12-105566City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: FAKER -FEIST
Project Address: 36428 6TH AVE SW
Project Description: Installation new meter base.
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`i Electrical
Permit #: 12- 105566 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number:
0700 y
302104 9172
Owner
A_Pp1ican
Contractor
MICHAEL J FAKER -FEIST
MICHAEL J FAKER -FEIST
OWNER IS CONTRACTOR
36428 6TH AVE SW
36428 6TH AVE SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is Use Educational or Institutional ? .......................No
Mast or Meter Repair (ResidentiaU 1
PERMIT EXPIRES Tuesday, June 11, 2013
Permit Issued on Thursday, December 13, 2012
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
n Ci of a ral Wa .
Owner or agent: Date: /Z— / 3 -2c7 / Z
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CITY OF r`
Federal Way
PERMIT #:
12- 105566 -00 -EL
THIS CARD IS TO MAIN ON -SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835 -3050
Address: 36428 6TH AVE SW
Project:. MICHAEL J FAKER -FEIST FEDERAL WAY, WA 98023 -7217
Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On -going inspections are logged on the back of this card.
Final - Electrical (4055)
Approved
Date
❑
UFER Ground (4295)
Ditch cover (4030)
Temporary Power (4275)
Slab /Concrete Floor (4255)
❑
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Date
❑
Pool Bonding (4195)
Temporary Power (4275)
❑
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
❑
Feeders /Sub - panels (4045)
❑
Rough Electrical (4225)
❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Date
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
PROJECT NAME
(Tenant or Homeoumer Last
PROJECT DESCRIPTION
Detailed description of uiork to
be included on this permit only
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PROPERTY OWNER
NAM
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PRtlfARY PHONE
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STATE
ZIP
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PRUEARY PHONE
YAUMO ADDRSSS
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ELECTRICAL
CONTRACTOR
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ZIP
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FEDERAL WAY UczMU9 f
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APPLICANT
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PROJECT CONTACT
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I certify under penalty of perj—v that I am the property owner or authorised agent of the properly osaieer. r aertTy that to the best
of my knowledge, the Wormation submitted in support of this permit application is true and correct. I urWy that r will comply with
all applicable City of Federal Way regulations pertaining to the work authorised bg the issuance of a permit. I understand that the
issuance of this permit doss not remove the owner's responsibility for compliance with local, state, or federal lams regulating
construction or environmental laws,
I fwther agree to hold harmless the City of Federal Way as to any claim (bwhuiing costs, -9 —tses, and attorneys' fees incurred in
the investigation and dgfense of such claim), which may be made by any person, including the undervfgnal, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employee; upon the accuracy of the
Worm Non supplied to the city as a part of this application
j1 SIGNATURE. DATE 1Z —1-5
PRINT NAME: n
33325 8° Avenue South ♦ Federal Way ♦ WA ♦ 98003 - 63251253- 835 -2507 ♦ fax: 253-835-2609 ♦ www_cityoffedemlway.com
Bulletin #160 – January 1, 2011 Page 1 of 2 k:\Handouts\Electrieal Permit Application
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