15-101947 •
Electrical
CuFederalWay Permit #: 15-101947-00-EL
Community
&Econ.on.0ev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: CALVARY LUTHERAN CHURCH
Project Address: 2415 S 320TH ST Parcel Number: 797820 0525
Project Description: Lighting& outlets for hallway remodel.
Owner Applicant Contractor
CALVARY LUTHERAN CHURCH LAKES ELECTRIC INC LAKES ELECTRIC INC
2415 S 320TH ST PO BOX 7060 LAKESEI101MC(7/3/16)
FEDERAL WAY WA 98003 COVINGTON WA 98042 PO BOX 7060
COVINGTON WA 98042
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps9 No
Electrical Fixtures
Circuits-Commercial 5
PERMIT EXPIRES Monday, October 19, 2015
Permit Issued on Wednesday, April 22, 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
and�he Cir of Federal Way.
Owner or agent: � % Date:
• THIS CARD IS TO REIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 15-101947-00-EL Address: 2415 S 320TH ST
Project: CALVARY LUTHERAN CHURCH FEDERAL WAY, WA 98003-5442
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) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding (4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) Ceiling Cover(4020)
Approved Approved Approved
By Date By Date '7°- 1 li l S By Date
❑ Final-Electrical(4055)
Approved
By
Date -
❑ Rough Electrical Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
i SNE •
4414.,‘. APR 2 2 2015 ELECTRICAL
CITY OF _.
Federal Way CITY FEDERAL
WAY PERMIT APPLICATION
PERMIT NUMBER / 5 _ / 0 7 7 `f 7 / -
//! ( (( C . SUITE/UNIT/SPACE#
SITE ADDRESS: a � .! s 0- 3 2 �l �� tV d// s
PROJECT VALUATION 0 y ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
s 1 5.-67 b -
PROJECT NAME - 4orz ",Lp),/ 7-. ,',e.,/,./ , /,/./-7,-e:
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION ,e ��g.da ��- ' � C/'i/s' /77, ' 9L
Detailed description of work to ellj% z'7
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ' /J4 'i/.�// / 7#";//),P ( ) -
MAILING ADDRESS E-MAIL
7/S s v. Y1 ° r�✓
CITYSTATE ZIP FAX
/� (
NAMEPRIMARY PHONE
'/1' S G-/ e''Gz (<2 g.4) ((,j.�- 6a2.P fes'
LING ADDRESS �, E-MAIL
E,E 'I 'ICAL 0. .�'I d Y 13i 0 G-p.G'r.5 ekz'GT�/CC 6",0-9ie
ill , • CTOR CITY STATE ZIP FAX or 14
6. /P'rb,1/ 1,* : (.2.(3) ? v/ - .7 2 9
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDE-'.#,,/BUSINESS LICENSE#
7' >//�?- .44-/ / 17/ ft/if 2 / J / /‘
NAME i PRIMARY PHONE
APPLICANT 'S` e /` (7'6 )'//J- d2.s77
MAILING ADDRESS0
E-MAIL
CITY STATE ZIP FAX
6 /74/r /Z/ /i/41 9' 2 ° ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ,it-r d /1 (2 •
i' )9,Z f- 6? "9
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 apart of this application.
SIGNATURE: DATE / J
PRINT NAME: AA9/ u V%
Bulletin#160—January 1,2013 Page 1 of 2 k:AIIandouts\Electrical Permit Application