15-100503It a
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
E f
Electrical
Permit #: 15 -100503 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: LAKOTA SEWAGE TREATMENT
Project Address: 3203 SW DASH POINT RD Parcel Number: 122103 9105
Project Description: extend branch circuit for replacement of existing hot water heater
Owne
ARRlican
Contractor
LAKEHAVEN UTILITY DISTRICT
GARY COOK
OWNER IS CONTRACTOR
PO BOX 4249
lakehaven utility district
FEDERAL WAY WA 98063
3203 SW DASH PT RD
FEDERAL WAY WA 98023
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, August 2, 2015
Permit Issued on Tuesday, February 3, 2015
I hereby certify that the above information is t d that the construction on the above described property and
the occupancy and the use will be in ac an wit the laws, rules and regulations of the State of Washington
e ity of Federal Way.
Owner or agent: Date: /
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
15 -100503 -00 -EL Address: 3203 SW DASH POINT RD
LAKEHAVEN UTILITY DISTRICT FEDERAL WAY, WA 98023-2340
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)
Temporary Power (4275)
Slab/Concrete Floor (4255)
1:1Approved
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)
1:1Approved
Service (4235)
By
Approved
By
Approved
By
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
By
Date
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CRY OF V&
Federal Way
PERMIT NUMBER ( 5
ELECTRICAL
PERMIT APPLIION
_
IV 0 5 03_ 00
FEB 03 2015
SITE ADDRESS: " 2 3 S� �j�j ,��
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PROJECT VALUATION
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PROJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to�—
be included on this permit only
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NAME
PRQIMARY PHONE
PROPERTY OWNER
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MAHdNG ADDRESS77
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PRn1ARY PHONE
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STATE
ZIP
FAX
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
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E-MAIL
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PROJECT CONTACT
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I certify under penalty of perjury that I am the property owner or authorised 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 Fe a1 Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim/,,W ay be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out ere once of the city, including its officers and employees, upon the accuracy of the
information supplied to the cimils th application.
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Bulletin #160 —January 1, 2013 Page 1 of 2 OIIandoutsTlectrical Permit Application