14-105594 l•
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City of Federal Way
Community&Econ.Dev.Services F' PePermit #: 14-105594-00-EL
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33325 8th Ave S
I;.:
Federal Way,ax98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax::(253)835-2609 � q
Project Name: CHURCH OF GOOD SHEPHERD
Project Address: 345 S 312TH ST Parcel Number: 082104 9161
Project Description: Inspection of meter for reactiviation of power.
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Owner Applicant Contractor
EPISCOPAL PARISH CHURCH CHRIS PARLY
PO BOX 3108 3610 33RD ST NE
FEDERAL WAY WA 98063-3108 TACOMA WA 98422
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
Mast or Meter Repair(Commercia 1
PE., IT EXPIR: S Saturday, April 25, 2015
P. ,,it Issued o J Monday, October 27, 2014
I hereby certify that the above info - on is corn: t and that the construction on the above described property and
the occupancy and the use will be cco •an : ith the laws, rules and regulations of the State of Washington
:n, LC' of Federal Way.
Owner or agent: Date: �0 Z� (C(� l P
4,,,.' ', fit.. t y — J
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THIS CARD IS TO MAIN ON-SITE ,
aria, li& '' • Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 14-105594-00-EL Address: 345 S 312TH ST
Project: EPISCOPAL PARISH CHURCH FEDERAL WAY, WA 98003-4031
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) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) o Temporary Power(4275) Service(4235)
Approved Approved Approved
By Date By Date %IA, Datetl
▪ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) Ceiling Cover(4020)
Approved Approved Approved
By Date Bye,VI-- Date 1,_y,,,,ty By Date
❑ Final-Electrical(4055)
Approved
By0.4 ,\Axe. Date 3...._\,,ctt,..-1
❑ Rough•Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
• ‘ RECEIV910 •
CITYOFAOCT 27 2014 ELECTRICAL
Federal liVpyt OF FEDERAL WAY PERMIT APPLICATION
/CDS
(4/PERMIT NUMBER / _ 5 5-9 v-
SUITE/UNIT/SPACE#
SITE ADDRESS: I �'
P-.+ VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
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PROJECT NAME �Si( S o( C Vim-'�Lt
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION ac. ,, ( "'i ILckr UI/�G� SIJ t*• . -- S ,t
Cc & eck el Qtr -
Detailed description of work to C. OA pk t-,M,..F P S• _ Y ve� Gr
be included on this permit only t\� t
NAM/E � PRIMARY PHONE
PROPERTY OWNER lid�o[.ter' c GA1- � >rtrL (ZO) (0°9- 1362_
MAILING ADDRESS E-MAIL
L(S CO I2 S1 .
CITY STATE ZIP
FAX
Y`P&Q4WA cii rea. ( ) -
NAME - '
PRIMARY PHONE
( )
MAILING ADDRESSO E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP
FAX
( ) -
WA STATE CONTRACTOR'S LICENSE I EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE I
,_ / /
NAME PRIMARY PHONE -_ ---
APPLICANT MAILING ADDRESS
E-MAIL
CITY STATE ZIP
FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT
/' L.fa- (��3)�' - -c3'
I certify under penalty of perjury that I am the prope 1_ owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information s •misted in support .' this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way -• lations pertaini • to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not - ove the owner's I-sponsibility
-sponsibility for compliance with local, state, or federal laws regulating
construction or environmental law
I further agree to hold harmle -t City of Federal 'II•y as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of su h •faint) hich mayf•e made by any person,including the undersigned,and filed against the city,
but only where such claim arises ou• of reliance 111111• the city, including its officers and employees, upon the accuracy of the
information supplied to the city as •p. •• ' ap•lie•.on.
SIGNATURE: DATE 70/,7/"/ V
PRINT NAME:
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application