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CITY oF 41011
THIS CARD IS TO REMAIN ON-SITE
Federal WayConstruction Inspection Record
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16-103756-00-EL Address: 30820 8TH AVE SW
Project: MICHA GARRETT FEDERAL WAY, WA 98023-4605
Scheduled inspections may be failed if this card is not on-site. p0 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.
0 LIFER Ground(4295) CI Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By 104 Date q 1 ti I t(o,
❑ Feeders/Sub-panels(4045) [3 Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date Datee_ l_l� , By Date
❑ Final-Electrical(4055)
Approved
By ttio., Date 't(l'ri`(tr
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
�► RECEIVED ELECTRICAL
CITY Of
Federal Way AUG 02 2016 PERMIT APPLICATION
CITY OF FEDERAL WAY PERMIT NUMBER /
/ 0 3 q3-6- 00
CDS
SUITE/UNIT/SPACE#
SITE ADDRESS: o �`
•7 m
./ LI
PROJECTf Al/ f/✓_-'
N� ASSESSOR'S TAX C�# �" - O
CURRENT/PROPOSED USE
PROJECT NAME S
(Tenant or Homeowner Last Name) 4 F k r4 K z,e
9,4dl&c cite-ea-4e Kr_
PROJECT DESCRIPTION 5,e/-tic-- red', -
Detailed description of work to A A d 3 k .fete/e ..-
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER / 1~/Z aO6)`r l y, y3 32'
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
,.CCArs ( .253 ) 72° '77-33
MAILING ADDRESS . E-MAIL
ELECTRICAL 9-9940 3 j4 / 2
CONTRACTOR CITY STATE ZIP FAX
Res.,/yl 7 5) c) ( 23`.0 1 7413 - -40
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
5,i_ crd-r22" ?x,344( `t/z`(i/ 7
NAMEDD PRIMARY PHONE
APPLICANT 5 l�-L `S
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT L �6•-
' ' (25.3)- Ax)---(1-53
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:,- ;?if/& DATE
PRINT NAME: (r��4 GZ- 4A-- <-5 ('eLi C (((
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application