16-105880 I
Electrical
City of Federal
Community Development Dept. Permit #:16-105880-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: 1ST MAGNOLIA ADULT FAMILY HOME
Project Address: 2920 S 284TH ST Parcel Number:332204 9162
Project Description: Install(1)fire alarm outside of bedroom "E".
Owner Applicant Contractor
MARTIN MISAGHI MARTIN MISAGHI OWNER IS CONTRACTOR
2920 S 284TH ST 2920 S 284TH ST
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application? Yes
PERMIT EXPIRES Wednesday, 13 December,2017
Permit Issued on Tuesday,December 13,2016
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
ashington and the City of Fe.-ral Way.
Owner or agent: ,/�.�,L Date: ,I 3//,G
i
4/4
ZA
, S
THIS CARD IS TO REMAIN ON-SITE
�� 4A) Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 105880 00 Address: 2920 S 284TH ST
Project: SHIREEN MISAGHI FEDERAL WAY WA 98003-3315
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) "� Ditch cover(4030) `�El Slab/Concrete Floor(4255) `
Approved Approved Approved to place concrete
By Date By Date By Date
.. V •
El Pool Bonding(4195) Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date 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)
Approved
Bar.-- ---_, Date'_/4._ ((
0 Rough Electrical Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF DEC 1% so ELECTRICAL
Federal Wayctri ®F FE®� '�\"° PERMIT APPLICATION
PERMIT NUMBER _ ) 0 J �3 0— c_. (/
SUITE/UNIT/SPACE#
SITE ADDRESS: 24120 2 8 q 4
er4 I GJA 3 9 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# 1 CURRENT/PROPOSED USE
$-fie:00,too roc) NI 3 2 2 a 9_ _ 9 L z
PROJECT NAME M/c.7 �( /1/
(Tenant or Homeowner Last Name) l
PROJECT DESCRIPTION !'I,vST Reld nile_ Ftfe Ctla/lYI QV+Side. 6e-e116omE •
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER M14✓ TIN M/5 Acl14I ( )6)1/44(- /3LfC
MAILING ADDRESS E-MAIL
2q20 5. 28q .s+.
CITY STATE ZIP FAX
NAME PRIMARY
1 4/01j 4u4 °I2oo3 ( ) -
PRIMARY PHONE
)
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
. A p'L LIQ
APPLICANT DIRT/N 1 rS4�� ()X) -!`T 13 ` l .
LING ADDRESS / E-MAIL
qz0 2,5,4! 54'
CITY STATE ZIP FAX
Ft4 ( C✓39 4 ' 3 ( ) -
NAME PRIMARY NE
PROJECT CONTACT 1441 (N M451461114 / 6 ) 3/1- 1
Ller
I certify under penalty of perjury that 1 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.
'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 suppli to the city as a p rt of this application. /
SIGNATURE: 4.^ I ' DATE b `/5/(
PRINT NAME: N 1?-1 I IU M(5 Ac:
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609 +permitcentei@citvoffederalwav.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application