16-104897City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835.2609
Project Name: STONE
Project Address: 2420 SW 319TH PL
Electrical
PILE Permit #:16 -104897 -00 -EL
Inspection Request Line: (253) 835-3050
Project Description: Install low voltage intrusion alarm
Parcel Number: 193840 0430
Owner
Applicant
Contractor
NICOLE STONE
NORTHWEST PERMIT
A D T LLC (ELECTRICAL 06)
2420 SW 319TH PL
1345 W GULF RD
ADTLLL'881DO (3/20/18)
FEDERAL WAY WA 98023
POINT ROBERTS WA 98281
11824 NORTH CREEK PKWY SUITE 105
BOTHELL WA 98011
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
PERMIT EXPIRES Friday, 6 October, 2017
Permit Issued on Thursday, October 6, 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:
cmr or qAh�
Federal Way
PERNM #: 1610489700
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 2420 SW 319TH PL
Project: NICOLE STONE FEDERAL WAY WA 98023-2220
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)
®
Slab/Concrete Floor (4255)
UFER Ground (4295)
Ditch cover (4030)
113y
Slab/Concrete Floor (4255)
By
Date
By
Date
By
Date
M
Pool Bonding (4195)
0
Temporary Power (4275)
®
Service (4235)
Pool Bonding (4195)
Temporary Power (4275)
113y
Service (4235)
By
Date
By
Date
By
Date
El
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Feeders/Sub-panels (4045)
Rough Electrical (4225)
I
Ceiling Cover (4020)
By
Date
By
Date
By
Date
Final - Electrical (4055)
Final - Electrical (4055)
By Date Q ..
Rough Electrical
Final Electrical
Right of Way
Approved
I
Approved
Approved
By
Date
L By
Date
By
Date
CITY OF iA
Federal Way
ELEC'T'RICAL
PERMIT APPLICATION
PERMIT NUMBER ( � _ 1 O + S? (9 7— 100
RECEIVED
OCT 06 2016
SITE ADDRESS: 2 L24)
eyRI&MERAL WAY
CDS
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL #
CURRENT/PROPOSED USE
$ 343 0. o 0
1 `� 3 8 - 0 4
PROJECT NAME
(Tenant or Homeowner Last Name)
r4kcok S he-
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
1.1 w co\r- S+ovse
( tot, YLz.c. -
MAILING ADDRESS
EMAIL
242 O Svl 319'=` P L
CITY
STATE
FAX
C
/ZIIP �7
NAME
PRIMARY PHONE
Aby LLC,
(24)G ) V+4 - 9yr
MAMING ADDRESS
E-MAIL
ELECTRICAL
1187A p,%0rjA.\Grtte— kWi j4 *105
CITY
STATE
V4
[T;I
8ot
FAX
(888 )HCO -94901
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
fiDTLLLk 851Do 03/20 /t to
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
1Joci\WtS� !mer ,r .-V �I }
(Z.0C- )4+k - 9499
MAILING ADDRESS
%11AS' G'a ikDSwKi
E-MAIL
�e r@_t4% *A
CITY
STATE
ZIP
FAX
Y%. 1�2ober�-
Wh
"187.81
(8$8 )400 -0383
PROJECT CONTACT
NAME
Covelkd
PRIMARY PHONE
(20(e )-.'4y -9494
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 cert(& 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 taws 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 to the city as apart of this application.
SIGNATURE: DATE 10/(0/ 1(#
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Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Ilandouts\Electrical Permit Application