17-103549 1
Electrical
Comm ityryne�pm Permit #:17-103549-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609
Project Name: CHARWOOD MOBILE HOME PARK-SPACE 100
Project Address: 1660 S 333RD ST Parcel Number:797820 0081
Project Description: Inspection of disconnected meter to resume power.
•
Owner Applicant Contractor
CHARWOOD PARK LLC CHARWOOD PARK LLC OWNER IS CONTRACTOR
6619 132ND AVE NE PMB 254 6619 132ND AVE NE PMB 254
KIRKLAND,WA 98033-8627 KIRKLAND,WA 98033-8627
•
Additional Permit information
Is this an Online or O.T.C.application? Yes
Service or Feeder-Manu./M.l 1
PERMIT EXPIRES Tuesday,24 July,2018
Permit Issued on Monday,July 24,2017
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. sy
Owner or agent: otjDate: .7C 7
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 103549 00 Address: 1660 S 333RD ST Space 100
Project: CHARWOOD PARK LLC FEDERAL WAY WA 98003
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 Slab/Concrete Floor(4255) ® Final-Electrical(4055)
Approved to place concrete Approved
By Date :.ByQ„GJ Date's--Z C
Rough Electrical 0 Final Electrical C Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
AIL ELEC'T'RICAL
CIrYor rf JUL 4ZO��
Federal Way PERMIT APPLICATION
COM UNRF Y DEVELOPMENT"
PERMIT NUMBER / f o ? 5 c _
// / SUITE/UNIT/SPACE#
SITE ADDRESS: /(DCO Sac
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PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME �Q �, ./ [�
(Tenant or Homeowner Last Name) /9P
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PROJECT DESCRIPTION Y / r i7 y "`t(/l('GL/
Detailed description of work to /
be included on this permit only
NAM
PRIMARY PHONE
PROPERTY OWNER /,C//-.-,(,(/Oed )'�ch�/ //ii �r:LI��,C et" ) 1/4t, //d7
MAILING ADDRESS
akMAIL
/664 13_30 9p. pr
CITY t� STATE ZIPyP
FAX
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NAME D A PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME l` PRIMARY PHONE
APPLICANT MAILINGRES(/�3Jt ( )
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 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.
7-0/4--//7
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SIGNATURE: - .
�q DATE
PRINT NAME: r�<I ,) •&ft-6
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application