08-102139City of Federal Way
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: RIENHOLM
Project Address: 32725 6TH AVE SW
Project Description: Temp power pole at panel
Electrical Permi: 0
Inspection
139 -00 -EL
ie: 663) 835 -3050
926491 0810
Owner
Applicant
Contractor
ARTHUR WILHELM REINHOLM III
MADSEN ELECTRI
EN ELECTRIC
32725 6TH AVE SW
3939 S ORCHARD ST
D 4OP8 (4/30/10)
FEDERAL WAY WA 98023 -5624
TACOMA WA 98466
93 RCHARD ST
COMA WA 98466
THIS CARD IS T MAIN ON -SITE -
CITY OF Community Develop ent Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 08- 102139 -00 -EL
Owner: ARTHUR WILHELM REINHOLM III
Address: 32725 6TH AVE SW
FEDERAL WAY, WA 98023 -5624
This card is part of your required inspection documents. 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.
❑ UFER Ground (4295)
❑
Ditch cover (4030)
❑
Slab /Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By Date
By
Date
By
Date
❑
❑
—
❑ Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
Approved
Approved
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
By Date
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date • •4:5e
i � �� 2 ��
EI`I PERMIT 'I`
C M&VffTYDSMOPMWSERVICBS SF MF CO M EL PL DE EN FP
"'25 -,.4� BP SO
20-8,25-2&M 99d2 n APPLI CATI O 1l
FEDERAL WAY, WA 9d B 2O� �
TIIe ,I9dFre DC�&L 1 UnAY incomplete application will not be accepted Please tint legibly or
P 9 ll (in inkj t1/Pe•
SITE ADDRESS SUITE /UNIT 9
ASSESdOR'S TAX /PARCEL f _ _ _ _ _ _ _ LOT SIZE (sj)
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(AftsA PWfir4wuwlmddamodw)
PRoirCT INFOMIATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL -
❑ DEMOLITION ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Pro vided d despiptu►n of work irufuded o kL
Qom'' ,�."� ,
PROJECT NAME (Name of Business or Owner L Name) l e C) ' V►.�
PEOPLr, INFOMIATION
PROPERTY
NAM r 1
PRIMARY PHONE
OWNER
`
_
A-- NUMBER
MAILING ADDRESS
CITY, STATE, ZIP
E -MAIL ADDRESS
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
MPANY AME n
Q
CANT N
®1%
ST� E, ZIP
92L46
OFFICE PHONE
_ c
LL PHONE
(,A&3Q0-7
M0ADD RESS
- r2
1 EDERAL WAY BUSINESS LICENSE NUMBER
EXPI T[ON DA E
A-- NUMBER
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
LL
'�7t?/-/
CONTRACTOR'S REO IMS ON NUMBER
EXPIRATION DATE
E-MAIL ADDRESS
CO NAVIN
0.Q
APPLICANT NAME
OFFICE PHONE _
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( _
NAME PRIMARY PHONE _ E-MAU. ADDRESS
6
NAME
Per ROW 19.27.096:
Lender information is required if project value exceeds $6,000
MAUMO ADDRESS
CITY, STATE, ZIP PHONE
EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE, PROVIDER ❑ LAKEHAVEN ❑ HIGHLIKE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
BASEMENT
EXISTING
80-FT.
PROPOSED
S . FT.
TOTAL
8 . FT.
FIRST
FANS
GAS WATER HEATERS
MISC (Describe)
SECOND
FIREPLACE INSERTS
HOODS r,.= ;d q
THIRD
FURNACES
RANGES
a NO
ADDITIONAL FLOORS (DESCRIBE)
GAS LOG SETS
REFRIG. SYSTEMS
UP /SEPA /SU?
DECK (❑ COVERED OR ❑ UNCOVERED ?)
o NO
PLATTED LOT?
a YE8 a NO
GARAGE Ir CARPORT ❑
LAVE (s.e ... sw o
URINALS
MISC (Describe)
NUMBER OF FLOORS
M"o
rse"M
corer
roru.s sr
car'""*~snar
ror"or
•'NEWHOAM ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate. number of each type of f xture to be installed or relocated as part of this prnject. Do not include existing fixtures to remain.
AWCFIdNICAL
Value of Medumical Work $ M COPY OF BID OR ESTIMATE MUST BE INCLUDED WITHAPPLICATIONJ
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS
WOODSTOVES
BBQS
FANS
GAS WATER HEATERS
MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS r,.= ;d q
COMPRESSORS
FURNACES
RANGES
a NO
DUCTS.
GAS LOG SETS
REFRIG. SYSTEMS
UP /SEPA /SU?
3
o NO
PLATTED LOT?
a YE8 a NO
BATHTUBS Iornrb /sh~ Co.. b4
LAVE (s.e ... sw o
URINALS
MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (ros,q
ELECTRIC WATER HEATERS
SINKS
WASHING MACHINES.
HOSE BIBBS
SUMPS
I certify under penalty of perJury that I an the property owner or authorised a t q/ the property owner. I aerb(fy that to the best 4%mdl
knowledge, the Wormation submitted in support of this permit app[icatbn is true �nd comet, I eert(jy that I wl[I aompty with alI gppUcab[s
City Of Federal Way regulations pertaining to the work authorised by the /aauance j a permit. I understand that the Issuance f thts permit
doss not remove the owner's reaponaibility for eompitance with burl, state or fsdera[awe regrtlaNng eonatruetbn or enrdronmsatal lava.
I further ages to hold harmless the City of Federal Way as to any eiaim ( including costs, expenses, and attorneys' Jess ineumd in the
investigation and dq/snss of such eiaim), which may be made by any person, tneluding the undarsignad, and filed agatna! the city, but only
where such claim arises out of the reliance of the city, including its ojjicers and smpbyses, upon the accuracy of the te{formatbn supptied to
the city as apart of t_kis-cqqQftNgio.,
R M f- A /1
a NEW a ADDITION
a ALTERATION
a REPAIR a, TENANT IMPROVEMENT
BUILDING SHELL ONLY?
a YES ONO
BASIC PLAN?
OYES
o NO
ZONING DESIGNATION
CHANGE OF USE?
a YES
a NO
NEW ADDRESS REQUIRED?
a YES a NO
UP /SEPA /SU?
a YES
o NO
PLATTED LOT?
a YE8 a NO
DEMO PERMIT REQUIRED?
a YES
ONO
Bulletin #100 — January 1, 2008 Page 2 of 4 Mandouts\Pennit Application