16-104012 Electrical
City of FederalWay Permit #: 16-104012-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 reoL
Request
Line:
Ph:(253)835-2607 FaX (253)835-2609 Inspection (253)835-3050
Project Name: HEILAND
Project Address: 2723 SW 328TH ST Parcel Number: 894520 0480
Project Description: 0-200 AMP PANEL UPGRADE
Owner Applicant Contractor
G W HEILAND SUNNY ELECTRIC&REFRIGERATION SUNNY ELECTRIC&REFRIGERATION
2723 SW 328TH ST (ELECTRICAL) (ELECTRICAL)
FEDERAL WAY WA 29617 58TH PL S SUNNYER903BM(1/11/18)
98002 AUBURN WA 98001 29617 58TH PL S
AUBURN WA 98001
Additional Permit Information
Electrical Work Valuation? 1200.00 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Thursday, August 17, 2017
Permit Issued on Wednesday,August 17, 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: 09/X//Z
THIS CARD IS TO REMAIN ON-SITE ,
Federal WayConstruction Inspection Record
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16-104012-00-EL Address: 2723 SW 328TH ST
Project: G W HEILAND FEDERAL WAY, WA 98023-2824
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) E Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
.
o Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By 111‘ Date _!
4.
O Feeders/Sub-panels(4045) 0 Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
o Final-Electrical(4055)
Approved
By Lir Date Gli_2 d l
•
El Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
. RECEIVED ELECTRICAL
CITY OF . Way AUG � 7 20,E
Federal PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS 00
PERMIT NUMBER l 4/
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SUITE/UNIT/SPACE#
SITE ADDRESS: ----P- ‘5K) 3 8 sT eclec, 1 /tn)ety , ►k!A- c�g)3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# ' � CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) D vkD 1-1 0 l>
PROJECT DESCRIPTION up a 'C pa we) ~'It. - -e'D s
Detailed description of work to
be included on this permit only
NAME W /�� � )\ PRIMARY PHONE
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PROPERTY OWNER l4k qCOk 1 L A J / 4o4 ) ' -- - )..Z 0
MAILING ADDRESS V E-MAIL
37.E 3 6t 4 3 sr
CITY ,�STtATTE ZIP FAX
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NAME {(l�,p�(�:p �/�,, PRIMARY PHONE
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MAILINGtit An y ADDRESS ale C 6.( IRL.- 1 `a 4L1`vV \ lJC ) 7.�0� _T
ELECTRICAL -2-C}b 17- _4 'Y l pi. `� I
CONTRACTOR CI Y STATE ZIP FAX
tnbcokP- wA Ta'o01 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
•canny ER 610-3 BM ( / I o /�17 .
NAME r,��,, PRIMARY PHONE
APPLICANT v,S \ 6 )3`'
LING ADDRESS E-MAIL
CITY STATE ZIP FAX
tiJA ('$op ( ) -
Nfritktrr
PRIMARY PHONE
PROJECT CONTACT G (. .06) 311- 0,.--i--,6
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: i i r DATE `-3%r/1 d
PRINT NAME: 0 tA..0 / Z
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application