18-105420City of Federal Wry
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 8352609
Project Name: TORNOW
Project Address: 35003 5TH AVE SW
Electrical
Permit #:18 -105420 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 132174 0150
Project Description: Electrical work to include Installing a 40A 240V outlet in the garage. ***12/7/18 ADD:
Installation of 50 -amp sub -panel and relocation of 7 circuits.***
Owner
Applicant
Contractor
JOAN C TORNOW
BRANNON HOGANB P E ELECTRICAL
B P E ELECTRICAL CONSTRUCTION
35003 5TH AVE SW
CONSTRUCTION
BPEELEC892CH (2/24/19)
FEDERAL WAY WA 98023-8107
351 S 309TH ST
PO BOX 15174
FEDERAL WAY WA 98003
SPOKANE WA 99215
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
PERMIT EXPIRES Thursday, 14 November, 2019
Permit Issued on Wednesday, November 14, 2018
hereby certify that the abo 'nfo ion is correct and that the construction on the above described property
and the occupancy a us 11 be in accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Owner or agent: Date: /4 /�
RECEIVED
CITY OF A ELECTRICAL
Federal Way NOV 14 2018 PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNf1Y DEVELOPMENT �f /� /
PERMIT NUMBER I _ ' O L— V
SITE ADDRESS: S5-6) 2 5,b F� .
SUITE/UNIT/SPACE#
PROJECT VALUATION
6,0• L%0
ASSESSOR'S TAR/PARCEL #
-1 3 -2- 1 7
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
Q NSW
PROJECT DESCRIPTION
Detailed descriptidn of work to
be included on this permit only
4 ?
PROPERTY OWNER
NAME \
PRIMARY PHONE
MAILING ADDRESS
(ia3 s�vw.
E-MAIL
CITY
rdb,-CAAo,L w -Ay
STATE
I ZIP
FAX
-
ELECTRICAL
CONTRACTOR
NAME
3">e- ecer, ,w CvruSi2vc T ri
PRIMARY PHONE
(tr,Co) YW - "51W
MAILING ADDRESS
7 D --t>o,< J S1)Y
E-MAIL
e)ecy-r�-4.(„
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
E _ Zr��c'c r'� 84�eH ?-
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
-
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
PRIMARY PHONE
( )
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 1 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 prises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to ity ys apart of this application.
SIGN
PRINT NAME: R bwJ N" V`I
Bulletin 4160 - April 14, 2016 Page 1 of 1 Ul-landoutsTlectrical Permit Application
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