17-104506 Elec ica
CityofFedlopmeny Permit #:17-104506-00-EL
Community Development Dep[.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: DECATUR SENIOR HIGH SCHOOL
Project Address: 2800 SW 320TH ST Parcel Number: 122103 9034
Project Description: Data cabling in room 101
Owner Applicant Contractor
FEDERAL WAY PUBLIC SCHOOLS LARRY INTRACOMMUNICATION NTWK SYS IN
33330 8TH AVE S HOWSERINTRACOMMUNICATION NTWK (INSI)(06)
FEDERAL WAY WA 98003-5433 SYS IN(INSI) INTRANS994JL(4/10/19)
4922 N PEARL ST 4922 N PEARL ST
TACOMA WA 98407 TACOMA WA 98407
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
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Low Voltage-Other(Commei 1
PERMIT EXPIRES Wednesday, 19 September,2018
Permit Issued on Tuesday, September 19,2017
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
Was ' gton and the City of Federal Way.
Owner or ag-/1111W G=- 7 Date:
/ I _ 20/2
111 THIS CARD IS TO REMAIN ON-SITE .�
CITY Or �'.. :. • '
Construction
ton Record
rdFederal Way INSPECTION 53)835-3050
PERMIT#: 17 104506 00 Address: 2800 SW 320TH ST
Project: FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY WA 98023-2207
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.
® UFER Ground(4295) ® Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
111 Pool Bonding(4195) ® Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date
By Date
Its Final-Electrical(4055)
Approved
-.LANNIIIr Datel
Eill Rough Electrical fl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
;, AIL RECEpti
•� ELECTRICAL
CITY OF D
Federal Way SEP f g 201? PERMIT APPLICATION
CITY O,--,, ER-AL WAY
COMMUtv''I DE ERMIT NUMBER i 7 _ 1 O 1 5 0 6 -
�,, SUITE/UNIT/SPACE#
SITE ADDRESS: .2_g('O C 1 S 2 J' ' ' 5+-
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
s %26..s', -2,----- 1 2- 1 0 3 - 1 0 3 £/
PROJECT NAME ,..
(Tenant or Homeowner Last Name) ,,�eL-Ol�� /rye J G' .6,6/ 0,4' /a l.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER /;'l4-.0s/ /640, ,c -74--1°jo7/V ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP ( FAX
l )
NAME PRIMARY PHONE
,Z.C/sT (23)7 '/ - .°Vier
MAILING ADDRESS E-MAIL
ELECTRICAL </. /,Z-- /Lf' ,,e!,41/Z-1 5-:-7/: L4/4.€ �/ ll t 4t i �€1j,ece
CONTRACTOR CITY STATE ZIPFAX
G-# 49 ZJI, ;iv' 7 (21"3) I?7- .'/1""-
WA STATE CONTRACTOR'S LICENSE# gEXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
-.37-4/7-,e/91-B. 9 -'4",.v2._ / / 3o /Zd/'
NAME PRIMARY PHONE
APPLICANT /V, s . "Z (2.53 )7‘i - 6 We
MAILING DR7ESS ,p E-MAIL
`l 'Z �� / ' 7 ..5� '- eli,et ,47o°ns'sC.d5(i .c-e,
CITY J� STATE ZIP
Cj
S-f' (( FAX
/ e�% ?- W 7 (7- 3)6 - 1/.1
NAME � PRIMARY PHONE
PROJECT CONTACT 2.,.x/1 /`1.04 6-1,4e.
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 t reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part this application.
SIGNATURE .0,...e. 5.41/
DATE ( ` ' --.26/ 2
PRINT NAME:_�i.446e ' / ',z.
Bulletin#160—April 14,2016 Page 1 of 1 k\Handouts\Electrical Permit Application