14-101125Electrical
City of Federal Way C t
Community & Econ. Dev. Services ' ` 7 Permit #: 14 -101125 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 InS ection Re uest Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 �. , ;__ , , . p q
Project Name: EVERGREEN COURT UNIT G-19
Project Address: 33010 19TH LN S Bldg G Parcel Number: 797880 0460
Project Description: Replace 125 -amp panel.
Owner
ARplican
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
TUKWILA, WA 98188-3326
600 ANDOVER PARK W
SEATTLE WA 98188
Additional Permit Information
Is Use Educational or Institutional?.......................No Service greater than 999 Amps? ............................. No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps m 1
PERMIT EXPIRES Monday, September 8, 2014
Permit Issued on Wednesday, March 12, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and twill be in accordance with the laws, rules and regulations of the State of Washington
,
— ii
Owner or agent: < L and the City of Federal Way.r date: 3 l (L I Q
THIS CARD IS TO REMAIN ON-SITE
Federal Way Construction Inspection Record
y INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 14 -101125 -00 -EL Address: 33010 19TH LN S Bldg G
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.
Final - Electrical (4055)
er !� M f1aApproved
By — g Date -S S
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)11
Slab/Concrete Floor (4255)
1:1Approved
Approved
Service (4235)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
er !� M f1aApproved
By — g Date -S S
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)11
1:1Approved
Right of Way
Service (4235)
Date
Approved
By
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
er !� M f1aApproved
By — g Date -S S
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
RBCMVED 0
CITY OF MAR 12 2014 ELECTRICAL
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
i CDS
PERMIT NUMBER
SITE ADDRESS:
PROJECT 7ASSESSOR'S VALUATION TAR/PARCEL #
1 �� � D
PROJECT NAME
(Tenant or Homeowner Last
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
ELECTRICAL
CONTRACTOR
APPLICANT
PROJECT CONTACT
NAME
/'.tj� �Lt
MAILING ADDRESS
CITY
�ulcwz�
NAME
C> L,'.) A, f C✓L
MAILING ADDRESS
36 6�
&421�0
STATE ZIP
Ltil ��t$
SUITE/UNIT/SPACE #
V)
CURRENT/PROPOSED USE
PRIMARY PHONE
391-' (3 ac)
E-MAIL
J ® t4u .
FAX
(Zob 614 4224
PRIMARY PHONE
E-MAIL
CITY STATEZIP FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE #
NAME
I �(� J
MAH.ING ADD -J
-1 Dl)L� L
1 ukwl, t.�
NAME
M QA376I Nf
STATE ZIP
(.t.✓t
PRIMARY PHONE
(2�b�39(-3t3�
E-MAIL
cJ ca IL cm • iY
AX
2-6 FlZ2�
PRIMARY PHONE
(N ) iql -3 13 e,
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 su aim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information suppl ed to a city as apart of this application.
,SIGNATURE: `TT
PRINT NAME: a4A
Bulletin # 160 —January 1, 2013 Page 1 of 2
3I1-I�:t
k:\Handouts\Electrical Permit Application