16-101547Project Name: TOWN SQUARE PARK
Project Address: 31600 PETE VON REICHBAUER WAY S
Project Description: Install and wire new LED pole lighting.
Electrical
Permit #: 16 -101547 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 092104 9021
Owner
ARRfican
City of Federal Way
CITY OF FEDERAL WAY - PARKS
Community & Econ. Dev. Services
FILE
33325 8th Ave S
27726 131ST CT SE
Federal Way, WA 98003
FEDERAL WAY WA 98063
Ph: (253) 835-2607 Fax: (253) 835-2609
27726 131ST CT SE
Project Name: TOWN SQUARE PARK
Project Address: 31600 PETE VON REICHBAUER WAY S
Project Description: Install and wire new LED pole lighting.
Electrical
Permit #: 16 -101547 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 092104 9021
Owner
ARRfican
Contractor
CITY OF FEDERAL WAY - PARKS
M JONES ELECTRIC
M JONES ELECTRIC
33325 8TH AVE S
27726 131ST CT SE
MJONEJE90400 (9/20/16)
FEDERAL WAY WA 98063
KENT WA 65080
27726 131ST CT SE
KENT WA 65080
Additional Permit information
Electrical Work Valuation?....................................37000 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 .................... 5
PERMIT EXPIRES Thursday, March 30, 2017
Permit Issued on Wednesday, March 30, 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 W4 the laws, rules and regulations of the State of Washington
an a ty of Federal Way.
Owner or agent: Date:
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE '
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
16 -101547 -00 -EL Address: 31600 PETE VON REICHBAUER WA`
CITY OF FEDERAL WAY - PARKS FEDERAL WAY, WA 98003-5426
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 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)
Final Electrical
Approved
Slab/Concrete Floor (4255)
Approved
Pool Bonding (4195)
Approved
Temporary Power (4275)
Approved to place concrete
By
Date
By V.,4
Date + (3 I t,
By
Date
Rough Electrical
Approved
Final Electrical
Approved
E]
13
Pool Bonding (4195)
Date
Temporary Power (4275)
Service (4235)
Date
Approved
By
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
Final - Electrical (4055)
Approved
By
Date a
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY CWV& WE=
Federal Way MAR 3 0 2016
ELECTRICAL
PERMIT APPLICATION
SITE ADDRESS:316Ov PETE VON "R61 C 4BAUP_K
SUITS/UNIT/SPACE #
PROJECT VALUATION7777
$ 37 Doo
#
0
CURRENT/PROPOWD USE
PROJECT NAME
(Tenant or Homeowner Last Name)
�+ _ _
f KDtRAL WAY TOwW VhRE: PA 2 K
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
S TA L lt WINCW 4,VD POLE- 1.„
PROPERTY OWNER
NAME
CA -T-1 OF PEO 5R AL w A Y
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATS
I Zw
FAX
ELECTRICAL
CONTRACTOR
NAME PI JONE-5 F-LECT%k1G(253)
PHONE
�l ) Z33
MAILING ADDRESS
2777_(o t3t 5t --
CcorrrRACTOR
E -MAH.
1t ENT
W
q8O 3 O
( FAX
WA STATECONTRACTOR'S LICENSE # EXPIRATION DATE
M jo&jC- .1t,:. 9 0N4a
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
rARKS HAL.L SONES
PRIMARY PHONE
(Zs3 �(ol - �Z33
NAMING ADDRESS
Z77Z4o 13k GT5E
�MpIL
CITYSTATE
WA
ZD?
900-60NAME
FAX
-
PROJECT CONTACT
M fttz% t ALL. 30NEs
PRIMARONE
(Z53) 5401 YPHZ33
I certgy under penalty of perjury that I am the property owner or authorised agent of the property owner. I certgy 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
'applicable City of Federal Way regulations pertaining to the work autkoriaed by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with locai, 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 o the city, including its officers and employees, upon the accuracy of the
information supplied to thea as a pcyt of fts n.
SIGNATURE:
PRINT NAME:
3-30-110
Bulletin #160 —January 1, 2013 Page 1 of 2 k:lHandouts\Electrical Permit Application