15-105594 . — Electrical
City of Federal Way
ti Community&Econ.Dev.Services Permit #: 15-105594-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: HARTLEY
Project Address: 4900 SW 310TH ST Parcel Number: 184080 0050
Project Description: Add(2)circuits
Owner Applicant Contractor
BARNEY HARTLEY ROBERT DAVENPORT GALLIHER ELECTRIC LLC
SHERRY L M HARTLEY 1420 NW GILMAN BLVD SUITE 2111 GALLIEL864NQ(8/18/16)
4900 SW 310TH ST ISSAQUAH WA 98027 1420 NW GILMAN BLVD SUITE 2111
FEDERAL WAY WA 98023 ISSAQUAH WA 98027
•
Additional Permit Information
Is this an Online or O.T.C.application'? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 2
PERMIT EXPIRES Sunday, May 1, 2016
Permit Issued on Tuesday, November 3, 2015
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 Wa .
Owner or agent: r hi;•4_ Date: f//e
•
r
• THIS CARD IS TO REMT ON-SITE .. ,,
CRY OF -leilliiikl Construction Ins peCTion Record
Federal Way INSPECTION REQUESTS: (253)835-3050 .
PERMIT#: 15-105594-00-EL Address: 4900 SW 310TH ST
Project: BARNEY HARTLEY FEDERAL WAY, WA 98023
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) El Ditch cover(4030) '0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
ByDate By Date By Date
❑ Pool Bonding(4195) ❑ Temporary Power(4275) ElService(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ElCeiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055) ,
Approved
By cl, 2 Date ,`al.
El Rough Electrical Final Electrical E Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
11111 III
41111111111.. NOV 03 2015 ELECTRICAL
' CITY OF
Federal Way CITY OF CDSRAL WAY PERMIT APPLICATION
PERMIT NUMBER l S _ 1 b J 4 q Li - V
C/e.eti C c, / INhil•>) SUITE/UNIT/SPACE#
SITE ADDRESS:
5nv6.ej 5707-C...-- 7 , 5' g
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ S7-0C)4":--' -/ - Z'( U 4' - 0 5----0__ ' e i?,r 44/
PROJECT NAME /
(Tenant or Homeowner Last Name) / ' T /f , --w"
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PROJECT DESCRIPTION 7?)- CAE -- a ( J /1-Ac a75- C0 dt/ . cy/kat '
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Eil& y �/fXj4r #4--/" ( ) -
MAILING�1ADDRESS E-MAIL
l /n ,fj i;-'2-/1
CITY STATE ZIPFAX
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NAMEPRIMARY PHONE
r7/Lim /
� e-i ,ere:- (49S-)6' #7 - /693'
MAILING ADDRESS 47'ff i 421 /( E-MAIL
ELECTRICAL /4-610 / ildt C(C/.*mei-4v 14z,/,) /r- (/At-ei,le75t' 6) 'f11<,Y.
CONTRACTOR CITY STATE ZIP FAX ed E"
sem,liftA Gad 9 ;a 7 ( ' - -
WA ST�ATE C TRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
e. i1,L/el- 36`i /14) 0/f / tri{ 20-/5--/4C. _a,'-‘91--
NAME / _�' PRIMARY PHONE
APPLICANT </L 1/�-�--- 4,41 "7 'T/e4k ( /b ) 418'- .5 7
MAILING ADDRESS E-MAIL
315--. /-� ' #1/5 a
CITY ST TE ZIP FAX
P7• 1e7 (74 �-) . - �8z4/111./rdi
ME.. PRIMARY PHONE
PROJECT CONTACT ��/7e,G j4 l f ` f (2-06 ) f e_ ?Vet-
./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 Iaws.
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: `/ fd
fif,o u C' , , DATE /7/75/.549/5--
PRINT NAME: /C"P Al-. )Z ' 6+17esAlf`'+I'T.
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application