13-105183 r electrical
City of Federal Way F, --
Community&Econ.0ev.Services t l' Permit #: 13-105183-00-EL
33325 8th Ave S
Federal Way,WA 98003 Li L w , Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p Q
Project Name: LARSEN
Project Address: 450 SW 297TH ST Parcel Number: 720520 0150
Project Description: Complete rewire of house and 200-amp panel change.
•
Owner Applicant Contractor
THOMAS LARSEN ALTERNATIVE ELECTRIC ALTERNATIVE ELECTRIC
450 SW 297TH ST PO BOX 422 ALTERE*891LA(6/1/15)
FEDERAL WAY WA 98023 RAINIER WA 98576 PO BOX 422
RAINIER WA 98576
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Sunday, May 18, 2014
Permit Issued on Tuesday, November 19, 2013
I hereby certify that the abov= information is correct and that the construction on the above described property and
the occupancy and the us= ill be i :ccord c/- ith the laws, rules and regulations of the State of Washington
/ el'e City of Federal Way.
/
Owner or agent: , Date:
aloTHIS CARD IS TO AIN ON-SITE ..
CITY OF '' , , .
' . • • Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-105183-00-EL Address: 450 SW 297TH ST
Project: THOMAS LARSEN FEDERAL WAY, WA 98023-3553
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.
O UFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) El Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) CI Rough Electrical(4225) ' El Ceiling Cover(4020)
Approved Approved Approved
By Date 4: Date l2- / By Date
El Final-Electrical(4055)
Approved
liar----i:- Date 5.-Zs:,/
O Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
.1116,
•CEIVED EL!CTRICAL
CITY OF
Federal Way Nov 19 2013 PERMIT APPLICATION
CITY OF FEDERAL.WAY
D/
PERMIT NUMBER / 3 - / D C g3 _ E L
(—ISO 9.) 0--971. > S SUITE/UNIT/SPACE#
SITE ADDRESS:
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
° 7 ; 0 5 ; b - o C go
PROJECT NAME
(Tenant or Homeowner Last Name) X)adi4-P
---"7,-_,
4( ND yr?
PROJECT DESCRIPTION 1 an.f.) C o 1
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 0 ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ) -
.. .. NAME }IPRIMARY PHONE
frf -V- Com-}f� G (dam) 3/o -
MAILING ADDRESS E-MAIL
f
ELECTRICAL O B (0-a
CONTRACTOR CITYSTATE ZIP FAX
r7
l�ii'n‘� (.tib ZI/ S7co ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE k
-
NAME PRIMARY PHONE
(J)L}br&4).70
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( ) -
NAME� J( p
PRIMARY PHONE
fy
PROJECT CONTACT 0, (d'3 ) .4 .1).5-- 39/g'
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, e reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to >!-ci as a ., o'this application.
// /! /
SIGNATURE: %i / DATE ///l �/
PRINT NAME:
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application