23-104540City i Way
y L.Vcia Ckpo.
Cpamm�nn}2
5 Ell% S
333?5 Bd� AveAvc S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: KACZOR
Project Address: 30303 17TH AVE SW
Project Description: 10 can lights all over the house
Electrical
Permit #:23-104540-00-EL
Inspection Request Line: (253) 835-3050
Parcel Number: 005070 0030
Owner
Applicant
Contractor
RANDY KACZOR
WILLIAM TIBBENGO HAWK ELECTRIC
GO HAWK ELECTRIC (02)
30303 17TH AVE SW
37804 27TH PL S
GOHAWHE837DN(3/15/25)
FEDERAL WAY WA
FEDERAL WAY WA 98003
37804 27TH PL S
98023-3452
FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C. application?... ............... Yes
Electrical Fixtures
Circuits - Residential 2
PERMIT EXPIRES Saturday, 9 March, 2024
Permit Issued on Monday, September 11, 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
ONE
ItQ
Ef Federal Way.
Owner or agent: Date:
<,? Y O+ ViA
Federal Way
THIS C_ -RD IS TO RE1i_A.IZ 4--SITE
Construction Inspection Record
INSPECTION BEQUESTS: (243) 833-3050
Scheduled inspecrions nnv.: be Nied if ilia c.-ad is aot on-i:te. DO NOT LOSE THIS C AR:D. Ltlspectieas are listed is {lose ro sequeur:al order as possible
(read let to ri-ght, too to bottom'. Please schedule msVecrietu as aMcpriate Work rlrtist trot be cvvered until it is approved. Check with your, aspector if
You are uastire about all." ai the ii.'spectioL�s or tale impe%-tion sequence. Ou-?oLag inspe� iom are logged an the back of' f3_, Gird.
ELECTRICAL
❑
LiFER Ground (4295)
❑
Ditch cover (4030)
❑
SlablConcrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
❑
Pool Bonding (4195)
❑
Temporary Power (4275)
❑
Service (4235)
ApprW..ed
Approved
Approved
By
Date
By
Date
By
Date
❑
Feeders/Sab-panels (4045)
❑
Rough Electrical (4225)
❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
Bi-
Date
By
Date
Final - Electrical (4055)
Bv-
approved
Date f
MECHANICAL
❑
Mechanical Rough -in (4165)
❑
Gas Piping (4125)
Q
Final -Mechanical (4065)
Approved
Approved to release test
Approved
By
Date
By
Date
By
Date
PLUMBING
❑
Plumbing Groundwork (4190)
0
Rough Plumbing (4230)
❑
Final - Plumbing (4075)
Approved to cover
Approved
Approved
By
Date
By
Date
BS
Date