23-104580Electrical
City of Federal yDevelopment Permit #:23-104580-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: (253) 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: MBUGUA
Project Address: 31044 20TH AVE S ' /� rl Parcel Number: 053700 0622
Project Description: Add aZ3 417�� fl 3
Owner
Applicant
Contractor
f
LOISE MBUGUA
33025 19TH CT SW
LOISE MBUGUA
33025 19TH CT SW C4 '
OWNER IS CONTRACTOR
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
I/
Additional Permit Information
Is this an Online or O.T.C. application? ................ Yes
Electrical Fixtures
Circuits - Residential 2
PERMIT EXPIRES Sunday, 10 March, 2024
Permit Issued on Tuesday, September 12, 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: Date: 1
i Y `L
CITY ("
Federal Way
THIS CARD IS TO REAL -Us ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-30M
Scheduled inspections man: be f-ailed if this card is not on -site. DO NOT LOSE THIS CARD. Inspecttoas are listed as close to sequcnittal order ai possible
i read let't to right. too to bottom~ Please schedule uispectrons as appropriate. It orb uat:;t not be co zred until it is appro� ed_ Check :+ itlz otL inspector if
you are unsure about any of the aipectimi or the inspection sequence. on -going inspections are logged on the back of this card.
ELECTRICAL
❑
L"FER Ground (4295)
Q Ditch corer (4030)
❑
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By Date
By
Date
❑
Pool Bonding (4195)
El Temporary Power (4275)
El
Service (4235)
Approved
Approved
Approved
By
Date
By Date
B-
Date
Feeders/Sub-panels (4045)
0 Rough Electrical (4225)
❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By Date 3 �
By
Date
El
Final - Electrical (4055)
Approved
B.
Date
i
MECHANICAL
0
-Mechanical Rough -in (4165)
❑ Gas Piping (4125)
0
Final -Mechanical (4065)
Approved
Approved to release test
AppIotied
Bv-
Date
B}Date
By
Date
PLUMBING
0
Plumbing Groundwork (4190)
Q Rough Plumbing (4230)
❑
Final - Plumbing (4075)
Approved to cover
Approved
Approved
By
Date
By Date
By
Date
RECEIVED
CIFY 4F
Federal Way SEP 12 2023
ELECTRICAL
PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY ❑MLOPMERRMIT NUMBER
SITE ADDRESS: = ` ' owl['. �
SUITE/UNIT/SPACE #
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
r
N%u U �y
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
(rec0 .-�
PROPERTY OWNER
NAME
Ln1 Se
PRIMARY PHONE
S5 � — Q C� 13
MAILING ADDRESS
2
V D
E-MAIL
CITY
-�da\
STATE ZIP
IUOK I
FAX
-
ELECTRICAL
CONTRACTOR
NAME
wv�,-
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY STATE ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
UBI #
APPLICANT
NAME `
1��
PRIMARY PHONE
(��)
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
g b o3
FAX
( )
PROJECT CONTACT
NAME
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 laws 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 where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied tot a city as apart of this application.
1
SIGNATURE: - _ _DATE !
PRINT NAME:L)1�C
PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter ccityoffederalway.com
Bulletin #160 — April 14, 2020 Page 1 of 1 k:\Handouts\Electrical Permit Application