16-104822 Electrical
City of Federal Way Permit #:16-104822-00-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
Project Name: NGUYEN
Project Address: 2923 SW 339TH ST Parcel Number:010920 0130
Project Description: 0-200 PANEL CHANGEOUT
Owner Applicant Contractor
LIEN NGUYEN SAFE HOME ELECTRIC SAFE HOME ELECTRIC
707 SW 328TH PL PO BOX 39758 SAFEHHE902NE(8/9/18)
FEDERAL WAY WA LAKEWOOD WA 98496
98023-5225 PO BOX 39758
LAKEWOOD WA 98496
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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Electrical FixtIIres r ro `<
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Alt.Serv./Feeder: 0 to 200 ami 1
PERMIT EXPIRES Saturday,30 September,2017
Permit Issued on Friday, September 30,2016
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. y�
Owner or agent: • Date: Q —c..>0 -/6
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16 104822 00 Address: 2923 SW 339TH ST
Project: Lien Nguyen FEDERAL WAY WA 98023-7732
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)
UFER Ground(4295) Ditch cover(4030) Slab/Concrete Floor(4255)
By Date By Date By Date
® Pool Bonding(4195) ,® Temporary Power(4275) �® Service(4235)
Pool Bonding(4195) Temporary Power(4275) Service(4235)
By Date s By Date By Date
Il
Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Feeders/Sub-panels(4045) Rough Electrical(4225) Ceiling Cover(4020)
By Date By Date By Date
.
El Final-Electrical(4055)
Final-Electrical(4055)
Date [0— S- (Co
Rough Electrical 0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF ELECTRICAL
Federal Way PERMIT APPLICATION
RECEIVED
PERMIT NUMBER
Ao / 0 q.E3Z _ 00
SEP 3 0 2016
CITYQFTi i iihici iAY
SITE ADDRESS: (.29,2 SGt.� ! - 6.4 CDS
PROJECT
OJECT VALUATION ASO SOR'S TAX/PAR # c - Q I O CURRENT/PROPOSED USE
SCJ --- l O 2 \30
PROJECT NAME
(Tenant or Homeowner Last Name) Lie il GrwAlt-tLfe.
PROJECT DESCRIPTION 0 14 '" u' u-Akka`u i
Detailed description of work to
be included on this permit only
NAME )) ',9.,,, PRIMARY PHONE
PROPERTY OWNER f-) /��V_3 tit �/ . (P ) g�- ''/7B
MAILING ADDRESS l" E-MAIL
iia 3 CS w 339 5
CITY STATE ZIP} FAX
Fel l/"
NAME ,-� A4-0e__
��✓'-`� k
� , ( ) PRIMARY PHONE
R."
MAILINDRESS ����� E-MAIL
�eELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/i 7 c rt -f .,t.-',/_- e-z/ i / t, I"YB
NAME / PRIMARY PHONE
-
APPLICANT ' S ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ) -
NAME �. it) PRIMARY PHONE
PROJECT CONTACT feri e-,71 ( )
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.
4111111 ,
-
SIGNATURE: r DATE 9--S° /`—`
PRINT NAME: \' C^"o`eA Arc.
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application