13-102609 Electrical
City of Federal Way • Permit #: 1 3_102609-00-E L
11111.
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
Project Name: COMCAST CABLE POWER SUPPLY 27b°7 10
Project Address: 34234 16TH AVE S Parcel Number: 212104 9055
Project Description: Installing a 20amp, 120 volt service mounted on pole,for cable amplifier.
Owner Applicant Contractor
PUGET SOUND ENERGY/ELEC TRI COUNTY ELECTRICAL SERVICES LLC TRI COUNTY ELECTRICAL SERVICES LLC
PO BOX 90868 PO BOX 931 TRICOCE948DZ(3/13/14)
BELLEVUE WA ANACORTES WA 98221 PO BOX 931
98009 ANACORTES WA 98221
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
New Service: 0- 100 amps(Comm 1
PERMIT EXPIRES Tuesday, December 10, 2013
Permit Issued on Thursday, June 13, 2013
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. I
Owner or agent: .' �' Date:
•
A., • THIS CARD IS TO MAIN ON-SITE
CITY UP Construction Ins ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 13-102609-00-EL Address: 34234 16TH AVE S
Project: PUGET SOUND ENERGY/ELEC FEDERAL WAY, WA 98003-6801
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 Ditch cover(4030) ❑ Slab/Concrete Floor(4255) El Service(4235)
Approved Approved to place concrete Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) El Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
❑ Final-Electrical(4055)
Approved
Date L (A
❑ Rough Electrical111 Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
�ECEIVED
. N.. ELICTRICAL
CITY OF : JUN 1.3 2013
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
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PERMIT NUMBER ( 3 _ 1 D r,( / / 9 - CO
CCCC///J 111 \ lll[[[/// l/ SUITE/UNIT/SPACE#
SITE ADDRESS: 3 a,34 1(9.:i- A.00 F -1)r'n..W ik-AtA1
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ r7 bo'O -
PROJECT NAME //�� � l
(Tenant or Homeowner Last Name) L-l9 VV\C.A25f C.-106.b lc av-+clot—-s,s9� y
PROJECT DESCRIPTION �0 A Ptilp 1 ZO 004 e.eb.hkE t1/4L oN -
Detailed description of work to 'ate cA k- ---- Lt 1-le-eC. ,,
be included on this permit only
NAM . ft PRIMARY PHONE
PROPERTY OWNERS ( ) -
MM ADD E-MAIL
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C STATE ZIP FAX
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76(614/(C
NAME PRIMARY PHONE
1721 bYvravk-Nt. C tL Olt,D)5- COS(
ING AD S Q E-MAIL
ELECTRICAL D t 31 - C Q t- - mal
CONTRACTORCria/J ues
ded ZIP j/]? ( FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
T2 l cmc. ,-1,`‘. DZ. / /
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME , PRIMARY PHONE
PROJECT CONTACT l U-)Ell I Jg-A— AD) Ce 2.i4.3
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 • et"as part . litiv.plication.
--'A _�
SIGNATURE: ��,I ` /,DATE ( II
15 /1 5
PRINT NAME: �+Iftir
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application