16-105826 r '. . ,
,
Electrical
City of Federal way Permit #:16-105826-00-EL
Community Development Dept. a
33325 8th Ave S "°
Federal Way,WA 98003 ... Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 '
. Project Name: XU
Project Address: 33446 11TH PL SW Parcel Number:926496 0270
Project Description: Relocate light fixture at remodeled entryway.
•
Owner Applicant Contractor
JUAN XING XU JUAN XING XU OWNER IS CONTRACTOR
33446 11TH PL SW 33446 11TH PL SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or Q.T.C.application? Yes
Circuits-Residential �ti E ''
1
PERMIT EXPIRES Friday,8 December,2017
Permit Issued on Thursday,December 8,2016
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
and theCity of Federal Way. t f�
Owner or ag�"t. 41.--- ---..___,— Date: [ -2/U //,
4 i • .
THIS CARD IS TO REMAIN ON-SITE
� Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 105826 00 Address: 33446 11TH PL SW
Project: HUIMIN CHEN FEDERAL WAY WA 98023-5309
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.
El UFER Ground(4295) J � Ditch cover(4030) Q Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date ..By Date
® Pool Bonding(4195) El Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
. •
Q Feeders/Sub-panels(4045) 1 ® Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By 0. m Date \2 ..,2:.s..11.6, By Date
•10 Final-Electrical(4055)
Approved
B)d Date(.p-2--3 C
—7
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
TECTRICAL
CITY OF „,,,,,,,,..., RECEIVED
Federal Way PERT APPLICATION
DEC 082016
CITY OF FEDERAL WAY PERMIT NUMBER / / S _ �jCDS v Cs
..��„ SUITE/UNIT/SPACE#
SITE ADDRESS:
s3 � l/ fi L S Fzeterri
ye=p 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# � � - � � � CURRENT/PROPOSED USE
��(f/ 7
PROJECT NAME
(Tenant or Homeowner Last Name) 4al-ry 4,60ti�
'
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME ' " PRIMARY PHONE
PROPERTY OWNER / 14,1,0 /64 0-)2.5-6 -r
MAI G ADDRESS E-MAIL
CITY STATE ZIP FAX
,„,,,,,as w k 9'&74 ( )
NAME PRIMARY PHONE
(,t,°' ) -
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 MAxi ING ADDRESS )
E-MAIL
243 ? 2.39 .pc_
CITY STATE ZIP
FAX
r:A4 -NOr2')SH i!4`4 /6i)74 ( ) -
N E 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.
SIGNATURE: DATE (2/ 7j
PRINT NAME:
r
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