13-104017CITY OF 'A
Federal Way
PERMIT NUMBER I
ELECTRICAL
PERMIT APPLICA'T'ION
In 4 d 1 _od
SITE ADDRESS.• T�''w'6r
-3 3 � LA`
SUITE/UNIT/SPACE #
PROJECT VALUATION
$2800•I
ASSESSOR'S TAX/PARCEL #
( 3 Z� C) - 0 ( 0
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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PROPERTY OWNER
NAME
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PRD4ARYPHONE
( 9,410) q 15 -ZS y
MAILING ADDRESS
1 9 0 S 3
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9 S Oti 3
FAX
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ELECTRICAL
CONTRACTOR
NAME C ve G ` C,
( O) PRIMARY PHONEI
MAILING ADDRESS C�
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CITYSTATE
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FAX
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WA STATE CONTRACTOR'S LICENSE # S"IRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
( ) -
MAILING ADDRESS
9 -MAH,
CITY
STATE I
ZIP
FAX
PROJECT CONTACT
NAME
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PRIMARY PHONE
(50-3) z5 S- -12-0
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. 1 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 clainy, 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 cityasa part of this application.
SIGNATIIRE: 1 l W DATE
PRINT NAME: 'j oy b ca v ci-
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
Coat
lel—
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
41 i. Electrical
Permit #: 13 -104017 -00 -EL
Inspection Request Liner (253) 835-3050
Project Name: THE COMMONS APARTMENTS 12,4-5-�
Project Address: 33417 1ST IN S Parcel Number: 132203 0160
Project Description: 125 amp panel replacement
Owner
ERP OPERATING LIMITED PAR
ARRlicant
D & R ELECTRIC
Contractor
D & R ELECTRIC
33423 1ST LN S
13215 SE MILLPLAIN BLVD C8-314
DRELERE946M5 (10/1/14)
FEDERAL WAY WA
VANCOUVER WA 98684
13215 SE MILLPLAIN BLVD C8-314
98003-6287
VANCOUVER WA 98684
Additional Permit lnfomnation
Is this an Online or O.T.C. application?.................Yes
Service greater than 999 Amps? .............................No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps 0 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Tuesday, March 11, 2014
Permit Issued on Thursday, September 12, 2013
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
F11 th of Federal Way.
Owner or agent: Date:
CITY OF
Federal Way
PERMIT #:
13 -104017 -00 -EL
THIS CARD IS TOree�tion
ON-SITE
Construction InRecord
INSPECTION REQU3) 835-3050
Address: 33417 1 ST LN S
Project: FEDERAL WAY, WA 98003-6.233
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
By VAj$ Date t 0 (3 t ( ?
F
UFER Ground (4295)
Ditch cover (4030)
0
Slab/Concrete Floor (4255)
0
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By VAj$ Date t 0 (3 t ( ?
F
Pool Bonding (4195)
Temporary Power (4275)
0
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
E]
0
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By VAj$ Date t 0 (3 t ( ?
F
Rough Electrical
Approved
Final Electrical
Approved
11
Right of Way
Approved
By
Date
By
Date
By
Date