16-104936City of Federal Way
Applicant
Community Development Dept.
ti'
33325 8th Ave S
F
Federal Way, WA 98003
;3
Ph: (253) 835-2607 Fax: (253) 835-2609
FEDERAL WAY WA 98023-7014
Project Name: CHRISTENSON
Project Address: 35421 11TH AVE SW
Electrical
Permit #:16 -104936 -00 -EL
Inspection Request Line: (253) 835-3050
Project Description: Installation of circuit & GFCI for new ductless HP system.
Parcel Number: 257180 0065
Owner
Applicant
Contractor
RANDY CHRISTENSON
M M COMFORT SYSTEMS (GENERAL)
M M COMFORT SYSTEMS
34839 11TH AVE SW
18103 NE 68TH SUITE C-200
(ELECTRICAL)
FEDERAL WAY WA 98023-7014
REDMOND WA 98052
MMCOMCS85ORB (11/30/17)
18103 NE 68TH SUITE C-200
REDMOND WA 98052
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
PERMIT EXPIRES Tuesday, 10 October, 2017
Permit Issued on Monday, October 10, 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: Date: �- l
crrr OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
16104936 00 Address: 354211 1TH AVE SW
RANDY CHRISTENSON FEDERAL WAY WA 98023-6911
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)
®
Ditch cover (4030)
®
Slab/Concrete Floor (4255)
Approved
Approved
Approved 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
®
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
ED Final - Electrical (4055)
Approved
By Date I a .
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
` OCT 10 2016
Crff OF Federal Wi''
OF FEDERAL WAY
CDS
� � ELECTRICAL
PERMIT NUMBER Y/ _ /_Q_
Y' �.3_ _ S
PERMIT APPLICATION
SITE ADDRESS: 35421 11 TH AVE SW
SUITE/UNIT/SPACE#
PROJECT VALUATION
$ 350
ASSESSOR'S TAX/PARCEL #
257180-0065-
57180-0065_PROJECT
CURRENT/PROPOSED USE
PROJECTNAME
(Tenant or Homeowner Last Name)
CHRISTENSON
PROJECT DESCRIPTION
INSTALL SINGLE HEAD DUCTLESS HP SYSTEM AND GFCI
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
RANDY CHRISTENSON
(253-95)1-7083 -
MAIIJNG ADDRESS
E-MAIL
35421 11 TH AVE SW
CITY
STATE
ZIP
FAX
FEDERAL WAY
WA
98023
I
( ) -
NAME
MM COMFORT SYSTEMS
PRIMARY PHONE
( 425) 881 - 7920
MAHJNG ADDRESS
E -MAD,
ELECTRICAL
18103 NE 68TH ST, C-200
CONTRACTOR
CITY
REDMOND
STATE
WA
ZIP
1 98052
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
MMCOMCS85ORB 11/30/17
20 -07 -100701 -00 -BL
NAME
SAME AS CONTRACTOR
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
I ZIP
( FAX
l )
PROJECT CONTACT
NAME
JANETTE WELLS
PRIMARY PHONE
( 425) 881 - 7920
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 flied 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 apart of this application.
SIGNATURE:
PRINT NAME: AMANDA EISTER
10/3/16
Bulletin #160 —January 1, 2013 Page 1 of 2 kMiandouts\Electrical Permit Application