22-104365City of Federal Way
Community DeveloJ19>tnl Dept.
33325 8th Ave'S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 83~2609
Project Name: CARCAMO/PENA
Project Address: 29609 18TH A VE S
·--.... ---
Electrical
Permit #:22-104365-00-EL
Inspection Request Line: (253) 835-3050
Parcel Number: 367440 0015
Project Description: Relocate electrical meter, install emergency disconnect, instaU Ufer ground in new addition
footing, and add 3 circuits to existing panel
Owner Applicant
ELEODORO CARCAMO EVANS ELECTRIC GROUP
29609 18TH A VE S 17420 64TH A VEE
FEDERAL WAY WA 98003 PUYALLUP WA 98375
Additional Pennit Information
Is this an Online or O.T.C. application? .................. Yes
Alt. Serv./feeder: 0 to 200 am1
E lectrical Fixtures
PERMIT EXPIRES Wednesday, 22 March, 2023
Permit Issued on Friday. September 23. 2022
Contractor
EVANS ELECTRIC GROUP
EV ANSEG9S7DI (7 /29/24)
17420 64TII A VE E
PUYALLUP WA 98375
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
Wash ington and the City of Federal Way.
Owner or agent~~ Date:._'J,.L..:.....~.....1,L.z -=-3,_/ZL __ r1 Y'vr}..)1
~
CITYOF ~>
Federal Way
PERMIT#:
Project:
22104365 00
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUE~TS: (253) 835-3050
Address: 29609 18TH A VE S
MARIA BARRERA PENA FEDERAL WAY WA 98003-4279
' .
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THI S 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.
[TI UFER Ground (4295) 0 Ditch cover (4030)
By //{
Approved Approved
Date 9> ft./ 7..,, ~ :J-. By Date
III Pool Bonding (4195) ~ Temporary Power (4275)
Approved Approved
By Date By Date
III Feeders/Sub-panels ( 404S) [ii Rough Electrical (4225)
Approved 11< Ap::::d/-//~ ( By Date By
l!QJ Final· Electrical (4055)
By
Approved
Date -ft.ff-~
uh-v ic '*'IJ*
r:14~1 V ~ti/ G~I C /Jex;/
D
By .
Rough Electrical
Approved
Date
D
By
Final Electrical
Approved
Date
--
[!]
'
By
III
By
m
By
Slab/Concrete Floor ( 4255)
Approved to place concrete
Date
Service ( 4235)
Approved
// Date / ~J<; /v-2 ~
D
By
Ceiling Cover (4020)
Approved
Date
Right of Way
Approved
Date
CITYOF~
Federal Way
RECEIVED
SEP 2 3 2022
CITY OF FEDERAL WAY
COMMUNfTY DEVELOPMENT
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER d ~ J D Y 3 (o 5 _D 0 6c
---------------.-
SITE ADDRESS: z q WCf
PROJECT VALUATION
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
ASSESSOR'S TAX/PARCEL#
NAME
SUITE/UNIT/SPACE 11
CURRENT /PROPOSED USE
Q_ -.2... _Q_
i:11
PRIMARY PHONE
PROPERTY OWNER E le..a:loro Pe,,o.. Ca("(A ,.,
ELECTRICAL
CONTRACTOR
APPLICANT
PROJECT CONTACT
l\lAILING ADDRESS
1.q6o~ ti"'~ AJ
CITY
~t.l v.Jc
MAJLING ADDRESS
11~zo er~ 4-..1, l
CITY
ATE O NTRACTOR'S LICENSE #
f3G frV4
MAILING ADDRESS
CITY
NAME
Gt:rcrtk
E-MAJL
FAX
PRIMARY PHONE
E-MAIL
STATE ZIP FAX
( )
EXPIRATION DATE UBI#
7 I 2, !'LC/ 6 02-457-677-
PRIMARY PHONE
E-MAIL
STAT£ ZIP FAX
PRIMARY PHONE
(253 )5q'2.-&-lo
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 pennit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
1 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 si,ch 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
infonnation supplied to the city as a part of this application.
SIGNATURE: ~
PRJNT NAME: H,c/ue_/ f<-eeS.
PERMIT CENTER+ 33325 8th Avenue South+ Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoff.ederalway.com
Bulletin #160-April 14, 2020 Page I of I k:\Handouts\Electrical Pennit Application