13-100265 ♦ y
III Electrical
City of Federal Way Permit #: 13-100265-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 e
Ph:(253)835-2607 Fax:(253)835-2609 I Inspection Request Line: (253)835-3050
Project Name: EVERGREEN COURT APARTMENTS UNIT 8
Project Address: 33015 19TH LN S Parcel Number: 797880 0460
Project Description: Replace 0-200 amp panel
Owner Applicant Contractor
KING COUNTY HOUSING AUTHORITY KING COUNTY HOUSING AUTHORITY OWNER IS CONTRACTOR
600 ANDOVER PARK W 600 ANDOVER PARK W
TUKWILA,WA 98188-3326 TUKWILA,WA 98188-3326
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(I\ 1
PERMIT EXPIRES Tuesday, July 16, 2013
Permit Issued on Thursday, January 17, 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
_ ity of Federal Way. /
Owner or agent: Date: 1 i 1/13
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THIS CARD IS TO MAIN ON-SITE -
CIFeTYOF i , • Construction In ection Record
Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-100265-00-EL Address: 33015 19TH LN S
Project: KING COUNTY HOUSING AUTHOR FEDERAL WAY, WA 98003
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) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By(_ _, Date a LV`3
❑ Feeders/Sub-panels(4045) '0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
O Final-Electrical(4055)
Approved
By 0.41 ..., Date Q ` t. -i m
O Rough ElectricalEl Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
. v•A • EL2CTRICAL
CITY OF
Federal Way PERMIT APPLICATION
PELT NUMBER ( � _ ( 0 0 2(o 5 _ CO
SUITE/UNIT/SPACE i
SITE ADDRESS:J?3 Q 15 i ct-�-►1 la5 48
PROJECT VALUATION ASSESSOR'S TAX/PARCEL I CURRENT/PROPOSED USE
$ &SO .G° Z97- 0g0 _ o4 )
PROJECT NAME
(Tenant or Homeowner Last Name) Eve i-.r-e e l". C.:NA i-
PROJECT DESCRIPTION <s T I).SA rev IACU/new -
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER kI c✓�c�, co,A vi 17 /- u / ✓t\ Au�l�ri4 (cZ)57&1 - 1)..P-3
MAHdNG.DRES8 ( ((( E-MAIL
600 i VI 010�4 - Pcir k t2
CITY STATE ZIP FAX
_ K.,..`10L A . crg Ig�j ( ) -
NAME � PRIMARY PHONE
,4J/�/1 a ( ) -
MAILING ADDRESS
E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( ) -
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
/ /
NAME r ( PRIMARY PHONE
APPLICANT Act h k in1` hl--- ( ) -
MAILING ADDRESS E-MAI
L
CITY VVV STATE ZIP FAX
( ) -
NAME, HONE
PROJECT CONTACT rd.n kin t k4- QO)J.71 - 4L,?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.
SIGNATURE: `< DATE if 7/13
PRINT NAME• 4
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application