15-105565 111
Electrical
City of Federalay
Community&Econ.De.Services Permit #: 15-105565-00-EL
33325 8th Ave S
Fed ,wA 003 Inspection Request Line: (253)835-3050
Ph:(253)835-2eral 607wayFax:(25398)835-2609 p q
Project Name: KING COUNTY HOUSING AUTHORITY
Project Address: 29221 18TH AVE S UNIT 6 Parcel Number: 042104 9207
Project Description: Replace 125 amp panel and alter(2)circuits.
•
Owner Applicant Contractor
KING COUNTY HOUSING AUTHORITY TOM JENKINS OWNER IS CONTRACTOR
700 ANDOVER PK W KING COUNTY HOUSING AUTHORITY
TUKWILA WA 9,0188 700 ANDOVER PARK W
TUKWILA WA 98188
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
Alt.Serv./Feeder:0 to 200 amps(11 1 Circuits-Multi-family 2
PERMIT EXPIRES Saturday, April 30, 2016
Permit Issued on Monday, November 2, 2015
I hereby certify that the -••ve information is correct and that the construction on the above described property and
the occupancy and t use ill be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: r G c f Date: k l 21
i ry t ,
...- THIS CARD IS TO REWN ON-SITE ' _ y
CITY OF r. Construction Inspion Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 15-105565-00-EL Address: 29221 18TH AVE S UNIT 6
Project: KING COUNTY HOUSING AUTHOR 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.
El UFER Ground (4295) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) '❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ElRough Electrical(4225) '❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By G� Date ,\ "jam,\ 5By Date
El Final-Electrical(4055)
Approved
fly.. .
S Date 12_ 1 ! _ fT
Ei Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED S
1► ELECTRICAL
CITY OF NOV 022015
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER
S _ 1 0 5 DS
5
SUITE/UNIT/SPACE#
SITE ADDRESS: 1_0)7_2_t 1t) IIV C '
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ "t( w n o 1 . 9 z07
PROJECT NAME
(Tenant or Homeowner Last Name) n
t 1-* l25 Auto P 6—
PROJECT DESCRIPTION
1\-1 ,f
� 2 C c�c u,
Detailed description of work to
be included on this permit only
NAME / PRIMARY PHONE
PROPERTY OWNER Vt,c£� t tr w7y '-L r;c�6alve r� ( lob) f•-E t oo
MAILING ADDRESS C E-MAIL
100 41601)cit PMit ,, I c �"E F .J 1 CC t { .ca-e?
CITY STATE ZIP FAX
�t (LLA-RUA- UJI 4c)[Seo (ZCb )91a -(1.24(
NAME ��/� PRIMARY PHONE
01-0-)1,45(1.-
c(( -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PRIMARY PHONE
APPLICANT t° A ` 7u'-!A)S (2v, ) (-3 (B C'
MAILING ADD SS'(,OD tTN 7Yt 40t Lo �Iw J E-MAIL
t�C�h4.a
CITY STATE ZIP FAX
iot,( (4-(i)r3 Pie )P4 _ 1z2.y
NAME `�` PRIMARY PHONE
PROJECT CONTACT U�'v 1- ( ) 3cS
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 cl• a es out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to he cit a part of this application.
SIGNATURE: DATE It �'2- •
PRINT NAME: C574
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application