16-104708 E1Pctri al
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City of Federal Way
Community&Econ.Dev.Services Permit #: 1 6-104708-00-E
33325 8th Ave S
Federal Way,WA 98003 pPh:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
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Project Name: CAI
Project Address: 31412 10TH AVE S Parcel Number: 787540 0205
Project Description: Panel Change
Owner Applicant Contractor
YAN CA! EDWIN PORTER AMPERE ELECTRIC
31412 10TH AVE S AMPERE ELECTRIC AMPERE*916PF(10/6/17)
FEDERAL WAY WA 98003 18618 16TH AVE CT E 18618 16TH AVE CT E
SPANAWAY WA 98387 SPANAWAY WA 98387
Additional Permit Information
Electrical Work Valuation? 1500 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional9 No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps(F 1
PERMIT EXPIRES Thursday, September 21, 2017
Permit Issued on Wednesday, September 21, 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.
4f
Owner or agent: 7/������% Date: /f s�2/
,�`'� THIS CARD IS TO REMAIN ON-SITE M
CITY of Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 16-104708-00-EL Address: 31412 10TH AVE S
Project: YAN CAI FEDERAL WAY, WA 98003-5356
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.
O LIFER Ground (4295) 0 Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding (4195) ' 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) 0 Rough Electrical (4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical (4055)
Approved
By Date — `l b—/ 4
❑ Rough Electrical CI Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RIVED
'�. SEP 2 0 2016 ELECTRICAL
CITY OF
Federal Way cmr of FEDERAL WAY PERMIT APPLICATION
CDS
PERMIT NUMBER 1 _ 0 Li . g _ �j E.
v SUITE/UNIT/SPACE#
SITE ADDRESS: ti ' 1 c` V
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
s i `) C 00 S _ 7 5 lei b _ 0 2 5-
PROJECT
PROJECT NAME t {t
(Tenant or Homeowner Last Name) r • 4� % I
PROJECT DESCRIPTION �J
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER (. 01e:5)17/64e - S t/k
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
79' c f- -I • L (,2s )5e 3 - (j?(,+
MAILING ADDRESS E-MAIL
ELECTRICAL • i2 (W-(' tblr k ,
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
l - (- 1 /1 / >C- //r
NAME PRIMARY PHONE
APPLICANT
4c- EL1 C — r• C ( ) -
MAILING ADDRESS E-MAIL
/ p-u-k__ C7
CITY STATE ZIP r FAX
v 4- 9e- ) -
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: / j ` DATE / (//�F
PRINT NAME: E o 6w11�' 9� 1ri
Bulletin#160-January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application