16-104784 . w
Electrical
City of Federal Way . _4 Permit #:16-104784-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
roject Name:
4 PNGUYEN
Project Address: 29908 21ST AVE SW Parcel Number:012103 9036
Project Description: REP-Replace existing 125 amp service with new 200 amp mast,meter housing and panel.
Existing wiring to remain
Owner Applicant Contractor
AARON NGUYEN BESELER ELECTRIC BESELER ELECTRIC
13440 4TH AVE S 9717 E"F"ST BESELE*872PU(10/31/1
FEDERAL WAY WA TACOMA WA 98445 9717 E"F"ST
USA
TACOMA WA 98445
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Alt.Serv./Feeder:0 to 200 am] 1 Mast or Meter Repair(Resider. 1
PERMIT EXPIRES Wednesday,27 September,2017
Permit Issued on Tuesday,September 27,2016
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 the City of Federal Way.
Owner or agent: it*"( / ,,6_,1-41-1 Date: (7/27j26/@
FINALED
r , .
S .'
•
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 104784 00 Address: 29908 21ST AVE SW
Project: AARON NGUYEN FEDERAL WAY WA 98023-2301
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) El Ditch cover(4030) El Slab/Concrete Floor(4255)
UFER Ground(4295) Ditch cover(4030) Slab/Concrete Floor(4255)
By Date ,By Date By Date
® Pool Bonding(4195) ID Temporary Power(4275) ® Service(4235)
Pool Bonding(4195) Temporary Power(4275) Service(4235)
By Date By Date By Date
'® Feeders/Sub-panels(4045) 'f® Rough Electrical(4225) „® Ceiling Cover(4020)
Feeders/Sub-panels(4045) Rough Electrical(4225) Ceiling Cover(4020)
By Date By Date By Date
o Final-Electrical(4055) .
Final-Electrical(4055)
Date(O/� 2
0 Rough Electrical El Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
ilk ELECTRICAL
CITY OF =yrr
Federal Way PERMIT APPLICATION
CEIVED
PERMIT NUMBER ( ( _ 10 4 ez(- _ 0._ SEP 2 @ 2016
CITY OF FEDERAL W ITE/UNIT/SPACE#
SITE ADDRESS: 2 G la s .2e 64--- ki. 1�< CDS
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# c� CURRENT/PROPOSED USE
� O 1 2 ( O
$ 21aa _ 90 3 t
PROJECT NAME /1 `n
(Tenant or Homeowner Last Name) A N,5 .p/I
KciG/a.ee -u�10 r�`"t tt-6 12,6' ,4-, Sc tilL� w r i
PROJECT DESCRIPTION tc') 2('"Ai/NI /In*'tet nt e-r 14'A L✓ts 1 P'
Detailed description of work to
be included on this permit onlyC `S�
t In td0 LIIZ IAt `fid CC=AA A"1!\
NAME PRIMARY PHONE
PROPERTY OWNER 41%-,loin Ai� )y Q' ( ) -
MAILING ADDRESS E-MAIL
/S V/a yrh ,que.,
CITY STATE ZIP FAX
&Da)el, .100/4'48r- ULA qt t l ( ) -
NAME PRIMARY PHONE
5 , C(CCtit L ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL Q`Z 1 7 s-- 5)
CONTRACTOR CITY STATE ZIP FAX
I 701.4-- L.,44 q8 t (1s^ ( ) -
WA STATE Cp NTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
&-6e--/e(X, 872.flv 16 / 3) /. 1"2
NAME PRIMARY PHONE
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 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:
SIGNATURE: / DATE d /2-7)204 t,
PRINT NAME: I—!f,/ V i Sys .C2—L
Bulletin#160—January 1,2013 Page 1 of 2 kaHandouts\Electrical Permit Application