19-104743 4111
4
Electrical
City of Federal Way Permit #:19-104743-00-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: STEEL LAKE ANNEX
Project Address: 2645 S 312TH ST Parcel Number:092104 9026
Project Description: Splicing the secondaries off transformer.
Owner Applicant Contractor
CITY OF FEDERAL WAY J G M TECHNICAL SERVICES INC J G M TECHNICAL SERVICES INC
33325 8TH AVE S 4742 42ND AVE SW SUITE 169 JGMTETS956KJ(5/15/21)
FEDERAL WAY WA 98023 SEATTLE WA 98116 4742 42ND AVE SW SUITE 169
SEATTLE WA 98116
•
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Zer2 t t i€ ..... ._ ,ilOiNt 3 ,elf!S :
Alt.Srvc/Feeder 201-600 am 1
PERMIT EXPIRES Wednesday,30 September,2020
Permit Issued on Tuesday,October 1,2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the us- will be in accordance with the laws, rules and regulations of the State of
/ j s ington an• the City of Federal Way.
/ �
Owner or agent: �L L L./ - Date: �-" Z d7f
THIS CARD IS TO REMAIN ON-SITE
CITY Of
Way Construction Inspection Record
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104743 00 Address: 2645 S 312TH ST
Project: CITY OF FEDERAL WAY 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.
El UFER Ground(4295) ❑ Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date Date By A Date
® Pool Bonding(4195) ® Temporary Power(4275) 0 Service(4235)
Approved I Approved Approved
By Date �I B• y Date • .I By Date
,
0 Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•El Final-Electrical(4055) .
By & Approved
Date/0'.3.r•f
El Rough Electrical 0 Final ElectricalElRight of Way
Approved Approved Approved
By Date By Date By Date
CITY OF ....,-_,""k..
RECEIVED ELECTRICAL
Federal Way OCT 01 2019 PERMIT APPLICATION
COMMUNFEDERAL
p ERAL WAY 9 �"'�
LOPM 'PERMIT NUMBER / _ / . V f 3 _ LL
5 5 3 G f cA SUITE/UNIT/SPACE#
A 6,/...." T'u--
SITE ADDRESS:
PROJECT VALUATION f} ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
a 61, `� � q / 0 v _ . 7D A 6
PROJECT NAME _
(Tenant or Homeowner Last Name) S 7(f' j �' O� J .c;r k
S,4' /( E- A''' ( .r'i(f -f S'F. '' '',-e)...0-,4 f7/I'
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME RIMARY PHONE
PROPERTY OWNER /! v { t' 6---4,1, --- i_,-sy }�
MAILING DRESS E-MAIL
CITY STATE ZIP FAX
F tc) . Y')a ( ) -
NAME PRIMARY PHONE
>/r i-f(l`f_�U`lel - C se Y > (K,e, ) 2'/S`._ t705jr
MAILING ADDRESS /de,1( ,f). E-MAIL
ELECTRICAL 67 7 /( 2 e/? ,,,,.:.a _5-c-4_, 'I- // Jr 9_,
/
CONTRACTOR �-%FAR X f r Sf je'G/<i y,,
CITY STATE ZIP cy FAX `'
S -//747-e- ee'77 l /7‘' ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT SAL%`(i � ?'7!'fte ,, ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT
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 cla .J ses out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplie•^to A.a .AT- '%a part oft s application.
it Vt .1/(/ d/P- ---
SIGNATURE: DATE /O `( ?..6:7 / /'
PRINT NAME: --7-l'-4.4 r•°i5e/'/
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application