16-104914f 1 4.
City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: BELMOR MOBILE HOME PARK LOT 49
Project Address: 2101 S 324TH ST
Project Description: Add wiring for shed
Electrical
Permit #:16 -104914 -00 -EL
Inspection Request Line: (253)835-3050
Parcel Number: 162104 9037
Owner
Applicant
Contractor
BELMOR HOLDINGS LTD
GAVIN LUMSDENCOPPER CREEK
COPPER CREEK ELECTRIC INC
1571 BELLEVUE AVE W SUITE 210
ELECTRIC INC
COPPECE984KP (5118/18)
VANCOUVER BC
PO BOX 1773
PO BOX 1773
CAN
ORTING WA 98360
ORTING WA 98360
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
sE
V a s ;„
Circuits - Residential
PERMIT EXPIRES Saturday, 7 October, 2017
Permit Issued on Friday, October 7, 2016
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:
UI\JLI E
THIS CARD IS TO REMAIN ON-SUK
crryor - Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #:
Project:
1610491400
BELMOR HOLDINGS LTD
Address: 2101 S 324TH ST Space 049
FEDERAL WAY WA 98003
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.
El
UFER Ground (4295)
0
Ditch cover (4030)
0
Slab/Concrete Floor (4255)
Approved
Approved
I
Approved to place concrete
By
Date
By
Date
By
Date
El
Pool Bonding (4195)
Q
Temporary Power (4275)
®
Service (4235)
Approved
Approved
I
Approved
By
Date
By
Date
By
Date
90 Final - Electrical (4055)
Approved
Date
D
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Approved
Approved
I
Approved
By
Date
By
Date
By
Date
90 Final - Electrical (4055)
Approved
Date
D
Rough Electrical
Final Electrical
Right of Way
Approved
I
Approved
Approved
By
Date
By
Date
By
Date
41k
CITY OF
Federal Way
RECEIVED
OCT 07 2016
CITY OF FEDERAL WAY
CDS IPERMIT NUMBER
ELECTRICAL
PERMIT APPLICATION
oyCf14.�'- L
SITE ADDRESS. %%��t�� F
Ynj
SUITE/UNIT/SPACE #
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL F
CURRENT/PROPOSED USE
PROJECT NAME
Homeowner Last Name)
(Tenant or
7
PROJECT DESCRIPTION'
r,
Detailed description of work for
�<
be included on this permit only
NAME
/ e�, i033(1313
y (131 RY Pxor-4
PROPERTY OWNER
-
MAILING ADDRESS �.J
�1 C �71h <
A
E -MD.
CITY�SyT�ATE
ZIP _
FAX
NAME I
PRIMARY PHONE
MAILI ADDRESS
E -NAIL
ELECTRICAL
'¢^ ' --�.
f
�•"�
CITY ..
of
STATE
ZIWFAR
CONTRACTOR
WA ATE 'ICENSE N EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
NAME �aI p I
(( PRIMARY PHONE
APPLICANT
ING AD
E-MAIL
CITY rA
�
STATS
/r
ZIP �.� �
FAX
A `
1
PROJECT CONTACT
NAME
PRIMARY PHONE
)
I cert(fy 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 ofj4cers and employees, upon the accuracy of the
information supplied to the city as a part of thi ation.
SIGNATURE: - DATE
PRINT NAME:
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter(rrcityoffederalway.com
Bulletin # 160 - April 14, 2016 Page 1 of 1 kaHandoutstElectrical Permit Application
/J4