19-100397 Electrical
City ofderalWay Permit #:19-100397-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: SHERWOOD FOREST ELEMENTARY
Project Address: 34600 12TH AVE SW Parcel Number:415920 0004
Project Description: Low-voltage wiring for replacement of fire alarm system.
•
Owner Applicant Contractor
MIKE BENZIENFEDERAL WAY PUBLIC D&R MONITORING NETWORKS D&R MONITORING NETWORKS
SCHOOLS PO BOX 1008 DRMONRM847K6(5/26/20)
33330 8TH AVE S SUMNER WA 98390
FEDERAL WAY WA 98003-5433 PO BOX 1008
SUMNER WA 98390
Additional Permit information
Is this an Online or O.T.C.application Yes
Low Voltage-Fire Alarm(Co 1
PERMIT EXPIRES Thursday,23 January,2020
Permit Issued on Wednesday,January 23,2019
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.
Owner or agent: •
Date: 1(1-3) 11
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THIS CARD IS TO REMAIN ON-SITE
u.,►e�. Construction Inspection Record
IFederal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 100397 00 Address: 34600 12TH AVE SW
Project: MIKE BENZIEN FEDERAL WAY WA 98023-8002
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. Wodc 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 LIFER Ground(4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) 6❑ Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ® Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
al Final-Electrical(4055)
lie
Approvede ii..1By Datl5
4
•
0 Rough Electrical El Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
ELECTRICAL
CITY OF JAN 232019
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT f�
PERMIT NUMBER / 9 _ l (/ 9 7 _ £ L
SUITE/UNIT/SPACE#
SITE ADDRESS: t o O O -1- 4,{ �
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PROJECT VALUATION � ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$(o? .94) `/ l 5 9 o n - O 0
PROJECT NAME
(Tenant or Homeowner Last Name) �ju � � �cX? S�y- v-PGL -(
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER "� , `,� P.►�j��L SQL t (Zc>) 9 's - Sg9fi
MAILING ADDRESS • E-MAIL
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
e- Mc1..•cca-, . u1/4-40ar lkC4- ( 253) Fe-7 -Stoc'L
MAILING ADDRESS E-MAIL
ELECTRICAL -e6 ( c 100 C?A'ti e.'
CONTRACTOR CITY STATE ZIP FAX
139$5 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
(41
APPLICANT MAILING ADDRESS E-MAIL
CACV Kt?4P-4-
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT � ,� ' (vs) ZZ8--
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: DATE //L 3/) 1'
PRINT NAME:_4-7 J1►lc_ 0.1'k S`+-
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application