13-101291 e
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0 Electrical
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City°f Ecderal WayPermit #: 13-101291-00-EL
L'ommunity&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
(253)835-2607 Fax:(253)835-2609
i
Project Name: AT&T MOBILITY-82935 CEEJAY WA
Project Address: 2041 S 324TH ST Parcel Number: 162104 9037
Project Description: Install(1)back-up power generator to existing cell site
Owner Applicant Contractor
BELMOR HOLDINGS LTD A T C TOWER SERVICES INC e. - . . , w. S R
1571 BELLEVUE AVE W SUITE 210 10 PRESIDENTIAL WAY / '1 trl,
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VANCOUVER CN WOBURN MA 01801 61 H - C 9.L2-14 T/ 3/s
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•
Alt.Srvc/Feeder 0 to 200 amps(C 1
PERMIT EXPIRES Monday, Sept r 16,13 [V--la/,1 (
Permit Issued on Wednesday, March 20, 2013
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent Date: . a 7/3
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THIS CARD IS TO MAIN ON-SITE
41&'CITY OF • Construction In ection Record - y
Federal Way INSPECTION REQ TS: (253)835-3050 ,
PERMIT#: 13-101291-00-EL , ' Address: 2041 S 324TH ST
Project: BELMOR HOLDINGS LTD FEDERAL WAY, WA 98014-5915
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.
LIFER Ground(4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By 1M9 Date I ( 2-o f (c— By Date
•
❑ Pool Bonding(4195) 0 Temporary Power(4275) ❑ 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 (\ Date el y tx_‘
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
____ ECTRICAL
4 CITY OF Irwmullimmoor
Federal Way PERMIT APPLICATION
RECEIVED
PERMIT NUMBER / _ 1 0 j Z 1 _ CO
— - - MAR 202013
SITE ADDRESS: 210 S �2� ��'1 f te-\- CITY O F ii$LA'10E#
CDS
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED
$ 50q .t0Q b 2.- 1 0 U - a Q '3 -7 Ce�ivRiv �l`` -
PROJECT NAME
(Tenant or Homeowner Last Name)
\ *�V 1 t Qd Gptic Oct ett PQ,\\S(�4..
PROJECT DESCRIPTION JJ
Detailed description of work to
be included on this permit only
PROPERTY OWNER N MEl e\\ �1��Y 'tT ( )PRIMARY PHONE
E-MAIL
1 bMAILING ADDr l��vve, iVit S\Ikk IZ�
CITY STATE ZIP FAX
\Irn�c�►�Q,J,�ac ��_ V1'f \A o ( ) -
NAME PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
APPLICANT N "" ` � (%\a ) - -Y �
MAIL
3 ADDRESS
C i gIP 6STASn.e\JG ecory`tco4A eitco
C
FAX
U/1)1 `^
AM
PROJECT CONTACT N v� j� ( A \ PHONE
b ) 2 l� -PRIMARY 7cY/
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 authorised 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 investigatio and defense of such claim),which may be made by any person,including the undersigned,and filed against the city,
but only where\- ch claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information- ••I ed , the city a part Ifif this application.
• //SIGNATURE. \ DATE r
PRINT NAME: ` _.\A
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application