17-100106 Electrical
City of Federal Way rPermit #•17-100106-00-EL
Community Development Dept. "l ,,„R,..., •
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: ARBUCKLE
Project Address: 31309 41ST PL SW Parcel Number: 873199 0150
Project Description: Add circuit breaker to sub-panel and install outlet boxes.
Owner Applicant Contractor
ELVIRA ARBUCKLE BRUCE ARBUCKLE OWNER IS CONTRACTOR
31309 41ST PL SW 31309 41ST PL SW
FEDERAL WAY WA 98023-2114 FEDERAL WAY WA 98023-2114
,
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Circuits-Residential 1
PERMIT EXPIRES Tuesday,9 January,2018
Permit Issued on Monday,January 9,2017
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.
Owner or agent: -t(4;31),,txt,_f/..., Date: 1/Cif//7
411111
THIS CARD IS TO REMAIN ON-SITE
CITY°� Construction Inspection Record '
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 100106 00 Address: 31309 41ST PL SW
Project: ELVIRA ARBUCKLE FEDERAL WAY WA 98023-2114
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) E Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved ApprovedApproved to place concrete
•By Date By Date By Date
® Pool Bonding(4195) ® Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date ��By Date By Date
Q Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date �,�By A 1 Date a_I.1,—t7 * By Date
•El Final-Electrical(4055)
Approved
By e} s,.l Date ,iF—fib^y)
0 Rough Electrical Final Electrical
0 Right of Way
Approved Approved Approved
By Date By Date By Date
1►� ELECTRICAL
CITY OF frr' JAN 0-12017
Federal Way CITYOF FEoUALwAy PERMIT APPLICATION
CD,
PERMIT NUMBER / - - / 0 0 / 0 6
SUITE/UNIT/SPACE#
SITE ADDRESS:3 / 3 0 C) L [ & f / /, S
PROJECT VALUATION ASOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 0- -0
7ac 1 7 - O ( S---0
PROJECT NAME D�M
(Tenant or Homeowner Last Name) C��6 ' Ip c
ADD c 1 rc,L T Zre&k'eY '-"o f.e1,„ Prriou4 Cde) AA0-33
PROJECT DESCRIPTION sfi t /ef &yr E- rd COAL r "'A 6. 1 crew, at ny
Detailed description of work to p lat/e w`r' `'4 ( 1?t �� 14/g v t t iv ( i t//i /_hyuy4
be included on this permit only ^ 1 J
�, (-Lii .AA a. +01) kEs 1- r-o�-, es-o, pie-nna,
NAME PRIMARY PHONE
PROPERTY OWNER Prci e ,►-ba eke_ ) 7 Sn r(
MAILING ADDRESS E-MAIL
43/(309 .S//sf d2 (3 a)
CITY STATE ZIP FAX
FEEep oL VAll ►iri- ?go,.-3 ( ) -
NAME PRIMARY PHONE
0 W` ielf' ( ) -
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 0 t vl er ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT k,uvi. Qr ( )
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: 432U&- 44L-G Q DATE (0 o
PRINT NAME: Bruce 4 bGe i-k le-
Bulletin
#160-January 1,2013 Page 1 of 2 k:\Iandouts\Electrical Permit Application