16-103160 I
. - 1 o
Electrical
City of Federal Way Permit #: 16 103160 00 E L
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: KURTZ
Project Address: 3214 SW 327TH ST Parcel Number: 951090 0020
Project Description: Adding/altering(1)circuit for smoke detector install
Owner Applicant Contractor
MARY ELLEN KURTZ BIG DOG ELECTRIC LLC BIG DOG ELECTRIC LLC
3214 SW 327TH 14122 94TH AVE E BIGDODE854N7(8/26/17)
FEDERAL WAY WA PUYALLUP WA 98373 14122 94TH AVE E
98023 PUYALLUP WA 98373
Additional Permit Information
Electrical Work Valuation 300.00 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 1
PERMIT EXPIRES Friday, June 30, 2017
Permit Issued on Thursday, June 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
an the i Federal Way.
Owner or agent --c Gly Date: W3o�10
' --- L s
' THIS CARD IS TO REMAIN ON-SITE '
trr las 1A t
Federal WayConstruction Inspection Record
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16-103160-00-EL Address: 3214 SW 327TH ST
Project: MARY ELLEN KURTZ FEDERAL WAY, WA 98023-2542
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.
ID UFER Ground(4295) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) ❑ Temporary Power(4275) ElService(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
' ,
Final-Electrical(4055)
Approved
By _../Me4.�4 Date 1t�...s —V
O Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF11!` ELECTRICAL
Federal Way PERMIT APPLICATION
( 0 RECEIVED
l
PERMIT NUMBER ` _ 3 ( (00 _ 00
- - JUN 3a 2016
CI 1 Ystaiirf/rocwgy
SITE ADDRESS: 3 2 \ y SW 32 S-- CDS
PROJECT VALUATION ASSESSOR'S T�PAOL#� O _ M � �� CURRENT/PROPOSED USE
PROJECT NAME SS V
(Tenant or Homeowner Last Name) V.-4A
PROJECT DESCRIPTION V1QID coffeC;- a C'z V2 -co\ frcf' Xl�'
Detailed description of work to G ,C. \1;.A1 O f c q t a s make
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Y'J\ I k UV T - (2°0) ei i:3-i-J t(CIO
MAILING ADDRESS E-MAIL
321 - Sw 329-AA. S4-
CITY STATE ZIP FAX
' k.-- 4NA l.,:iat C91C`3O2' ( ) -
NAME PRIMARY PHONE
`e-A mac., Es. E =rQ.,C,_. LL(_ (2253) 2(c -0D2-1.4
MAILING ADDRESS E-MAIL
ELECTRICAL I t-}►'ZZ co-1 sAAre J
CONTRACTOR CI STATE ZIPFAX
AV))\U L %31-3 ( ) -
WA STAVE CONT CTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
13 NS OS/ 24. / ri- jS'--/4963'4715—
NAME PRIMARY PHONE
APPLICANT
CB934 el M�,P tI--L ` fE. ( ) -
MAILING ADDRESS PROVU E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT S E 1PIC IRO\E) ( )
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.
SIGNATU- . / DATE CO/3D i 40
PRINT NAME: r k4111m V\- 4 Ute,_
Bulletin#160—January 1,2013 Page 1 of 2 161-landouts\Electrical Permit Application