15-100173 • • Electrical
City of Econ.Federal v S Permit #: 15-100173-00-EL
Communi &Econ.Dev.Services
33325 8th Ave SIF
Federal Way,wA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p G
Project Name: LAKEHAYEN UTILITY DISTRICT-SEATAC WATER TOWER
Project Address: 1919 S 324TH ST Parcel Number: 162104 9039
Project Description: Added pole light,changed out main disconnect and 100 amp panel
Owner Applicant Contractor
LAKEHAVEN UTILITY DISTRICT LAKEHAVEN UTILITY DISTRICT LAKEHAVEN UTILITY DISTRICT
PO BOX 4249 PO BOX 4249 PO BOX 4249
FEDERAL WAY WA 98063 FEDERAL WAY WA 98063 FEDERAL WAY WA 98063
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
Circuits-Commercial 1
PERMIT EXPIRES Sunday, July 12, 2015
Permit Issued on Tuesday, January 13, 2015
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
n e City ofF S eral Way.
Owner or agent Date: i3
THIS CARD IS TO MAIN ON-SITE
CITY OF111P."11 •
Construction I ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 15-100173-00-EL Address: 1919 S 324TH ST
Project: LAKEHAVEN UTILITY DISTRICT 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.
UFER Ground (4295) Ditch cover(4030) Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) Rough Electrical(4225) Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
Final-Electrical(4055)
Approved
By Date _ \c -CS
El Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
MSD EL CTRICAL
JAN 13 2015
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER / 5 _ / d D /DS 3 _ D o
SUITE/UNIT/SPACE#
SITE ADDRESS: �tik.�4C v fq r 3Ly -t"c '
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ /(0) 0 / 62_ 2 ( 0V - ? 03 ?
PROJECT NAME '( f - �'�
(Tenant or Homeowner Last Name) ( �
PROJECT DESCRIPTION60,X1
A !'/4 CO ( tint-PCs AAIB t-tAibt'�2C�a°.o u-,4
Detailed description of work to
be included on this permit only /Bc tser, 015016,-,-11°"1) 2Ctix .
— NVrAW aC ( /`'tdid 1)(s
NAME
`� .� 7)y� PRIMARY PHONE
PROPERTY OWNER cl(Afe1 i / T ,c e 7e� ( ) -
MAILING ADDRESS / E-MAIL
3i/4.23 / s( A-VC
C Y STATE ZIP FAX
etotRA-c y WA fQ o c3 ( ) -
NAME PRIMARY PHONE
( )
MAILING ADD S E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT neACleS o A! (253)2-29 --nc
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT ( ) -
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.
O/ /3 /37
SIGNATURE: DATE
PRINT NAME: e-L 6 tis nN
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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