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1 • Electrical
City of&Federal Way •EPermit #: 15-105276-00-E L
CommuniEcon.Dev.Services
33325 8th Ave S
:(253)
Federa835-2l60W7 ay,wA(295830)0:3
253)89800335-2609 p Ins ection Request Line: (253)835-3050
PhFax:
Project Name: CASSMAN
Project Address: 30914 5TH PL S Parcel Number: 241330 0140
Project Description: Add circuit for ductless heat pump.
Owner Applicant Contractor
TONI CASSMAN SUNDANCE ENERGY SERVICES INC SUNDANCE ENERGY SERVICES INC
WILLIAM L CASSMAN (MECHANICAL) (ELECTRICAL)
30914 5TH PLS 10228 MAIN ST SUNDAES062J8(4/28/16)
FEDERAL WAY WA 98003 BOTHELL WA 98011 10228 MAIN ST
BOTHELL WA 98011
Additional Permit Information
Is this an Online or O.T.C.application Yes Is Use Educational or Institutional9 No
Electrical Fixtures
Circuits-Residential 1
PERMIT EXPIRES Tuesday, April 12, 2016
Permit Issued on Thursday, October 15, 2015
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 Washington
and the City of Federal Way.
Owner or agent:(::::)SDate: 0.... grip 1
ev,
op„,
t THIS CARD IS TO RE�ON-SITE '
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CITY OF Construction Inspartion Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-105276-00-EL Address: 30914 5TH PL S
Project: TONI CASSMAN FEDERAL WAY, WA 98003-4013
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) -0 Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0
O Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
By 4 Date t l I et-L 14-
Rough Electrical ElFinal Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
•
RECEIVED LECTRICAL
.r €119 OF 1111111
Federal Way OCT 2 5 2015 PERMIT APPLICATION
` CITY OF FEDERAL W V
PERMIT NUMBER / 5 - / 0 5 al 7C S
/�/
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 09` 6 c, 1 P 5
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 20^ ?- l ' - e ! o
PROJECT NAME
gSSM�/J
(Tenant or Homeowner Last Name)
Atm/Ag. A G/A4v t1 Aa— A NEW Q 'c.-i f'sS lJr��Pu4P
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME //�'"" PRIMARY PHONE
PROPERTY OWNER 6IGG 'i -" CASS/KA/✓ (?s,3) �yl - (4712--
MAILING
ADDRESS E-MAIL
3oI1/y S -rw /L S
CITY STATE ZIP FAX
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NAME !J PRIMARY PHONE
Sy
Alb AA/( . CiA 5jAI �.S
MAILING ADDRESS E-MAIL
ELECTRICAL 0'2-Z4 /11.41A) 5� 90..0on/lek.A.eiv2-
CONTRACTOR CITY STATE ZIP FAX
� WA 92'O/I ( L(2. ) L 'Qt- S9gY
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
5 coLoAE$a(o i,zir � ?.)-m-l a(e66.s-�-B
NAME ��y�/ S PRIMARY PHONE
APPLICANT 5a M b- a c E�`" - / " C� ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
PROJECT CONTACT $ J/.< . ,i��,�y 5 ✓/(,�
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 arcs=s out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci a-art of this application.
SIGNATURE: // � I DATE 4
PRINT NAME: /r
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application