16-103376 r tFl &tri.�al
City of Federal Way
Community&Econ.Dev.Services Permit #: 1 6-103376-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: THOMPSON
Project Address: 32842 22ND AVE SW Parcel Number: 894500 0730
Project Description: 200 AMP SERVICE CHANGE
Owner Applicant Contractor
RAYMOND J THOMPSON J W ELECTRIC J W ELECTRIC
32842 22ND AVE SW 9625 DEKOVEN DR SW JWELEE*934JW(4/27/17)
FEDERAL WAY WA 98023 LAKEWOOD WA 98499 9625 DEKOVEN DR SW
LAKEWOOD WA 98499
Additional Permit Information
Electrical Work Valuation? 2500.00 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 Friday, July 14, 2017
Permit Issued on Thursday, July 14, 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.
r
Owner or agent: 1
_ Date: I E #
THIS CARD IS TO REMAIN ON-SITE
aryCe "Il ,....,,,, Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 16-103376-00-EL Address: 32842 22ND AVE SW
Project: RAYMOND J THOMPSON FEDERAL WAY, WA 98023-2802
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.
0 UFER Ground (4295) 0 Ditch cover(4030) -o Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
,
•
Pool Bonding(4195) ,0 Temporary Power(4275) 0 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
0 Final-Electrical(4055)
Approved
By.....,- ____ ___...� Date 2(T, 7
Rough Electrical CI Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY OF "�.. ELECTRICAL
Federal Way JUL 14 2016 PERMIT APPLICATION
CITY OF FEDERAL WAN/'
y�/_ / 033-7-6
0 3 2 p CO
CDS PERMIT NUMBER / t0 J
SITE ADDRESS: , 3 L/) _. ,2. A J �� SUITE/UNIT/SPACE#
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PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 5 r + V 0 - u 7 3 0 I<es ! (,).-, . {
PROJECT NAME
(Tenant or Homeowner Last Name) . I'L+'^r. S 0,
{
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PROJECT DESCRIPTION " C l2 S ('-'4.' ' L�` C J^r•r c,
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER u— r s° ( )
MAILING ADDRESS
7 -/ a ))IV J l`J,'
�.A c 1;. E-MAIL
CITY STATE ZIPFAX
1-� �� 1 � d' � j )I ) . ( )
NAME �I CC '/7 G. PRIMARY PHONE
(}0 ) 60E - 63^3?
MAILING ADDRESS E-MAIL( /
��. _S,....) .J JG e5.3�`lt(.-✓�1. r .
ELECTRICAL l W s
0.e 4....,:(-
CONTRACTOR CITY STATE ZIP FAX
( ).s ',) 5-6-f - ix.'7 6
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT
( ) -
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 c' as a part of this application.
SIGNATURE: DATE ! (/ 6
PRINT NAME: adG L!-I SLI) •
PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter(cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:AHandouts\Electrical Permit Application