14-104728City of Federal way � � •. Electrical
Community & Econ. Dev. Services Permit #. • 14-104728-00-EL
33325 8th Ave S
Federal Way, WA 98003 Request uest Li
j Ph: (253) 835 -2607 Fax: (253) 835 -2609 Inspection ) 83,5 -3050
Project Name: SIBURG
Project Address: 806 S 295TH PL Parcel Number: 515210 0060
Project Description: INTRUSION ALARM & CCTV INSTALLATION
Owns
ARRlican t
Contractor
JIM SIBURG
JENNIFER BURGESS
A D T LLC
JEANNETTE SIBURG
A D T LLC
ADTLLL *881D0 (3/20/16)
806 S 295TH PL
11824 NORTH CREEK PKWY SUITE 105
11824 NORTH CREEK PKWY SUITE 105
FEDERAL WAY WA 98003
BOTHELL WA 98011
BOTHELL WA 98011
Additional Permit Information
Is this an Online or O.T.C. application ? .................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Low Voltage - Burglar Alarm (Res 1
PERMIT EXPIRES Wednesday, March 11, 2015
Permit Issued on Friday, September 12, 2014
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: AM AL Date:
n
CITY OF 4Z&1�
Federal Way
PERMIT #:
14- 104728 -00 -EL
TIUS CARD IS TO REMAIN ON -SITE
Construction Inction Record
INSPECTION REQ TS: (253) 835 -3050
Address: 806 S 295TH PL
Project: JIM SIBURG FEDERAL WAY, WA 98003 -3703
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
Bx'�t Date d C)— — )
LIFER Ground (429)
Ditch cover (4030)
Temporary Power (4275)
Slab /Concrete Floor (4255)
0
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Bx'�t Date d C)— — )
Pool Bonding (4195)
0
Temporary Power (4275)
0
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Rough Electrical (4225)
0
Feeders /Sub - panels (4045)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Bx'�t Date d C)— — )
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date