16-103667 Electrical
City &EFcon.
Way Permit #: 16-103667-00-EL
Community con.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 r" Inspection Request Line: (253)835-3050
74 Ph:(253)835-2607 Fax:(253)835-2609 p Q
Project Name: MILLER
Project Address: 2234 S 298TH ST Parcel Number: 768380 0081
Project Description: Install conduit for future installation of electrical service.
Owner Applicant Contractor
TONY J MILLER TONY 3 MILLER OWNER IS CONTRACTOR
MARICAR MILLER 2234 S 298TH ST
2234 S 298TH ST FEDERAL WAY,WA 98003
FEDERAL WAY,WA 98003
Additional Permit Information
Electrical Work Valuation? 125 Is this an Online or O.T.C.application Yes
Is Use Educational or Institutional No
No Fixtures Associated With This Permit!!
PERMIT EXPIRES Friday, July 28, 2017
Permit Issued on Thursday, July 28, 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
an• e City of Federal Way.
Owner or agent Date: 7 -2-5(-/6
1A, THIS CARD IS TO REMAIN ON-SITE
Federal WayConstruction Inspection Record "
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16-103667-00-EL Address: 2234 S 298TH ST
Project: TONY J MILLER FEDERAL WAY, WA 98003-4216
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 LIFER Ground(4295) "0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By amia. Date -1.2 IL By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) CI 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
O Final-Electrical(4055)
Approved
By 0...Ak!`.4 Dateg -'1.�ti.
0 Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
ELECTRICAL
CITY OF
Federal Way RECEIVED PERMIT APPLICATION
JUL 28 2016
PERMIT NUMBER / c - 1 0 7 -
�✓
CITY OF FEDERAL WAY — — — —
CDS
SUITE/UNIT/SPACE#
SITE ADDRESS: 2 2 3 LI 5, 02 [ C� 5 T 1
rJ IY 14-
PROJ/ T 2.5 O GN ASSESSOR'S TAX/PARCEL# C) cuatekt
0 0 I
- �CURRENT/PROPOSEDkAAVvr e_, �n
USE
$PROJECT NAME '/J tog
(Tenant or Homeowner Last Name) rn ; d 1,,,,,-
U,vlcAse cs re) tAivi e4 Ce&t S 42-r v 4 ce CCs -I.J I. 4-
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 1071- )(yi. t`[1-eiy- (z b) 6 SO - clO4 2.
MAILING AD ESS E-MAIL
Z 3 LA S, el5- IIr- - ty,G
CITY STATE ZIP FAX
FeJ eivJ U) w, a 8.003 ( ) -
NAME PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/
NAME PRIMARY PHONE
APPLICANT 1 in, I leA, (20 b) 650 - 4 k12-
MAILING AVDREss E-MAIL
CITY STATE ZIP FAX
Fe-rJ (,ij (j) q $'003 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT
"ran j Mt' 1( - (20& )b 50 - R.q z—
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 aDATE .7` 2 8 -1 f,
PRINT NAME:" Y I f �
e4"
Bulletin
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Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application