13-101886 •
} Electrical
City of Federal Way Permit #: 13-101886-00-EL
Community&Econ.Dev.Services
33325 8th Ave S 11
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: SISTERS OF PROVIDENCE
Project Address: 32861 38TH AVE S Parcel Number: 614360 0085
Project Description: Alter circuits for exterior building&landscape lighting.
Owner Applicant Contractor
SISTERS OF PROVIDENCE OLD TIME ELECTRIC INC OLD TIME ELECTRIC INC
1801 LIND AVE SW UNIT 9016 PO BOX 39745 OLDTIEI021LB(6/2/14)
RENTON WA 98057 LAKEWOOD WA 98498 PO BOX 39745
LAKEWOOD WA 98498
•
Additional Permit Information
Is this an Online or O.T.C.application Yes Is Use Educational or Institutional' No
Electrical Fixtures
Circuits-Residential 3
PERMIT EXPIRES Saturday, October 26, 2013
Permit Issued on Monday, April 29, 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
and the City of Federal Way.
Owner or agent CADate: ac:k`\3
dit•s
I,
AIL • THIS CARD IS TO ON-SITE
CITY OF Construction In ection Record
FederarWay INSPECTION REQ TS: (253)835-3050
PERMIT#: 13-101886-00-EL Address: 32861 38TH AVE S
Project: SISTERS OF PROVIDENCE FEDERAL WAY, WA 98001-9665
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) ❑ Ditch cover(4030) 0 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
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
O Final-Electrical(4055)
Approved
Date S--- t—k3
Rough Electrical Final Electrical Right of Way
❑ Approved ❑ Approved ❑ Approved
By Date By Date By Date
R•EIVED •
CITY OF 41.111%esFrol 9 2013 ELECTRICAL
Federal Wa APR 2
y Cm of FEDERAL WAY PERMIT APPLICATION
CDS /
PERMIT NUMBER /3 - / 0 / s s lL/ _ 00
SITE ADDRESS: 3Y310 1 3S-4-" Aft S SUITE/UNIT/SPACE S
PROJECT VALUATION ASSESSOR'S TAX/PPARCEL# CURRENT/PROPOSED USE
$ 0 00 ('S ` 3 (: 6 _ 0 0 e
s----
PROJECT NAME 5%5 S & c�
(Tenant or Homeowner Last Name) - rDV i t' C .
C<4eri or bc.)i\ai nc\ 4- \ctv,Jlsc.,34.,- \ i -i Al
PROJECT DESCRIPTION U 1
Detailed description of work to
be included on this permit only
NAM PRIMARY PHONE
PROPERTY OWNER t S S CA. Qfbvy a-CNN-CU- ( )
MAILING ADDRESS E-MAIL
Sag( I 3S-4' . S
CITY STATE ZIP FAX
w Gci& ( ) -
NAME PRIMARY PHONE
0\& T;vvAe 1_,`ecA :c._ \vAS._ PS3) $t1q 3\'mks-
MAILING ADDS E-
MAILELECTRICAL TD 39-7 LLS-
CONTRACTOR
CONTRACTOR CITY STATE ZIP FAX
.1.-COLIZA.0 oo& Li.... -- cISLV ,t (a3) $Kg- 3a(0$
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
0L
-c--z E = aaa.L3 / /
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( )
E-MAIL
CITY STATE ZIP FAX
( )
Y
PROJECT CONTACT NAME b ` \a\ PRDd -PHONE
� (a53) b'177 - 3‘a1
I certify under penalty of perjury that I amt he 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: ' +', ` jj DATE ``�- 13
PRINT NAME: DL `
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts'Electrical Permit Application