21-101883City of Federal Way
FILE
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: SCHWARTZ
Project Address: 34117 LOTH CT SW
Project Description: Install circuit for car charger
Electrical
Permit #:21-101883-00-EL
Inspection Request Line: (253) 835-3050
Parcel Number: 957850 0230
Owner
Applicant
Contractor
ADAM SCHWARTZ
JAN ROSANDERCUSTOM ELECTRICAL
CUSTOM ELECTRICAL SERVICES LLC
34117 LOTH CT SW
SERVICES LLC
(01)
FEDERAL WAY WA 98023
3716 AUBURN WAY N
CUSTOES893J2 (4/22/23)
AUBURN WA 98002
3716 AUBURN WAY N
AUBURN WA 98002
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Circuits - Residential
Electrical Fixtures
PERMIT EXPIRES Friday, 13 May, 2022
Permit Issued on Thursday, May 13, 2021
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
Washin t n a the i Federal Way.
Owner or agent: C
Date:
CITY OF
Federal Way
PERMIT #: 21 101883 00
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 34117 LOTH CT SW
Project: ADAM SCHWARTZ FEDERAL WAY WA 98023
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
❑
Pool Bonding (4195)
❑
Temporary Power (4275)
❑
Service (4235)
Approved
Approved
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
Final - Electrical (4055)
ppr ovvc d
By Datelr_
❑
Rough Electrical
❑
Final Electrical
❑
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date