19-102276Electrical
City of Federal Way Permit #.19-102276-00-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: MIRROR LAKE ELEMENTARY SCHOOL
Project Address: 625 S 314TH ST 110() Parcel Number: 082104 9035
Project Description: Installation of a 40-amp temporary service for job trailer.
Owner
Applicant
Contractor
MIKE BENZIENFEDERAL WAY PUBLIC
STURGEON ELECTRIC CO
STURGEON ELECTRIC CO
SCHOOLS
3902 B ST UNIT A
STURGEC853BL (4/14/21)
33330 8TH AVE S
AUBURN WA 98001
BST UNIT A
FEDERAL WAY WA 98003-5433
URN WA 98001
AUBURN
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Electrical Fixtures
Temp. Service: 0 - 60 amps (A 1
CONDITIONS:
This permit does not approve the placement of a job trailer prior to land use
PERMIT EXPIRES Friday, 8 May, 2020
Permit Issued on Thursday, May 9, 2019
)royal of the project•
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
Washin t d the City of Federal Way.
Owner or agent: Date,-
THIS CARD IS TO REMAIN ON -SITE
CITY OF �� Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 19 102276 00 Address: 625 S 314TH ST
Project: MIKE BENZIEN FEDERAL WAY WA 98003-5214
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.
❑
UFER Ground (4295)
Ditch cover (4030)
®
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
z
Pool Bonding (4195)
0
Temporary Power (4275)
❑
Service (4235)
By
Approved
Date
By
Approved
Date
By
Approved
Date���- .'
®
Feeders/Sub-panels (4045)
0
Rough Electrical (4225)
0
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
•_� I zo19 ELECTRICAL
Federal Vila MAC o PERMIT APPLICATION
y CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER `/
I 7
SUITE/UNIT/SPACE#
SITE ADDRESS: 3625 S 315TH ST. FEDERAL WAY, WA 98003
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
$ 12,500
0 8 2 1 0 4_ 9 0 3 5
COM.TEMP POWER
PROJECT NAME
MIRROR LAKE ELEMENTARY SCHOOL
(Tenant or Homeowner Last Name)
SETTING A 40AMP SERVICE FOR TRAILER TEMP POWER
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
FEDERAL WAY PUBLIC SCHOOLS
(253)945.5937
MAILING ADDRESS
E-MAIL
1211 S 332ND AT
CITY
FEDERAL
STATE
WA
ZIP
98003
FAX
NAME
PRIMARY PHONE
STURGEON ELECTRIC INC
253) 7 3 7 - 5 2 5 2
MAILING ADDRESS
E-MAIL
ELECTRICAL
3902 B ST UNIT A
CITY
I STATE
ZIP
FAX
CONTRACTOR
AUBURN
WA
98001
( ) -
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
STURGEC853BL 4 / 14 / 21
20-19-r ((04-'0 -EL
NAME
PRIMARY PHONE
APPLICANT
BRAD HOLTFRETER
(253) 259-7609
MAILING ADDRESS
E-MAIL
3902 B ST UNIT A
CITY
STATE
ZIP
FAX
AUBURN
WA
98001
( ) -
PROJECT CONTACT
NAME
BRAD HOLTFRETER
PRIMARY PHONE
( 2 53) 2 5 9 -7 6 0 9
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 relianee * the city, including its officers and employees, upon the accuracy of the
information supplf to the cit as a part oft q tio
SIGNATURE: DATE l
PRINT NAME: "f i�[7F� T EfC
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
Bulletin #160 — April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application