14-104942 • Electrical
City of Federal Way Permit #: 14-104942-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 FILE Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: EARSLEY
Project Address: 32101 9TH AVE S Parcel Number: 609390 0220
Project Description: Circuit for heat pump.
Owner Applicant Contractor
BRIAN EARSLEY RACHELLE ALEXANDER BLACK HILLS INC(ELECTRICAL)
32101 9TH AVE S BLACK HILLS INC BLACKHI919DL(3/15/15)
FEDERAL WAY WA 98003-5919 1003 85TH AVE SE UNIT A 1003 85TH AVE SE UNIT A
OLYMPIA WA 98501 OLYMPIA WA 98501-5706
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 1
PERMIT EXPIRES Tuesday,March 24, 2015
Permit Issued on Thursday, September 25, 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
ff / and the City of Federal W a
.
Owner or agent: wK4/1 b( Date: q 9.S -1%-1
‘14
CITY OF • THIS CARD IS TO ON-SITE
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Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 14-104942-00-EL Address: 32101 9TH AVE S
Project: BRIAN EARSLEY FEDERAL WAY, WA 98003-5919
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.
0 LIFER Ground(4295) ❑ Ditch cover(4030) - f7 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
Feeders/Sub-panels(4045) 0 Rough Electrical(4225) Ceiling Cover(4020) '
Approved Approved Approved
By Date By Date By Date
. '
Final-Electrical(4055)
Approved
By H(j Date (• I 'I I 1 ef.
I
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
• v_ ,
A. ,ENE. ELECTRICAL
CITY OF
Federal Way sEP 2 5 2.014 PERMIT APPLICATION
IN F FEDERAL WAY
PERMIT NUMBER Z / / �D 5�J�-
LL l/ / SUITE/UNIT/SPACE#
SITE ADDRESS: 'i Lr \ 6 if\ C
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 5 0 Co 0 61 0 _ D 2 2 n
PROJECT NAME 1�1—�
(Tenant or Homeowner Last Name) ��JJ !v
PROJECT DESCRIPTION -J S )l€
Detailed description of work to
be included on this permit only
NAME PRIMARY PEON
PROPERTY OWNER I: ; (k \ bock-(0, -e-- ( 2(t) u40 10 MAILING ApDRESS E-MAIL
co k ' IAIL
CI STATE ZIP FAX
(� -U WIN ( ) -
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PRIMARY MAILING ADDRESS ` At `� _ E-MAIL
ELECTRICAL /\ VVVV���\ %/w
CONTRACTOR CITY OL l c . S�e7 zI ��C ( (`_ ) FAX
j1 /� �7 ( WA STATE CON _4 CTOR';LICN q ,^ (� EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY P NEB C� 1 , y ( 1 C -- J 0
APPLICANT MAILI G :Esi
rOdAettelarLackaArec_.c_AA,L
\'��,,G CITY STATE ZI FAX
NAM PRIMARY PHONE
PROJECT CONTACT ,f \ f awf 6/2 ( )705-- er-
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 reli. ce of the city, including its officers and employees, upon the accuracy of the
information suppl - • the city as a p• of thiI1i w li •tion.
� fr SIGNATURE: /,,�. u / DATE 1 25/1
PRINT NAME: k� r i ' �� 1 ��
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application