18-100271 •
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Electrical
City of Federal yDeveopmeny Permit #:18-100271-00—EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609
Project Name: ST VINCENT DE PAUL PARISH
Project Address: 30525 8TH AVE S Parcel Number: 082104 9005
Project Description: Install low voltage wiring for audio/speakers/projectors(voice/data cabling)
Owner Applicant Contractor
CCAS PROPERTY&CONST MADRONA DIGITAL MADRONA DIGITAL
710 9TH AVE 14210 NE 20TH ST SUITE B MADROD*877JR(4/19/19)
SEATTLE WA 98104 BELLEVUE WA 98007 14210 NE 20TH ST SUITE B
USA BELLEVUE WA 98007
USA
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
Low Voltage-Other(Commel 1
PERMIT EXPIRES Thursday, 17 January,2019
Permit Issued on Wednesday,January 17,2018
I hereby certify that the above information is correct and that the construction on the above described property
and the occupanc -the-ttse--will be in accordance with the laws, rules and regulations of the State of
ash[ ton and the City of Federal Way.
Owner or agent: Date: / /11
® C°
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O
THIS CARD IS TO REMAIN ON-SITE
"TMO Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 18 100271 00 Address: 30525 8TH AVE S
Project: CCAS PROPERTY & CONST FEDERAL WAY WA 98003-4115
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) ❑U Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
.El Pool Bonding(4195) El Temporary Power(4275) ® 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
D Final-Electrical(4055)
Approved
By -
�� Date '' ( C
❑ Rough Electrical 0 Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
CiTYOP ►., ELECTRICAL
Federal Way PERMIT APZ&ICATION
Ea GED
PERMIT NUMBER L ' I 0 0 .9.7( _ CC/ JAN 17 2018
CITY OF FEDERAL WAv
COMMU INCE#
SITE ADDRESS: 3 05"77 - g 4(r' A /,
PROJECT VALUATION ASSESSOR'S TAXA/PARCEL# - CURRENT/PROPOSED USE
Jt v il( 0 40
PROJECT NAME
(Tenant or Homeowner Last Name) 41-'1 U�v(c/ T (� � �k �a rt c
PROJECT DESCRIPTION &1A9 o ' ?� �0-- /I wL j .5yS4"0/1
Detailed description of work to
be included on this permit only I j cr J
NAME �� PRIMARY PHONE
PROPERTY OWNER ', L 0 C.I�(�C� C7�'C�) j I� (!(3)?.3T- 234,
MAILING ADDRESS EE--MAIL
"i
- ve ;lj liski•cei 6-1-14sCPKfeat's
CIT ST T ZIP FAX
edtki a er roo,
PRIMARY PHONE
NAM N.q V 1 o Y cc 0 (;�I L C. �4 L,F..C{-/J-61-04
MAILING ADDRESS / .
ELECTRICAL 1-2-(0 1 Y E' � �t- ��r�P _7 -Itev� piaci tictc1 I j,.bti,
CONTRACTOR CITY �/ STATE ZIP FAX co/Yj
WA S CONTRACTOR'S LICENSE# f/ /? /ry IRATION DATE FEDERAL WAY BUSINESS LICENSE#
MAD'RCM g-77 Z�
NAME o PRIMARY PHONE
APPLICANT e" ei' ( ) -
MAILING ADDRESS E-MAIL
— gain - qs q dve ---
CITY STATE ZIP FAX
)
NAME ]� „�
RIMARY PHONE
PROJECT CONTACT T eUpee-eAd” (4'Z.S) -440r6j-�n/
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 o the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied-to,_ city as cF rt oft application.
SIGNATURE: . -'" .-41111111L '° rskGta DATE
r/(1//
PRINT NAME:
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application