 -00-/b 3638-06-3L
NAME PRIMARY PHONE
APPLICANT MAILING
.u.Leo (.P5-3) 411 -/3 A,/
MAIIdNG ADDRESS E-MAIL
'/0f - Por-• cr loeAy
CITY STATE UP FAX
V>1, I-LGn„ wa q8 3 S'{ p-5-3 ) 9a2... 3,3,14 5-
NAME PRIMARY PRONE
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 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 ,l , ay as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of srlch /h be made by any person,including the undersigned,and flied against the city,
but only where such claim arj$as . - of the city, including its officers and employees, upon the accuracy of the
information supplied to the "1!hT,� _fen rn-r,
SIGNATUR - -E: / / DATE G. / I
PRINT NAME: D/�e,"?7- aze)J?-ig/C'
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcente ncityoffederalway.com
of
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application '.