14-10151441
City of Federal Way Permit #: 14-101514-00-EL
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609 ILE
Project Name: CELEBRATION SENIOR LIVING APARTMENTS
Electrical
Project Address: 1524 S 328TH ST
Inspection Request Line: (253) 835-3050
Parcel Number: 147318 0020
Project Description: Installing new 200 amp, single-phase 120/208 V temporary power for use during new
construction.
Owner
ARRlican
Contractor
CELEBRATION SENIOR LIVING
EVERGREEN STATE ELECTRIC INC
EVERGREEN STATE ELECTRIC INC
ASSOCIATES LIMITED PARTNERSHIP
PO BOX 849
EVERGSE066JA (4/1/16)
201 27TH AVE SE BLDG A-300
SUMNER WA 98390
PO BOX 849
PUYALLUP WA 98374
SUMNER WA 98390
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
Temp. Serv.: 101- 200 amps (Com 1
PERMIT EXPIRES Tuesday, September 30, 2014
Permit Issued on Thursday, April 3, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the se will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agen1rw Date: —
THIS CARD IS TO nNMAIN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 14 -101514 -00 -EL Address: 1524 S 328TH ST
Project: CELEBRATION SENIOR LIVING Ac 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.
Temporary Power (4275) Final - Electrical (4055)
Approved Approved
By Date rt By Q Date %_Lr I`L - l 4
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
1
�k
CITY OF
Federal Way
PERMIT NUMBER ' q-
0
RE'arwf��'
APR 0 3 2014. ELECTRICAL
CITY OF FEDERALPERMIT APPLICATION
CDS
c C)
SUITE/UNIT/SPACE #
SITE ADDRESS:
PROJECT VALUATIONASSESSOR'S
.
TAX/PARCEL # CURRENT/PROPOSED USE
, u.� _ P (opt ! Is n
PROJECT NAME
(Tenant or Homeowner Last Name)
,9M AmjQC S 190
PROJECT DESCRIPTION
V
Detailed description of work to
be inchtded on this permit only
NAME
ZL — 1
11�+
PRIMARY PHONEf
l�Ft���i 8W - z.J� 140
MAarwo vyq��Raes � � Ave �� I
E -MAH.
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
/M('AIIdNQAG, D/RESS
f �j;) IJty
SMALL
Ireci re- Vp&Ure,
ELECTRICAL
cTSTAM
WA
z�
FAx
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # E PIRATION DATE
FEDERAL WAY BUSINESS LICMSE #
APPLICANTS
NAME
PRIMARY PHONE
MAII.ING ADDRESS �
E-MAIL
CITY
STATE
ZIP
( FAX
l
PROJECT CONTACT
lzm'a
r
PRIMARY PHONE
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 Iaws.
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 supplie to the city a a partof this application.
SIGNATURE. DATE
PRINT NAME I /
Bulletin #160 —January 1, 2013 Page 1 Of 2 k:\Handouts\Electrical Permit Application
M