16-102011 "` - Electrical
City Community n
&Eco .DevaServices Permit #: 16-102011-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax.(253)835-2609 � � � `
Project Name: CHARWOOD MOBILE HOME PARK LOT 17
Project Address: 1660 S 333RD ST Space 017 Parcel Number. 797820 0081
Project Description: Connection of manufactured home.
Owner Applicant Contractor
CHARWOOD PARK LLC AYSHA PIKO D&A ELECTRIC LLC
' 6619 132ND AVE NE PMB 254 D&A ELECTRIC LLC DELEC*E897D5(4/5/17)
KIRKLAND,WA 98033-8627 11909 VICKERY AVE E 11909 VICKERY AVE E
TACOMA WA 98446 -TACOMA WA 98446
Additional Permit Information
Electrical Work Valuation? 800 Is this an Online or O.T.C.application? Yes
I s Use Educational or Institutional? No
Electrical Fixtures
Service or Feeder-Manu./Mobile 1
PERMIT EXPIRES Wednesday, April 26, 2017
Permit Issued on Tuesday, April 26, 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: q—Z6 " /e
%`141 NLED
art
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• THIS CARD IS TO MAIN ON-SITE 4 A. ).
Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 16-102011-00-EL Address: 1660 S 333RD ST Space 017
Project: CHARWOOD PARK LLC FEDERAL WAY, WA 98003
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed,a,s 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.
0 Slab/Concrete Floor(4255) - Final-Electrical(4055) -
Approved to place concrete Approved
By Date By 1,41 Date 41 74,1 (.
fl Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
E CTRI CAL
CITY OF
Federal Way ReCEP/ED PERMIT APPLICATION
APR 262016 ` /
CITY OF FEDERAL WAY PERMIT NUMBER /
CDS LLL
SUITE/UNIT/SPACE#
SITE ADDRESS:,/(/ , .3 3 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
•
rLJ —
PROJECT NAME
(Tenant or Homeowner Last Name) J Gh
PROJECT DESCRIPTION /G �✓�'` ` �t��
Detailed description of work to
be included on this permit only
PRIMARY PHONE
PROPERTY OWNER •ei'CVYy),� . �ti 5��' (LPO .4.16t C/, 3
MAILING ADDRESS E-MAIL
CITE STATE ZIP FAX
NAME PRIMARY PHONE
nn
MAILING ADDRESS E-MAIL
ELECTRICAL /29�j� �tv ./t y ,ar
CONTRACTOR CIS 7 STATE ZIP FAX
GClid'LGt- 0/51-- d✓� � ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT /1 �/rF'1 71-C^ (Z6j)6171- ?7 �
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT
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 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 officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
SIGNATURE: (% DATE L1 `G L f)JCS
PRINT NAME: 4"--e7)
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