19-103311 Eie ical
City of Federal Wry Permit #:19-103311-00-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: TODD BEAMER HIGH SCHOOL
Project Address: 35999 16TH AVE S Parcel Number:292104 9025
Project Description: Relocate(2)circuits from room 164 to room 163.
Owner Applicant Contractor
FEDERAL WAY SCHOOL DISTRICT ISAAC CONRADNORTH SHORE NORTH SHORE ELECTRIC INC
31405 18TH AVE S ELECTRIC INC NORTHSE983PH(10/13/20)
FEDERAL WAY,WA 98003-5433 14590 CAVALLI RD SE
OLALLA WA 98359 14590 CAVALLI RD SE
OLALLA WA 98359
•
Additional Permit Information
Is this an Online or O.T.C.application? Yes
� i'i 'd, m Y` ti R3 tlki3 �. . .. ,-` .3�-''• r '� s' 't• z'. • ,t r
Circuits-Commercial 2
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
gton and the City of Federal Way.
Owner or agent: Date: "711 /j
O^ r
l/)QZ
THIS CARD IS TO REMAIN ON-SITE
re�41.4
� , Construction Inspection Record
Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 103311 00 Address: 3599916TH AVE S
Project: FEDERAL WAY SCHOOL DISTRIC' FEDERAL WAY WA 98003-7416
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) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) El Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date
LBY Date
'
ID Feeders/Sub-panels(4045) ® Rough Electrical(4225) Q Ceiling Cover(4020)
Approved Approved Approved
��By Date By Date -'/ By %��� Date 75/#/7
0 Final-Electrical(4055)
Approved
By �, ( Date fn 7 /
Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
A RECEIVED ELECTRICAL
CITY OF �./
Federal Way JUL ' fy, 2019 PERMIT APPLICATION
CITY CF FED=4./-\i.WAY
COMMUNITY DEVELOPMENT Cj - 1 2 . - t
PERMIT NUMBER
SUITE/UNIT/SPACE#
SITE ADDRESS: 3.Faae‘ c 6A`^4 j , S
PROJECT VALUATION ASSESSOR'S TAX/PARCEL MCURRENT/PROPOSED USE
$ 4000.00 9' d- k 0 (4 _ 0 2
PROJECT NAME \066 4vvteir VsAc L1 c c,
(Tenant or Homeowner Last Name) v
V•e.\v cam.. eNeGXr Z G4 \ cre5 v % C00 v
PROJECT DESCRIPTION ‘61k 7c o G'�C 7..eD w '�. '' o 'Zoo....% t 6
Detailed description of work to 2 f>>AGU l 4.•.. )
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER "Todck 4w a At II 'L‘, 5Ct4001 ( ) -
MAILING ADDRESS E-MAIL
35`I�i ( ( 4 % Ave- S
CITY STATE ZIP FAX
°�'� A a'f003 ( ) -
NAME PRIMARY PHONE
No r OA Stip K. c..\e..... (23) 7-'113 13S-
MAILING ADDRESS tt c s'4 4 co E-MAIL
ELECTRICAL l�6T0 Cc.vc l% 5 dyjnr4•bS eCekCit0i0164
CONTRACTOR CITY STATE ZIP FAX 'Gem
01...kke.. 4�A qT3 Sri 21"? ) 27d- 77o7
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
)Jer-1-L7 SGg4??t 1m / ‘" /2O
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
MAW PRIMARY PHONE
�
PROJECT CONTACT ..1.5 Ah C. Cantreta, ( ) -
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 tot as a part of this application. r A
SIGNATURE: ' a DATE ?-1 d - ` [
PRINT NAME: ..5A4 G INCr.a
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application