12-100679' tledrical
City of Federal Way .* �/
Community & Econ. Dev. Services Permit #: 12 -100679 -00 -EL
33325 8th Ave S -
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: BROOKLAKE VILLAGE
Project Address: 34815 PACIFIC HWY S Parcel Number: 202104 9042
Project Description: Adding/altering (1) circuit for adding 2 lighting heads to pole
Owner
Applicant
Contractor
REINHARD ERNEST & CORNERSTONE
EMERALD ELECTRIC NW
EMERALD ELECTRIC NW
1115 S 348TH ST SUITE A
9830 220TH PL SE
EMERAEN902DT(3/30/12)
FEDERAL WAY WA 98003
SNOHOMISH WA 98296
9830 220TH PL SE
SNOHOMISH WA 98296
Is Use Educational or Institutional?.......................No
Circuits - Commercial .................... 1
PERMIT EXPIRES Sunday
Permit Issued on Tues��F
hereby certify that the above information is
the occupancy and the use will be in accor(
Owner or agent:
the (ity of
W
Service greater thanIT9 .............................No
Alf12, 2012
Cry 14,
onstrt. the above described property and
rules a ations of the State of Washington
\oma/ `t -
Date. l �I
' THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 12 -100679 -00 -EL Address: 34815 PACIFIC HWY S
Project: REINHARD ERNEST & CORNERST 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. 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.
a
❑
UFER Ground (4295)Ditch
Pool Bonding (4195)
cover (4030)
E]
Slab/Concrete Floor (4255)
Approved
(4235)
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Rough Electrical
Approved
Pool Bonding (4195)
E]
Temporary Power (4275)Service
Right of Way
Approved
(4235)
Date
Approved
Date
Approved
Date
Approved
By
Date
By
Date
By
Date
❑
E:]
Feeders/Sub-panels (4045)
Ceiling Cover (4020)
Rough Electrical (4225)
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
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 a part of this application.
SIGNATURE:
PRINT W'tMP': T- E?2 C 0 > 1-C 6
33325 8'h Avenue South ♦ Federal Way ♦ WA ♦ 98003-6325 1 253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin #160 - January 1, 2011 Page I of 2 k:\Handouts\Electrical Permit Application
CITY OF
Federal Way
ELECTRICAL
RECEIVED
PERMIT APPLICATION
FEB 1 4 2012
"Most electrical permits may be obtained on-line at www.city
a
SITE ADDRESS: 7� �/� `� /� 4c ge— • ��
/ ( I
SUITE/UNIT/SPACE r
ASSESSOR'S TAX/PARCEL #I CURRENT/PROPOSED USE
zoz( n4-(:�70�2
PROJECT NAME
(Tenant Homeowner Last Name)
` �/ � / �-
B l e- l�C=C� �., 1 Y
or
PROJECT DESCRIPTION
A2L Z ` f- Gt
��
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
ELECTRICAL
MAILING ADDRESS
o
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
A STATE CONTRACTOR'S LICENSE M EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE X
NAME.
PRIMARY PHONE
( )
APPLICANT
MAILING ADDRESS
EMAIL
CITY
STATE
ZIP
/ FAX
l )
PROJECT CONTACT(�Z��yG
N7
PRIMARY PHONE
r G c
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 a part of this application.
SIGNATURE:
PRINT W'tMP': T- E?2 C 0 > 1-C 6
33325 8'h Avenue South ♦ Federal Way ♦ WA ♦ 98003-6325 1 253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin #160 - January 1, 2011 Page I of 2 k:\Handouts\Electrical Permit Application