16-105432Electrical
CommuutyDevvelolm otDW. Permit #:16 -105432 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: (253) 835-3050
Ph: (253) 835-2607 Fax: (253) 8352809
Project Name: EVERGREEN COURT APARTMENTS
Project Address: 1911 S 330TH ST Parcel Number: 797880 0460
Project Description: Relocating a switch and (3) lights.
Owner
Applicant
Contractor
K C HOUSING AUTHORITY
STEVE ANDERSONB B ELECTRIC
B B ELECTRIC
600 ANDOVER PARK W
17404 MERIDIAN E
BBELEBE950P1(10/22/17)
TUKWILA WA 98188
PUYALLUP WA 98375
Additional Permit Informatign
Is this an Online or O.T.C. application? .................. Yes
PERMIT EXPIRES Tuesday, 14
Permit Issued on Monday, Now
I hereby certify that the above information is correct and that
and the occupancy and the use will be in accordance with
Washin ton and the City
•
Owner or agent:
w
V ,�
uction aPIGNMdescribed property
rules a7ghWulations of the State of
Date: (� ��lG
THIS CARD IS TO REMAIN ON-SITE
arra„
Federal Way Construction
35ord
INSECTION UES: 000
PERNUT #: 16105432 00 Address: 1911 S 330TH ST
Project: K C HOUSING AUTHORITY FEDERAL WAY WA 98003
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are li _ as &6 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
LIFER Ground (4295)
Q
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Service (4235)
Approved
Approved
Approved
:]By
Final Electrical
Approved to place concrete
By
Date
By
Date
Approved..
Date
®
Pool Bonding (4195)
FAI
Temporary Power (4275)
®
Service (4235)
Approved
Rough Electrical
Final Electrical
Approved
Approved
By
Date
Approved..
By
Date
By
Date
El FeederslSub-panels (4045)® Rough Electrical (4225) ® Ceiling Cover (4020)
Approved Approved Approved
By Date B Date I 0 By Date
® Final -.Electrical (4055)
Approved
By Date
E]
Rough Electrical
Final Electrical
Right of Way
Approved
Approved..
Approved
By
Date
By
Date
By
Date
RECEIVED
ELEC'T'RICAL
CITY OF Federal WayNOV 14 X016
CIN OF FEDERAL
PERMIT APPLICATION
CDS WAY (' � S /
PERMIT NUMBER I \ _ I l � v —5 � 3 2 _ C_ v
SITE ADDRESS:
SUITE/UNIT/SPACE#
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/ PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
�
li i) e^ u/-
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
K CLly
PRIMARY PHONE
MAILING ADDRESS
60 c
E-MAIL
CITY
i t4lcw; /
STATE
w✓�
ZIP
FAX
-
ELECTRICAL
CONTRACTOR
NAME
,r-) F�C,-- A f
PRIMARY PHONE
0 a Q (5( 171
MAILING ADDRESS
("k
E-MAIL
C TY
STATE
ZIP
FAX q N1
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME.
4
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
PRIMARY PHONE
( )
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 part f this application.
lL %
SIGNATURE; � DATE 6
PRINT NAME:
Bulletin # 160 —April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application