19-104673 - * I.-i
Eltibtrieal
City or Federal way Permit #:19-104673-00-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: LAKEHAVEN UTILITY EMERGENCY PUMP STATION 26
Project Address: Parcel Number: CITY WIDE
Project Description: Replace existing 100A service due to property development.Location: S 282nd Street&27th
Ave S
Owner Applicant Contractor
LAKEHAVEN UTILITY DISTRICT GARY COOKLAKEHAVEN UTILITY OWNER IS CONTRACTOR
PO BOX 4249 DISTRICT
FEDERAL WAY WA 98063 3203 SW DASH PT RD
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
s
Alt. Srvc/Feeder 0 to 200 arm 1
PERMIT EXPIRES Tuesday,29 September,2020
Permit Issued on Monday,September 30,2019
I hereby certify that the above information is -• -ct and that the construction on the above described property
and the occupancy and the us- b- n a fr•l dance with the laws, rules and regulations of the State of
i . ingt• - d the City of Federal Way.
Owner or agent s��/. Date: 7/47
tax
THIS CARD IS TO REMAIN ON-SITE
.
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104673 00 Address:
Project: LAKEHAYEN UTILITY DISTRICT FEDERAL WAY
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 LIFER Ground(4295) El Ditch cover(4030) 1 ® Slab/Concrete Floor(4255)
Approved Approved i Approved to place concrete
By Date By Date/(2,- By Date
0 Pool Bonding(4195) I El Temporary Power(4275) s❑ Service(4235)
Approved Approvedpproved
By Date ' By Date By // �/ Date / 7 '.
ID Feeders/Sub-panels(4045) ® Rough Electrical(4225) i ® Ceiling Cover(4020)
Approved I Approved iApproved
By Date B• y Date By Date
pit Final-Electrical(4055)
Approved
By irZ Date//'7•17
•
•
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY OF A SEP 3 0 2019 ELECTRICAL
Federal WayNOFFDE RLOPMEM PERMIT APPLICATION
COMMUNFTYPERMIT NUMBER I — l o 7 3 - l/
SUITE/ IT/SPACE#
SITE ADDRESS: �700 5 Z$2. '''5 7- C5 2$j"( 34- .F 2 7f1 #3/41,rY
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# C T/PROPOSED USE
$ 2S—d iz c' - - -
PROJECT NAME
(Tenant or Homeowner Last Name) AtAf.4���ldi✓ '-lo s92✓!C Er /AC-4-E : yam
<ST/'v
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER L / Eic, U TU/77 (2r3) .?‘//-/176
MAILING ADDRESS E-MAIL
PO ' O-t
CITY STATE ZIP FAX
/0f- Ai/4y 9,06 (2`x)23,- ?� '
NAME �'� PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE I EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT ` / Ceve )� r/ ( 1�
MAILING ADDRESSE-MAIL
324/3 6 ) ghc/F AT �c 4 e - 1 "1,C
CITY STATE ZIP FAX
9'x'02-3 (213) g2 R-57
NAMEPRIMARY PHONE
PROJECT CONTACT 2y COOK (2-\-31 9 h�o g
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 o edera •ay as to any claim(including costs,expenses, and attorneys'fees incurred in
the investigation and defense of such clai whic ''• -- made by any person,including the undersigned,and filed against the city,
but only where such claim arises •, the of the city, including its officers and employees, upon the accuracy of the
information supplied to the city of..064 ation.
SIGNATURE: aliS / DATE 7/704
PRINT NAME: ,(2-7'0-y A<
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+ FAX 253-835-2609 + permitcentel@cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 161-Iandouts\Electrical Permit Application