23-103322Electrical
City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Permit #:23-103322-00-EL
Inspection Request Line: (253) 835-3050
Project Name: LARSON/OSWALD
Project Address: 30037 4TH AVE SW Parcel Number: 720500 0010
Project Description: Replace existing electrical service
Owner Applicant Contractor
COLLEEN LARSON BOB STORMENTSTORMENT ELECTRIC STORMENT ELECTRIC
30037 4TH AVE SW 7911 SPRINGFIELD DR NW STORME*241CL (8/30/23)
FEDERAL WAY WA 98023 GIG HARBOR WA 98329 7911 SPRINGFIELD DR NW
GIG HARBOR WA 98329
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Alt. Serv./Feeder: 0 to 200 aml
Electrical Fixtures
PERMIT EXPIRES Sunday, 24 December, 2023
Permit Issued on Tuesday, June 27, 2023
I hereby certify that the above information is correct and that the construction on the above described property
and. 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. ll
Owner or agent: -
KyL Ot
Date
crtr ov
Federal Way
THIS CARD IS TO REAI_XI\ ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-30>0
Scheduled inspection um:• be failed if this card is pat on -site. DO NOT LOSE THIS CARD. Ittspectians are listedas close to sequential order as passible
(read left to right. top to bottom), Please schedule rml errto[ts as appropt ate %V0fk must not be covered until it is approved. Check with your impector if
You are Unsure about any of rite inspections ar the insvection sequence. On-goisng inspections are lagged ou the ball: of this card.
ELECTRICAL
❑
LTFER Ground (4295)
❑
Ditch cover (4030)
❑
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
BY
Date
Bv
Date
❑
Pool Bonding (4195)
❑
Temporary Power (4275)
❑ Service (4235)
Approved
Approved
Approved
Bv
Date
Bv
Date
B`
G�
Date,/
❑
Feeders/Sub-panels (4045)
❑
Rough Electrical (4225)
❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
B�
Date
Bj
Date
Final - Electrical (405 )
Approved
By
Date
MECHANICAL
❑ Mechanical Rough -in (4165) ❑ Gas Piping (4125) El Final -Mechanical (4065)
Approved Approved to release test Approved
B}' Date By Date By Date
PLUMBING
0 Plumbing Groundwork (4190) Q Rough Plumbing (4230) ❑ Final - Plumbing (4075)
Approved to cover Approved Approved
By Date By Date 138 Date
CITY OF
Federal Way
RECEIVED ELECTRICAL
JUN 2 7 2023 PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNfTY DEVELOPMENT
PERMIT NiFMBER
SITE ADDRESS: 300 7
SUITE/UNIT/SPACE #
_3
PROJECT VALUATION
ASSESSOR'S TAXIPARCEL #
CURRENT/PROPOSED USE
PRO CT NAME
2_<:::>
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
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PROPERTY OWNER
[Y.�^fir
MAILS G ADDRESS
t?d0 -3 7
E-MAIL
ST
CjIrT(yY—�
E ZIP
FAX
NAME
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MAILING ADDRESS
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ELECTRICAL
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CITY
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STATE
7
FAX
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CONTRACTOR
WA AT8 ONTRACTOR'S LICENSE #
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NAME
EXPIRATION DATE
ii,�3
UBI #
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/ PRIMARY PHONE
APPLICANT
1
MAILING ADDRESS
E-MAIL
CITY STATE
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ZIP
( FAX
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PROJECT CONTACT
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 Iaws 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 ch claim arises out of the reliance of the city, including its officers and employees, upon the accur cy of the
informati p the city as apart of this application.
SIGNATURE: v DATE fY
PRINT NAME:
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenteracityoffederalway.com
Bulletin #160 —April 14, 2020 Page 1 of 1 k:\Handouts\Electrical Permit Application