HomeMy WebLinkAbout15-103800City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: DURAM
6
Project Address: 33023 36TH AVE SW
Project Description: 0-200 AMP panel change
FILE
•
Electrical
Permit #: 15 -103800 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 873213 0310
Owner
Anulicant
Contractor
DIANN DURAM
SAFE HOME ELECTRIC
SAFE HOME ELECTRIC
JACQUALYNN NILSSON
PO BOX 39758
SAFEHBE902NE (8/5/16)
33023 36TH AVE SW
LAKEWOOD WA 984%
PO BOX 39758
FEDERAL WAY WA 98023
LAKEWOOD WA 98496
Additional Permit Infonnation
Is this an Online or O.T.C. application?.................Yes
E
Electrical Fixtures
Alt. Serv./Feeder. 0 to 200 amps (F 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Wednesday, January 27, 2016
Permit Issued on Friday, July 31, 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 of Federal Way.
Owner or agent: Date:
CITY OF
Federal Way
PERMIT #:
15 -103800 -00 -EL
THIS CARD IS TO RE ON-SITE '
Construction Inspe ion Record
INSPECTION REQUESTS: (253) 835-3050
Address: 33023 36TH AVE SW
Project: DIANN DURAM FEDERAL WAY, WA 98023-2615
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)
Temporary Power (4275)Service
lab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Temporary Power (4275)Service
(4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
0
Final - Electrical (4055)
Approved
By
Date %--i & _ _.
Rough Electrical
Approved1:1
Final Electrical
Approved
Right of Way —�
Approved
By
Date
By
Date
By
Date
s
ELECTRICAL
CITY OF
Federal Way PERMIT APPLICATION
/RECEIVED
PERMIT NUMBER 15 � O J � � � `�
-- - ------ - -- JUL 312015
SITE ADDRESS: Jam' �OZ2j
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PROJECT VALUATION
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A3FSOR'S TAR/PARCEL MI
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CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
r
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
( ) -
MAILING ADDRESS
E-MAIL
CITY ' J
STATE
ZIP
FAX
'
NAME
PRIMARY PHONE
MAILING DRESS
E -MAH,
ELECTRICAL
CONTRACTOR
CITY
STATE
1 c u
ZIP
FAX
-
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME �/
X 1 ),r, t- `, _ r
/
'e
PRIMARY PHONE
-
MAILING ADDRESS
d.
E-MAIL
CITY -
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STATE I
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ZIP
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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 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 reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
SIGNATURE: DATE
PRINT NAME:
Bulletin # 160 —January 1, 2013 Pagel of 2 k:\IlandoutsTlectrical Permit Application
