13-103640 i r r Electrical
trical
City of Federal Way
Community&Econ.Dev.Services Permit#: 1 3-103640-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
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Project Name: EVERGREEN COURT BLDG H UNIT 23 ,yt1
Project Address: 33006 19TH LN S Bldg H Parcel Number: 797880 0460
Project Description: Remove existing electrical panel and replae with a new 125amp main breaker panel.
•
Owner Applicant Contractor
KING COUNTY HOUSING AUTHORITY KING COUNTY HOUSING AUTHORITY KING COUNTY HOUSING AUTHORITY
600 ANDOVER PARK W 600 ANDOVER PARK W HOUSIT*215KD(3/12/15)
TUKWILA,WA 98188-3326 SEATTLE WA 98188 600 ANDOVER PARK W
SEATTLE WA 98188
Additional Permit Information
Is this an Online or O.T.C.applications Yes Is Use Educational or Institutional? No
Service greater than 999 Amps') No
Electrical Fixtures
Alt. Serv.Feeder:0 to 200 amps(I' 1
PERMIT EXPIRES Saturday, February 15, 2014
Permit Issued on Monday, August 19, 2013
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
d the City of Federal Way.
Owner or agent: ��ollw Date: e5 VI 3
e c\ cli,Sit,
• CARD IS TO " MAIN ON-SITE -
CITY°F '" Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-103640-00-EL Address: 33006 19TH LN S Bldg H
Project: KING COUNTY HOUSING AUTHOR FEDERAL WAY, WA
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.
0 Service(4235) ❑ Feeders/Sub-panels(4045) ❑ Rough Electrical (4225)
Approved Approved Approved
By Date By Date By Date
El Ceiling Cover(4020) ❑ Final-Electrical(4055)
Approved Approved
By Date `By ,, .)l Date 0-_rd '. 1
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
A._ REc, WED
CITY OF "
ELECTRICAL
Federal Way AUG 19 2013 PERMIT APPLICATION
Z CITY OF FEDERAL WAY
PERMIT NUMBER-J _ 1 0 S 1 „ 4- 0 _ CC
SUITE/UNIT/SPACE#
SITE ADDRESS: 3300 P
IT"'
In y
PROJECT VALUATION (FASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ x50 .00 -
PROJECT NAME
(Tenant or Homeowner Last Name) Eye v`,, y-se....e_✓I r�to y.
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PROJECT DESCRIPTION eA in ' F)),„,, -'' ' ci ✓.'E'- j 1 a 5 x4 Mar(,e‘ LeNea/C-e--
Detailed description of work to `�ar rt.e
be included on this permit only /
NAME f /n� PRIMARY PHONE i
PROPERTY OWNER rKv+A�c®L.evl, �c)u St\ AtAl-LtY, ( ) s7- )).�3
MAILING �I (( l E-MAIL
X 00 Avidlove P.A. Jam' J
CITY STATE ZIP FAX
l.Tt•A)cw, ii4 (4 ct Cd`d1$5 ( )
NAME PRIMARY PHONE
'i''
5 ( )
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 _ CO ;Gel
' k ((a062.)(a062.)271 --&7 3
MAILING ADDRESS E-MAIL
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CITY ��
STATE ZIP ��O..J
FAX FAX
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NAME PRIMARY PHONE
PROJECT CONTACT AOtn, s N 14- (7-06);.7I _ 11 to,7 3
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.
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SIGNATU ` ` _...> DATE a/)61//3
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PRINT NAME: AGE,e-0/l, tel*\3 h-1.--
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application