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18-103724s City of Federal Way Com®ity Development DepL 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 8352607 Fax (253) 835-2609 Project Name: FEDERAL WAY HIGH SCHOOL Project Address: 30611 16TH AVE S Project Description: Connect new compressor to existing electrical system. >, r Electrical Permit #:18 -103724 -00 -EL Inspection Request Line: (253) 835-3050 Parcel Number: 082104 9001 Owner Applicant Contractor FEDERAL WAY PUBLIC SCHOOLS BRIAN HUMPHREYSFEDERAL WAY OWNER IS CONTRACTOR 33330 81711 AVE S PUBLIC SCHOOL FEDERAL WAY WA 98003 1211 S 332ND ST FEDERAL WAY WA 98003 Additional Permit Information Is this an Online or O.T.C. application? .................. yes PERMIT EXPIRES Friday, 16 August, 2019 Permit Issued on Thursday, August 16, 2018 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 accordant with the laws, rules and regulations of the State of z A Washington and tj4City of Federal Way. Owner or agent: Date: C %' FINALED P- , , TMS CARD IS TO REMAIN ON-SITE "n'Op Construction Inspection Record Federal Way INSPECTION REQUESTS: (253) 835-3050 PERMIT #: 18103724 00 Address: 30611 16TH AVE S Project: FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY WA 98003-4903 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) 0 Ditch cover (4030)3❑ © Slab/Concrete Floor (4255) Approved Approved Approved to place concrete By Date By Date By Date ® Pool Bonding (4195) ® Temporary Power (4275) © Service (4235) Approved Approved Approved By Date By Date By Date ® Feeders/Sub-panels (4045) ® Rough Electrical (4225)9❑ Final Electrical Ceiling Cover (4020) Approved Approved Approved By Date By Date By Date 10 Final - Electrical (4055) �oved SDate 2� Rough Electrical Final Electrical Right of Way Approved Approved Approved By Date By Date By Date CITY OF Federal Way REc ELEC'T'RICAL �l��® PERMIT APPLICATION AUG 15 2018 C04'y,,O OP$MIT NUMBER — — SITE ADDRESS: 316 1 r^l� /� �� (�� (I / , �• c I W '� ATE/UNIT/SPACE 11 PROJECT VALUATION $2 ASSESSOR'S TAR/PARCEL A , no CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeowner Last Name) PROJECT DESCRIPTION Detailed description of work to be included on this permit only CC, /I✓-ec k,/7 Az6g ±1&nu- h, PROPERTY OWNER � PRIMARY PHONE MAILING ADDRESS Z(l '5. E-MAIL CITYSTATE ZIP FA% ELECTRICAL CONTRACTOR NAME Vc-t vf CMCA d PRIMARY PHONE rG MAD 2� ADDRESS _ S - ,Q2 p 6C,� wfWla✓, 0- F��" CITY e f Why STAT W zIP %q©6 FAx (�; )9y�- �q Si WA STATE CONTRACTOR'S LICENSE N E%PMATION DATE FEDERAL WAY BUSINESS LICENSE H APPLICANT NAME �PRIMARY /t �� `"t PHONE (Z�7 )3� MAA.IR ADD% y�-A��Ln CITY A � �00 ^ (JC (27 53)C c� J PROJECT CONTACT N G ��.� S PR�ARY PHONE (Z s-3 ) 351 -11 SS' 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 Wag 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 ci including its officers and employees, upon the accuracy of the information supplied:to yhe city as a of this application ` SIGNATURE: DATE /I ' PRINT NAME: Bulletin # 160 –April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application cFry OF 0 Federal WayF Property Owner Electrical Work Permit Application In Washington, only licensed electrical contractors may perform electrical work. Property owners may apply for an exemption from these requirements by completing this application and signing the affidavit below before beginning electrical work. As authorized under RCW 19.28.261, L jS,-gvt (4--,Vlitd �vcy S hereby apply (Printed name ofproper4 owner, Pfmer, or lessee) for an exemption from the electrical licensing and certification requirements of RCW 19.28 by submission of this affidavit. Which statement describesyoti? (Mark only one. If none apply, you may not take out this permit) I own this .property. Your name or your company's name must be shown on the deed to the property. Real estate agents' property management companies, relatives, etc. cannot purchase permits for the property owner. ❑ I rent or lease thisproperty. We need a copy of your rental agreement showing you have permission to perform electrical work. ❑ I am an officer for a 501(c)(3) nonprofit corporation, or a nonprofit religious organization. The total market value of electrical work must be $30, 000 or less and all electrical work must be done by a non -compensated appropriately certified electrician. lett your property, tjTpe (Mark only one. If none apply, you may not take out this permit.) ❑ New single family residence that is not intended for rent, sale, or lease, where I will be living for at least 24 months after completing the electrical work. I will be personally doing the electrical work. ❑ New 2, 3, or 4 unit residential building, owned by me, that is intended for rent, sale, or lease. I will be living in one of the units for at least 24 months after completing electrical work. I, personally, and/or a regularly employed employee(s), will be doing the electricalwork. ❑ New place of business, farm, or other property: Any new structure that is not intended for rent, sale, or lease. I, personally, and/or a regularly employed employees), will be doing the electrical work. Existing residential property, place of business, or farm. I, personally, and/or a regularly employed employee(s), will be doing the electrical work. DEPARTMENT OF COMMUNITY DEVELOPMENT / 33325 8TH AVENUE SOUTH / FEDERAL WAY, WA 98003-6325 253-835-2607 is www.citvoffederalway.com -,!& Permitcenter(Mcityoffederalway.com Bulletin #080 — June 6, 2018 Page 1 of 2 k:\1landouts\ Property Owner Electrical Work Application ❑ 501(c)(3) or nonprofit religious organization owned property: The total market value of the electrical work must be $30,000 or less, and all electrical work will be performed by appropriately certified electricians, or certified and properly supervised trainees, who are volunteering and not being compensated for the electrical work per RCW 19.28.091(7). (our signaturi ie ig requiired below: . I believe I should be exempt from the requirements to obtain an electrical license, or use a certified electrician, as provided under RCW 19.28.261. By signing below, I certify the information I am providing on this affidavit is true and accurate. I understand that if I make false statements or misrepresentation 0, i CA V1- (rs, I be asses ed penal ' s. Printed Name of Prope4 Owner, tenter, or Lessee Signatu Date FW PS Property Owner's Name (Last, First) or Company Name��, 17M ,32Hs Mailing Address Unit/Apt.# City State Zip -15-3 3� 1' �?kLt � r-45. 0 RG Daytime Phone Email Address Inspection Site Address (if different) Unit/Apt.# City State Zip 1<<n cj.A V, PS r 6 County Electrical Power Company / Serving Utility ��,irur' �Qc �'i (cl � l.J c�� iG �a c..ttt� ly /I v ✓-�/ C u✓�d/LS�v1 DEPARTMENT OF COMMUNITY DEVELOPMENT 133325 8TH AVENUE SOUTH / FEDERAL WAY, WA 98003-6325 253-835-2607,e www.citvoffederalway.com -, permitc;enter(Q-cityoffederalway.com Bulletin #080 — June 6, 2018 Page 2 of 2 k:\Handouts\ Property Owner Electrical Work Application