14-103498 zr Electrical
City of FederaloWay F ILEPermit #: 14-103498-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: 25
Ph:(253)835-2607 Fax:(253)835-2609 p q � 3)835-3050
Project Name: GORDON
Project Address: 29611 1ST AVE S Parcel Number: 062104 9093
Project Description: Replace service mast.
Owner Applicant Contractor
ANDREW B GORDON WATTS ELECTRIC SERVICE INC WATTS ELECTRIC SERVICE INC
ANDREA GORDON PO BOX 46410 WATTSES176OK(12/9/15)
29611 1ST AVE S SEATTLE WA 98106 PO BOX 46410
FEDERAL WAY WA 98003-3640 SEATTLE WA 98106
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Mast or Meter Repair(Residential/ 1
PERMIT EXPIRES Sunday, January 11, 2015
Permit Issued on Tuesday, July 15, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and e use will be in accord with the laws, rules and regulations of the State of Washington
h City of Federal Way.
Owner or agent: Date: 7 / 1�/T
FINALED
THIS CARD IS TO MAIN ON-SITE
CITY OFal'
Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050 '
PERMIT#: 14-103498-00-EL Address: 29611 1ST AVE S
Project: ANDREW B GORDON FEDERAL WAY, WA 98003-3640
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) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) 'El Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Viia Date -7 l IA0 ftt(
❑ Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
,
El Final-Electrical(4055)
Approved
By tt4 Date 1 i I to 1 1 L
El Rough Electrical CI Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
WIVED
16,
ELS C'TRICAL
CITY OF JUL 1 5 2014
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
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PERMIT NUMBER / f _ / 0
4/ g 8 - E",L-,,.
l 5 I- SUITE/UNIT/SPACE#
SITE ADDRESS: 2 9 ((/ ----- 5
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# � � � CURRENT/PROPOSED USE
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PROJECT NAME Qj���}�/ �q�� ,
(Tenant or Homeowner Last Name) *' "' / 6" "` dk
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PROJECT DESCRIPTION r( e.---- 1,1 C GM-sr
Detailed description of work to
be included on this permit only
NAME (` � II PRIMARY PHONE
PROPERTY OWNER t\ 6) f O z Q tii (2) o ) ss,-- S7 2 S
MAILING ADDRESS S,X E-MAIL
2Ct 2(( / ---r 5° •
CIT S�T�AT(EA- ZIP o79g FAX
NAME PRIMARY PHONE
6-4-rt-5 (.'t — fZ c_ (?C ) 76 7—SV
INGADDRESS EMAIL
ELECTRICAL 7ev -
CONTRACTOR CITY STATE FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
(5/ 7(7c ' / /
NAMEPRIMARY PHONE
S-1-1,'-C"---
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ( )
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 Iaws 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 slied to the city as a Apart oft . pplication.
4.--
SIGNATURE: ��x V DATE 3-/ i
PRINT NAME: 0-11-U\-0 ( Cp r
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application