23-102695City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
FILE
Electrical
Permit #:23-102695-00-EL
Inspection Request Line: (253) 835-3050
Project Name: HOLT
Project Address: 2027 S 304TH ST Parcel Number: 053700 0040
Project Description: INSTALLING NEW AND REPLACING GAS FURNACE
Owner
Applicant
Contractor
GARY L HOLT
SUSAN DUNHAMBLACK HILLS INC
BLACK HILLS INC (ELECTRICAL)
2027 S 304THST
1003 85TH AVE SE UNIT A
BLACKH1919DL (3/15/25)
FEDERAL WAY WA
OLYMPIA WA 98501
1003 85TH AVE SE UNIT A '
98003
OLYMPIA WA 98501-5706
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Electrical Fixtures
Circuits - Residential 1 Thermostat
1
PERMIT EXPIRES Sunday, 19 November, 2023
Permit Issued on Tuesday, May 23, 2023
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: I N I F Date:
-4k
CITY OF
Federal Way
THIS CARD IS TO REMAIN O\-SITE
Construction Inspection Record
INSPECTION REQUESTS: (2-53) 33-5-3050
Scheduled inspections nix; be failed if this card is not ou-site. DO NOT LOSE THIS C- RD. Inspections are listed as close to sequential order as possible
(read left to right. top to bottom). Please schedule inspections as appropriate. 'Work mist not be covered until it is approved, Check cvith your inspector if
you are unsure about any of the inspections or the inspection sequence. On-gomg-inspections are logged on the back of this card_
ELECTRICAL
❑
UFER Ground (4295)
❑
Ditch cover (4030)
❑
S1abiConcrete 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 (404-5)
❑
Rough Electrical (4225)
❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Fixtal - Electrical (4055)
a�rd
By
ZIXCX D,te.
MECHANICAL
❑
Mechanical Rough -in (4165)
❑
Gas Piping (4125)
❑
Final - Mechanical (4065)
Approved
Approved to release test
Approved
By
Date
By
Date
By
Date
PLUMBING
❑
Plumbing Groundwork (4190)
Q
Rough Plumbing (4230)
❑
Final - Plumbing (4075)
Approved to cover
Approved
Approved
By
Date
By
Date
By
Date