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23-105498A—Federalway CITY OF FEDERAL WAY Electrical Permit MyBuildingPermit. cam Permit Information Permit Number 23-105498-00-EL Issued Date 11/8/2023 Expiration Date 11 /7/2024 Job Address 30016 19TH AVE S Fee Paid $124.14 FEDERAL WAY, 98003 Order Confirmation 1264386 Floor Related Permit # Suite Application ID 1 1401909 Contact Information Contact Name Provident Electric Contractor PROVIDENT ELECTRIC INC Phone Number (253) 631-7750 LNILicense # PROVIE1103C2 Property Owner SSHI LLC Phone # (253) 631-7750 Address 11241 SLATER AVE NE KIRKLAND, WA City Bus License # 601 217 805 Property Owner Phone Tenant Name Job Description A (Single Family Residential) (New) Temporary Service project involving ( Single Family Dwelling, 1 Temporary Service) NEW 100 AMP TEMP POLE Conditions - Post Permit on site. Do not cover until inspected. rn� Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above may result in revocation of the permit. Applicant: Provident Electric Page 1 of 2 Federal Way " CITY OF FEDERAL WAY Electrical Permit M BuildingPermit.com Permit Information Permit Number 23-105498-00-EL Issued Date 11/8/2023 Job Address 30016 19TH AVE S Expiration Date 11 /7/2024 Fee Paid $124.14 FEDERAL WAY, 98003 Order Confirmation 1264386 Floor Related Permit # Suite Application ID 1401909 Inspections Inspection IVR Inspector Date Inspection IVR Inspector Date Rough Electrical 4225 Final Electrical 4055 Final- Electrical 4055 Inspection Scheduling Page 2 of 2