17-105102 Electrical
City of Federal Way , Permit #:17-105102-00-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: LAKEHAVEN WELL 25 GENERATOR
Project Address: 31001 8TH AVE S Parcel Number: 082104 9029
Project Description: Installing a Generator
•
Owner Applicant Contractor
LAKEHAVEN UTILITY DISTRICT SEAN HALLSTROMNORTHEAST NORTHEAST ELECTRIC LLC
PO BOX 4249 ELECTRIC LLC NORTHEL957D4(3/24/19)
FEDERAL WAY WA 98063 7004 S GREEN MOUNTAIN RD
WOODLAND WA 98674 1780 DOWN RIVER DR
WOODLAND WA 98674
Additional Permit Information
Is this an Online or O.T.C.application" No
rIC'dl Fixtures
New Service:401 -600 amps I 1
PERMIT EXPIRES Friday,4 January,2019
Permit Issued on Thursday,January 4,2018
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. f '
Owner or agent: v V (1\_) Date: I `l 12_0
(:1"----' ....)."' -1/"\-rx_9(: 2)
p .
•
4141%„S.,....... THIS CARD IS TO REMAIN ON-SITE
CITY OF ' Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 105102 00 Address: 31001 8TH AVE S
Project: LAKEHAVEN UTILITY DISTRICT FEDERAL WAY WA 98003-4703
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) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Yg Date ( \1/2.1i?' . By Date 1 1 Sr 1 l 4' By Date
® Pool Bonding(4195) ❑5 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
�® Feeders/Sub-panels(4045) ��0 Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
Final-Electrical(4055)
Approved
By C.;..._ 14r,+'�25 Date .,a_iv
Rough Electrical Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF l ELECTRICAL
Federal Way RECEIVED PERMIT APPLICATION
NOV 2 7 2017
5P-
_ —
ERMIT NUMBER ) 7 I O JCITY OF FEDERAWA - -COMMUNITY DEVELOPMENT SUITE/UNIT/SPACE#
SITE ADDRESS: 3/d O) 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ /Oo v o a 1 n tel - 1 o 1
PROJECT NAME
(Tenant or Homeowner Last Name) g 4 �aV�� �1� 2 G me)e�a
�rL r
1 w . a To r A
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 2 , k .i')a.,R., u 4:1;I� P1.1 r i c•')' ( ) -
MAILING ADDRESS E-MAIL
pv, )30.), /2 y9
CITY STATE ZIP FAX
FJIa .it'` 61. d 98x6 ( ) -
NAME PRIMARY PHONE
A6r 41¢a,s-4 E1 c=c;‘_ Z L L A o )a 25 - 706‘1
MAILING ADDRESS E-MAIL
ELECTRICAL /7$o Pow.n r i ver TD r• Se ck'n�!O h e i'C,ne l•
CONTRACTOR CITY STATE ZIP FAX
"161 LA. '.-.46). ” 0Y ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
kar4)7al 157DLi 03 /2y / )1
NAMEPRIMARY PHONE
APPLICANT K., J-)e a s 1 E//k c^Lf Z G C (34 a) 225-7 601
MAILING ADDRESS E-MAIL
1784 Vey.,l•'Tu.r Pr 52a1111 Q he)i . . ne4
CITYI� STATE ZIPFAX
\
"'aJ 1..1 kA is (57y ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 5e.a,n 1-a J?d- � (3(90 )225
1 i - 7ooy
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.
LSIGNATURE: D,yi,,,,. DATE i 0_ 2-) - (7
PRINT NAME: 41-1 k,i u4r'
Bulletin 4160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application