15-103952 • 410 r
Electrical
City of Federal WayFILE
Permit #: 15-103952-00-EL
Community&Econ.Dev.Services
` 33325 8th Ave S
Federal way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (2
53)835-3050
Project Name: KING COUNTY HOUSING AUTHORITY
Project Address: 29219 18TH AVE S Parcel Number: 042104 9207
Project Description: Replace 125-amp panel,alter 2 circuits.
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Owner Applicant Contractor
KC HOUSING AUTHORITY KC HOUSING AUTHORITY OWNER IS CONTRACTOR
600 ANDOVER PARK W 600 ANDOVER PARK W
TUKWILA WA 98188 TUKWILA WA 98188
Additional Permit information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1 Circuits-Residential 2
PERMIT EXPIRES Wednesday, February 3, 2016
Permit Issued on Friday, August 7, 2015
I hereby certify that th e information is correct and that the construction on the above described property and
the occupancy and e 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: ( j A4 Date: 15111,1:5-
ED
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�' - THIS CARD IS TO REWT ON-SITE
Federal Wa Construction Inspe tion Record
y •
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-103952-00-EL Address: 29219 18TH AVE S
Project: KC HOUSING AUTHORITY FEDERAL WAY, WA 98003-3826
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) 0 Ditch cover(4030) -❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date
By Date
Pool Bonding(4195) em
❑ EITTemporary rY Power(4275
) 0 Service(4235)
Approved Approved
Approved
By Date By Date
By Date
Feeders/Sub-panels(4045) Rough Electrical 4225
❑ ❑ g ( ) ❑ Ceiling Cover(4020)
Approved Approved
Approved
By Date By Date
By Date
❑ Final-Electrical(4055)
Approved
5.-
❑ , Rough Electrical ❑ Final Electrical Right of Way
Approved Approved El
Approved
By Date By Date
By Date
•CEIVED
PLECTRICAL
CITY OF AUG 07 2015
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
` CDS
PERMIT NUMBER /5 _ / D 3 _ E L
SITE ADDRESS' SUITE/UNIT/SPACE#
• 2g2t S •
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
� JJ~ SJ V / V _ 90 ' T
PROJECT NAME
(Tenant or Homeowner Last Name) �j
t1 t(7�t,C L• ` t.kt-�c�lrr 2S` T kt/2
PROJECT DESCRIPTION JL \\2) CrfIcIA4TS
Detailed description of work to f�t.'T'L��
be included on this permit only
NAME4PRIMARY PHONE
PROPERTY OWNER 6 CQ . 4.411+744
tStA16r ( X )51L - I too
MAILING ADDRESS r r E-MAIL
I DD �aJ et- (M* vu . C:44 (� teUi4.cam(
CITY STATE ZIP FAX
cc.4 \kW 9% Mt) (2PG)571 -C22.4
NAME PRIMARY PHONE
OWIclt�l-_ ( ) -
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 OM .11404�1 (2 ) ) f _332,
MAILING ADDRE E-MAIL�j �
CITY STATE ZIP FAX
KUALA' 144 q t 9 t, ( )574 - 12L`�
NAME PRIMARY PHONE
PROJECT CONTACT coo �- ic5 (2D) ( u3 t,
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 Iaws.
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 c :'m arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supp ed to th- city as a part of this application.
SIGNATURE: AIL DATE *t71 ` Ic
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PRINT NAME: fi
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Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application