16-103230 Electrical
City of Federal Way
Community&Econ.Dev.Services ' -"-"' Permit #: 16-103230-00-EL
33325 8th Ave S
Federal Way,WA 98003 12=1
Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax.(253)835-2609 P q
Project Name: SCOFIELD
Project Address: 30404 4TH AVE SW Parcel Number: 178890 0130
Project Description: 200-amp service change.
•
Owner Applicant Contractor
ERIK SCOFIELD CEDAR RIVER ELECTRIC INC CEDAR RIVER ELECTRIC INC
30404 4TH AVE SW 21629 SE 245TH ST CEDARRE016DP(3/25/17)
FEDERAL WAY WA 98023 MAPLE VALLEY WA 98038 21629 SE 245TH ST
MAPLE VALLEY WA 98038
Additional Permit Information
Electrical Work Valuation? 5000 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Thursday, July 6, 2017
Permit Issued on Wednesday,July 6, 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
a ® the -deral A -
Owner or agent: ,�� �Z•� Ass Date: 7 "4 '/G
THIS CARD IS TO REMAIN ON-SITE '~
Federalonstruction Ins ection Record
INSPECTION REQITS: (253)835-3050
PERMIT#: 16-103230-00-EL Address: 30404 4TH AVE SW
Project: ERIK SCOFIELD FEDERAL WAY, WA 98023-3911
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.
El UFER Ground(4295) El 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) 0 Service(4235)
Approved Approved Approved
By Date By Date By 0 Date r,_Ls,,1„
o Feeders/Sub-panels(4045) El Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
Final-Electrical(4055)
Approved
By , Date Pi`1-3
O Rough Electrical Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF ,` LVED ELECTRICAL
Federal WayRE�C PERMIT APPLICATION
6 2116
JUL 6
N
Cm OF FEDERAL VSA'( PERMITUMBER / /�, _ / 3 V E
CDS �/—
SUITE/UNIT/SPACE#
SITE ADDRESS:
6/ r/t A vim, ��"i & . Feci. r v
PROJECT VALUATION ASSESSO 'S TAX/PARCEL# / CURRENT/PROPOSED USE
$,.c410 / C90 g q ° - ( U
PROJECT NAME d
(Tenant or Homeowner Last Name) tic 1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER t 1- k '-Cc 1f f e l/d //` 7
MAILING ADDRESS E-MAIL
301/011 ' -tti 4 b'e w LS
CITY STATE ZIP FAX
Fever z ( a}(�` r8/6; ? ( ) -
NAME / PRIMARY PHONE
(tide, if' P, E/1 - ( 1.51Y:5 -..gg3t1
MAILING ADDRESS E-MAIL
ELECTRICAL ,2 ` , 7 r G
?'ito . sT
CONTRACTOR CITY STATE ZIP
FAX
izy
TC` ✓ o�WA S4& EONTRAC CONTRACTOR' # EXPIRATIONATE
FEDERAL WAY BUSINESS LICENSE#
CE DAR RE of . A P %2s ii7
NAME PRIMARY PHONE
APPLICANT' * ( /2cJq$2 X83'9
ILING ADDRESS E-MAIL
/ ( 2T SE 2q. 1
CITY STATE ZIP FAX
it- Vet key 6/ (?S&3,
( ) -
PROJECT CONTACT NAM r y�� PRIMARY PHONE
/�/`ll/ J 066 ?7?- 1.3 /7
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: �;AtI'T�/ DATE 7 6 (-
PRINT NAM L j �n
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application