19-103310 111
Electrical
City of Federal Way Permit #:19-103310-00-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: TAFA @ SAGHALIE SCHOOL
Project Address: 33914 19TH AVE SW Parcel Number: 192104 9033
Project Description: Add circuit for new range
Owner Applicant Contractor
MIKE BENZIENFEDERAL WAY PUBLIC ISAAC CONRADNORTH SHORE NORTH SHORE ELECTRIC INC
SCHOOLS ELECTRIC INC NORTHSE983PH(10/13/20)
33330 8TH AVE S 14590 CAVALLI RD SE
FEDERAL WAY WA 98003-5433 OLALLA WA 98359 14590 CAVALLI RD SE
OLALLA WA 98359
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
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Circuits-Commercial 1
PERMIT EXPIRES Thursday,9 July,2020
Permit Issued on Wednesday,July 10,2019
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
W hington and the City of Federal Way.
Owner or agent: Date: '7'- 10-
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THIS CARD IS TO REMAIN ON-SITE
Federal Wa Construction Inspection Record ' ,
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 103310 00 Address: 33914 19TH AVE SW
Project: MIKE BENZIEN FEDERAL WAY WA 98023
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) IDDitch cover(4030) .El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date ‘By Date
El Pool Bonding(4195) ID Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) ® Rough Electrical(4225) ' ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
ved
ByDate3-11--1
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date .By Date
-4k DECEIVED ELECTRICAL
CITY OF �...-
Federal Way JUL 2019 PERMIT APPLICATION
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PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
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PROJECT NAME "- �9 \` . �G `
(Tenant or Homeowner Last Name) 7�A
PROJECT DESCRIPTION acSido e_L'rLJ Or- r-• ine ) Cc,' e___.Detailed description of work to U
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER -'NE' 5 e
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MAILING ADDRESS E-MAI
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MAILING ADDRESS ��• � � � � E-MAIL
ELECTRICAL I 6`VMD Cava / %s 414,620r 4 S i~•vcre kebi IG'r4G
CONTRACTOR
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(Es-5 )276-774-L
�,brA��CONTRACTOR'S LICL��i� 'OEXP�;ION DATE FEDERAL WAY BUSINESS LICENSE#
NAME S 31Q 3 !/7►/V-'`1 PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
HAM �, PRIMARY PHONE
PROJECT CONTACT /Fs,....4-544
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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 art of this application. ^ /D ' / /lam
SIGNATURE: c DATE
PRINT NAME: ��".SAR C...." CO hra
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application