13-104824 • • Electrical
City of Federal Way �j
Community&Econ.Dev.Services Permit 1f. 1 �-104824-00-E
33325 8th Ave S r.* "`
Federal Way,WA 98003 Inspection Request Line: 253 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: BARDALES � (
Project Address: 28515 MILITARY RD S Parcel Number: 332204 9126
Project Description: 0-200 AMP service
Owner Applicant Contractor
JOSUE ODILIO BARDALES JOSUE ODILIO BARDALES OWNER IS CONTRACTOR
28515 MILITARY RD S 28515 MILITARY RD S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
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, April 27, 2014
Permit Issued on Tuesday, October 29, 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
and the City of Federal Way.
Owner or agent: `� Date: /c)— Z g— /3
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V
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.••' THIS CARD IS TO MAIN ON-SITE .
CITY OF -. ,� Construction In ection Record
Way Federal INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 13-104824-00-EL Address: 28515 MILITARY RD S
Project: JOSUE ODILIO BARDALES FEDERAL WAY, WA 98003-3329
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.
❑ UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) El Temporary Power(4275) El Service (4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
By VAC, Date R I (t 113
❑ Rough ElectricalCI Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF ELECTRICAL
Federal Way PERMIT APPI AA IISN
�I E
PERMIT NUMBER ! _ 1 0 4CDD
OCT 2 9 2013
CITY OF FEDERAl WAY
SUITE/UNIT E#
SITE ADDRESS: �.
92 FSj✓ M t�UrW I�C lJ S roch7a/ i aa'f uiA
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
0 4- - ,Ca
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to �rl e,/ C_•
�L L
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER �� > �r) Y C;IO % ()O Fi) •? (i -
MAILING ADDRESS E-MAIL
SSS 20( S-t—
CITY STATE ZIP FAX
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NAME
PRIMARY PHONE
)
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP
FAX
)
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME
PRIMARY PHONE
APPLICANT )
MAILING ADDRESS
E-MAIL
CITY STATE ZIP FAX
NAME )PRIMARY PHONE
PROJECT CONTACT
?4-r-cJc I?. (74 r ) f - :-( j '/`I
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
PRINT NAME:
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application