14-102139 Electrical
City of&Econrai Way EPermit #: 14-102t39-00-E L
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609FIIp a
Project Name: CELEBRATION SENIOR LIVING APARTMENTS-COMMUNITY BUILDING
Project Address: 1420 S 328TH ST Parcel Number: 147318 0020
Project Description: New 201-400 amp service
Owner Applicant 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? No Is Use Educational or Institutional? No
Service greater than 999 Amps? Yes
Electrical Fixtures
New Service:201-400 amps(Con 1
PERMIT EXPIRES Saturday, January 3, 2015
Permit Issued on Monday, July 7, 2014
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
City of Federal Way.
Owner or agent: Date: `_ 2
FINALED
THIS CARD IS TO IN ON-SITE •
,
CITY OF �'-�. �`
Federal WayConstruction In ection Record
INSPECTION REQU TS: (253)835-3050
PERMIT#: 14-102139-00-EL Address: 1420 S 328TH ST
Project: CELEBRATION SENIOR LIVING A: 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) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By 044 Date (b(Z 1 I¢ By V1/4/3 Date ( 1- I 1 By bm4 Date 1 1 I r-
El Pool Bonding(4195) 0 Temporary Power(4275) ' ❑ Service(4235)
Approved Approved Approved
By Date By Date By 0N! Date ? l l4-1 ttr-
e e e
,
O Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By ifia Date -I 1 -t I is- By uto Date -1/, I 16y f (c By A ,,,, Date to_LT—VS
Final-Electrical(4055) �-.w�,
® Approved
By 1jt,4 Date -R 1 1 S
Rough Electrical a El Final Electrical E] Right of Way
Approved Approved Approved
By Date By Date j By Date
• e
DATE INSPECTOR- AREA AND TYPE r INSPECTION
VV) 1 c( 14 PO v1.-r 1 w,.. D ver-(4 �a,,,,� . 0 k. -(� c woo. s Gt.
��o N Oti 1 T S-t-t OUTS (=oa, hw A-t t (2.@o wu..
%A44 41 (01 ;c Pavtutt RT. • Ls) st416 9c .
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417,4 its- Fe heal P-04k• 140.400 Gittw Ptviv►vel-irtir WAR; .
(Mr I( "'i I 1 t F.ttel✓ - ElGdaiW avel'Vvi N-oolvt
/0 / 13,41
•
CmOf(A. EL CTRICAL
Federal Way PERMIT AP ,ronATION
3 aco/t
PERMIT NUMBER IG- _ I O 2 ( 3 9 _ Oo MAY 0 9 2014
CITY OF FEDERAL WAY
, abler
" SSUITIT/SPACE#
SITE ADDRESS: 504 5 538112 ' Fderaj L Leega , L
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PROJECT VALUATION ASSESSOR'S TAX/PARCEL# USE
$ SC),COD, � 14 3 � a-- 00 ZO
PROJECT NAME
(Tenant or Homeowner Last Name) 61., 1 a vi I'7
Lei r� C't3rnmi Lfl lky el&/d c Y )y
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
O '1 Zn4er- C! con-'r`a� S 0-0.5) - 85Z
b j c J y eK MAILING ADDRESS
(j (�ADDDRESSE-MAIL
- A �o'
CITY STATE ZIP FAX
NAME PRIMARY PHONE
Elerc reen F�e�1n c., �n0 (d531770 -0510
MAILING DRESS E-MAIL
ELECTRICAL Po 80A 8q q w i Ceti le) -Vents re.c.am
CONTRACTOR pTY STATE ZIP FAX
SU,mn.Pr) Lc) ) cj 83cC ( a53 nf) - 11/D3-
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
EV ERG SE0LoLO SA 04'Of /20i6 99-lb(eip39- 00 et-
RAIZ r ^� ' PRIMARY PHONE
APPLICANT OCCM e S Fie d rl ca /�,�,,,iraC ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT Vt.( 1. ,l 11-flaryi er Lan ( 53) }0 '(xpC. )
I cert under penalty of perjury that I am the property owner or authorised agent of the property owner.I certlfy 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 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 oft pplication. L�
SIGNATURE: DATE 5/l//
PRINT NAME: Ir! G�'7 G7 fr z=Jiv
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application