21-101966City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: BERNARDEZ
Project Address: 29634 21ST PL S
Project Description: Replace panel
Electrical
Permit #:21-101966-00-EL
Inspection Request Line: (253) 835-3050
Parcel Number: 660300 0030
Owner
Applicant
Contractor
ERICSON BERNARDEZ
JAN ROSANDERCUSTOM ELECTRICAL
CUSTOM ELECTRICAL SERVICES LLC
2963421ST PL S
SERVICES LLC
(01)
FEDERAL WAY WA 98003
3716 AUBURN WAY N
CUSTOES893.12 (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
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 aml 1
PERMIT EXPIRES Wednesday, 18 May, 2022
Permit Issued on Tuesday, May 18, 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
Washington and the City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO REMAIN ON -SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 21 101966 00 Address: 29634 21ST PL S
Project: MELINDA C BERNARDEZ FEDERAL WAY WA 98003-4250
Scheduled inspections maybe failed if this card is not on -site. DO NOT LOSE. T lIS 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)
0
Ditch cover (4030)
El
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
❑
Pool Bonding (4195)
0
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
El Final- Electrical(4055)
Approved
By Datef�p���
Rough Electrical
❑
Final Electrical
❑
Right of Way
Approved
Approved
I
Approved
By
Date
By
Date
By
Date