17-104627 f �
Electrical
City of Federal .
Community Development Dept. � Permit #:17-104627-00-EL
ral Way
33325 8th Ave S
Federal Way,WA 98003 j Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: SOUTH KING FIRE STATION 63
Project Address: 33414 21ST AVE SW Parcel Number: 132103 9062
Project Description: power to security panels
Owner Applicant Contractor
SOUTH KING FIRE&RESCUE SOUTH KING FIRE&RESCUE OWNER IS CONTRACTOR
31617 1ST AVE S 31617 1ST AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
». ,..0�.,..,.. €f. ...,,.,:. .., �. 9,,. ,..<:' .. „xN„ ',,,?',":,€,en�,..? A� x ✓.:-. E€Es,...u:.a-vagi
PERMIT EXPIRES Thursday,27 September,2018
Permit Issued on Wednesday,September 27,2017
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: 9-Z7- -
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS :(253)835-3050
PERMIT#: 17 104627 00 Address: 33414 21ST AVE SW
Project: SOUTH KING FIRE&RESCUE FEDERAL WAY WA 98023-7761
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) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
•
•• •• .
® Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ® Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date .,By Date ' By Date
10 Final-Electrical(4055)
Approved
By Date 4"9....trasrt
•
0 Rough Electrical 0 Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
OF ELECTRICAL
CITY a
SEP 2 7 2017
Federal Way PERMIT APPLICATION
COLi MMUNITY DEVELOPMENT
PERMIT NUMBER ' 7 _ 1 0 Li ( Z 7 _ 1✓
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 1 Z ` 5' Av6 S-�
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) S 7`A 77 oN b3
PROJECT DESCRIPTION Peptic/2 ra Sec- 2 Ci-11 PA r.JE 5
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ,>�,-H K A-I 4 cg-E- ,a,ve sc vc (z$3 )417 - I ZS 5
MAILING ADDRESS E-MAIL c-
3/!o f 7 IST AVE.S: 'twice_Lee&50.4-lit)CiniFire, c,/G
CITY STATE ZIP FAX J
/ EL WALT 14/I '1fClati3 ( ) -
NAME PRIMARY PHONE
SA"..F ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT SA "` ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT
51-4A0N Moor (264) 3W -0.51//
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.
SIGNATURE: Z41 ' _ /"6 9 DATE -27 - 17
PRINT NAME: LANCE Bo6-
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenten'mcityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application