18-100946 a - t
Electrical
City of Federal Way Permit #:18-100946-00-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: RETREAT MEADOWS
Project Address: 35615 3RD AVE SWParcel Number: 302104 9021
Project Description: Install street light cabinet at the NE corner of S 356th St and 2nd Avenue SW
Owner Applicant Contractor
356TH STREET MGMT LLC SJA ELECTRIC/B B ELECTRIC INC SJA ELECTRIC/B B ELECTRIC INC
PO BOX 26116 17404 MERIDIAN E BBELEBE950PI(10/22/19)
FEDERAL WAY WA 98093 PUYALLUP WA 98375 17404 MERIDIAN E
PUYALLUP WA 98375
Additional Permit Information
Is this an Online or O.T.C.application? Yes
1 t `, 1' ' _Electrical Fixtures
Mast or Meter Repair(Resider 1
PERMIT EXPIRES Thursday,28 February,2019
Permit Issued on Wednesday,February 28,2018
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.
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Owner or agent: Z Date: �!
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THIS CARD IS TO REMAIN ON-SITE
CITY OF ` Construction Inspection Record
Fede al Way INSPECTION REQUESTS: (253)835-3050
PE 'MIT#: 18 100946 00 Address: 35615 3RD AVE SW
'roject: 356TH STREET MGMT LLC FEDERAL WAY WA 98023-7366
Scheduled nspections 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 te 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 un- re about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
3❑ UFER Ground(4295) ® Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
.® Pool Bonding(4195) ��0 Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
• .., .
•,,,
® eders/Sub-panels(4045) CI Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
.By Date By Date By Date
CI I inal-Electrical(4055)
Approved / / ,,
'; .,�,_ Dat9 //
CI Rough Electrical CI Final ElectricalCIRight of Way
Approved Approved Approved
By Date By Date By Date
CITY OF v„,.11111111.
RECEIVED ELECTRICAL
Federal Way FEB 28 2018 PERMIT APPLICATION
CITY OF FEDERAL WAY 1 O► 10 0 Q4-G
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COMMUNITY DEVELOPMENIERMIT NUMBER Q `
� SUITE/UNIT/SPACE#
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SITE ADDRESS: 3 5 4 -C 0 /1 U-e- s i- ti
PROJECToVAATI�/��v ASS R�S TAX/PARCEL# - ^ O
PROJECT NAME q-- CURRENT/PROPOSED USE
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(Tenant or Homeowner Last Name) pe:4-i-+ + ( \ pdo tAi S
PROJECT DESCRIPTION �� L� k i CAA i:):1 •� �"
Detailed description of work to
be included on this permit only
N ME PRIMARY PHONE
PROPERTY OWNER ,141 sit r'h- k (%lo M r: 5 ( ) -
MAILING ADDRESS E-MAIL
Cr STATEZIp FAX
NAME PRIMARY PHONE
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MAILING ADDRESS E-MAIL
ELECTRICAL (31-a -lel I f -)Li U LI Mu-4.4,N
CONTRACTOR CI Y STATE ZIP / FAX
WA1 �( w.� q g 3 ' > (E I ) -
_ I3 STATE6 � ��Ce ONTRACTOR'S LICENSE� ��ETION/�1 F� RAL}y}'�$ �I S CENSE 4
NAMF 1... / 5 Y 11PRIMARY PHONE
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APPLICANT MAILING ADDRESS E-MAIL
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CITY STATE ZIP FAX
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NAME PRIMARY PHONE
PROJECT CONTACT ( )
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 to the city as a part of this application.
SIGNATURE: ' ` / DATE / i
PRINT NAME: 5.-tl°scA (..00G./ C,./\
Bulletin#160-April 14,2016 Page 1 of 1 k.vHandouts\Electricai Permit Application