15-106536City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical
Permit #: 15 -106536 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: PANTHER LAKE ELEMENTARY - PORTABLE CLASSROOM
Project Address: 34424 1ST AVE S Parcel Number: 202104 9110
Project Description: Installing new data drops for computers.
Owner
ARRlicant
Contractor
FEDERAL WAY PUBLIC SCHOOLS
LARRY HOWSER
INTRACOMMUNICATION NTWK SYS IN
33330 8TH AVE S
INSI
(INSI)
FEDERAL WAY WA 98003-5433
4922 N PEARL ST
INTRANS994JL (4/10/17)
TACOMA WA 98407
4922 N PEARL ST
TACOMA WA 98407
Additional Permit Information
Electrical Work Valuation?....................................8500 Is this an Online or O.T. . application?.................Yes
Is Use Educational or Institutional?.......................Yes Service greater than s? ............................. No
Electrical Fixtures
Low Voltage - Other (Commercial: 9
PERMIT EXPIRES Sund a 26, 2016
Permit Issued on Tuesdndember 290011A
I hereby certify that the above information �Afhitv
t the c
the occupancy and the use will be in a aws, rL
® _ �ederal
Owner or
bove described property and
of the State of Washington
Date: f2—Z, — /-r—
CITY of
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record "
INSPECTION REQU TS: (253) 835-3050
15 -106536 -00 -EL Address: 34424 IST AVE S
FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY, WA 98003-6501
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.
0
UFER Ground (4295)
Ditch cover (4030)
❑
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
❑
Temporary Power (4275)Service
(4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
E]Ceiling
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
RECEIVED ELECTRICAL
DEC 2 9 2015 PERMIT APPLICATION
CITY OF FEDERAL WAVY
PERMIT NUMBER I _ ( O ,;> co
_ (/
SITE ADDRESS: t� 1�,2 y/ /S� �!/G�uC cSDN .C.aL ./�'
��
�p o 3
SUITE/UNIT/SPACE #
,c/tito 10,4Xfpalc
PROJECT VALUATION
$ �, s--oo.
ASSESSOR'S TAR/PARCEL #
1 n z ► a LI _ a
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
�i0�/is �c.� Q.d��•: .OJZe J G7 �d�t �
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
PRIMARY PHONE
MAILING ADDRESS/
�3 p �
EMAIL
CITY STATE ZIP
FAX
NAME
1 /S, f Z
PRIMARY PHONE
vr3 ) X/ - o y/d'
MAILING ADDRESS
1
ELECTRICAL
CITY
71,y,0l7,a
STATE
G✓rt
ZIP
r-I�% %
FAX
(zr3) j-% -
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
6/- °Y/r
MAILING ADD 3
L.s'r lee/ild�'ora/ r
CITY
STATE
ZIP 0 �7
FAX
PROJECT CONTACT
NAME
c SVS Dk ��' �s sy
PRIMARYPHONE
(L r1) �s_ y_ zo
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 he reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a p f this application. G
SIGNATU DATE /4? 1/— /S—
PRINT NAME:
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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