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18-105115Project Name: LAKEHAVEN UTILITIES - WATER SHOP BUILDING Project Address: 31623 1ST AVE S Project Description: Install (2)110V 20A circuits & network drops Electrical Permit #:18 -105115 -00 -EL Inspection Request Line: (253) 835-3050 Parcel Number: 072104 9017 Owner FILE City of Federal Wry LAKEHAVEN UnLrrY DISTRICT Community Development Dept. OWNER IS CONTRACTOR 33325 8th Ave S 31623 IST AVE S Federal Way, WA 98003 FEDERAL WAY WA 98063 Ph: (253) 8352607 Fax (253) 835.2609 Project Name: LAKEHAVEN UTILITIES - WATER SHOP BUILDING Project Address: 31623 1ST AVE S Project Description: Install (2)110V 20A circuits & network drops Electrical Permit #:18 -105115 -00 -EL Inspection Request Line: (253) 835-3050 Parcel Number: 072104 9017 Owner Applicant Contractor LAKEHAVEN UnLrrY DISTRICT KEITH BOURQUIN OWNER IS CONTRACTOR PO BOX 4249 31623 IST AVE S FEDERAL WAY WA 98063 FEDERAL WAY WA 98003 Additional Permit Information Is this an Online or O.T.C. application? .................. Yes Circuits - Commercial 2 PERMIT EXPIRES Wednesday, 30 October, 2019 Permit Issued on Tuesday, October 30, 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 accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. 4�m A Owner or agent: Date: 3 THIS CARD IS TO REMAIN ON-SITE CM OF Federal Way INSPECTION Inspection Record INSPECTION REQUE TS: (253) 835-3050 PERMIT #: 1810511500 Address: 316231ST AVE S 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. Wolk 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. El UFER Ground (4295) 0 Ditch cover (4030)3❑ Approved Slab/Concrete Floor (4255) By Date Approved By Date 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 Final - Electrical (4055) Approved By Date 13 Feeders/Sub-panels (4045) ® Rough Electrical (4225) ® Ceiling Cover (4020) Approved Approved Approved By Date By Date By Date 0 Final - Electrical (4055) Approved By Date 13 Rough Electrical Final Electrical Right of Way Approved Approved Approved By Date By Date By Date CITY OF Federal Way RECEIVED ELECTRICAL OCT 3 0 2018 PERMIT APPLICATION CRY OF FEDERAL WAY COMMUNfTY DEVELOPMENT j PERMIT NUMBER J g_ I O 5 5_ � (� I `c 1%,mL SITE ADDRESS: 6 p] J � PAC ��N • 1 WIN, I /j�PROJECT SUITE/UNIT/SPACE # VALUATION $ ASSESSOR'S TAX/PPAAjRCE)L # 0--7 2 1 v _ 9. 0 I CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeowner Last Name) W p Ct S PROJECT DESCRIPTION Detailed description of work to be included on this permit only ae61Le E• I V PROPERTY OWNER NAME I,G� ! fi c PRIMARY PHONE )qyI - Is -lb MAILING ADDADDRESSE-MAH. 6DX LI�M . CITY F STATEZIP InWY C) c FAR ) - ELECTRICAL NAME La kh b r&� PRIMARY PHONE c ` ) - MAILING ADDRESS 3 x-03 sW D j MAIL r . y�CONTRACTOR1W1\STATE Zyr ZIP O WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # APPLICANT NAMEj� evr ' '" �6�N � PRIMARY PHONE ) - MAILING ADDRESS S Poi E-MAIL CITYSTATE ZIP Nn -3 FAX ) - PROJECT CONTACT&auv N PRIMARY PHONE (aS )) - 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 tlr investigation and defense of such claim), which may be made by angperson, 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: PRINT NAME: Bulletin #160 —April 14, 2016 Page 1 of 1 k: 11andoutsTlectrical Permit Application