15-104248 • • -
Tlectrical
City of Federal Way .
..Community&Econ.Dev.Services Permit #: 15-104248-00-EL
33325 8th Ave S
Federal Way,Fax
98003 Inspection Request Line: (253)835-3050
Pik(253)835-2607 Fax:(253)835-2609 F ILEp q
Project Name: PEARSON
Project Address: 29904 4TH AVE S Parcel Number: 720535 0080
Project Description: Replace like for like 125 amp.
,
Owner Applicant Contractor
NICK PEARSON TROY EDWARDS TROY'S ELECTRIC
29904 4TH AVE S TROY'S ELECTRIC TROYSE*935JC(6/5/17)
FEDERAL WAY WA 98003 2308 S"L"ST 2308 S"L"ST
TACOMA WA 98405 TACOMA WA 98405
Additional Pet tit Information
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 Saturday, February 20, 2016
Permit Issued on Monday,August 24, 2015
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the u - will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. g
Owner or agent: Date: 7—d '' IS
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THIS CARD IS TO REWN ON-SITE
CITY OF eZrt
Construction Inspion Record ` --
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-104248-00-EL Address: 29904 4TH AVE S
Project: NICK PEARSON FEDERAL WAY, WA 98003-3622
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) ❑ Ditch cover(4030) 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 Date
'❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
By psi Date srI?ifI (s
I
I=1
Rough ElectricalEl Final Electrical Right of Way
Approved Approvedill Approved
By Date By Date By Date
REcEN
CITY OP ''
ASG 4 .05 ELECTRICAL
Federal Wayof co�1-WAY PERMIT APPLICATION
crrYPERMIT NUMBER (5 _ I 0 '4 q _ lir i-
3 SUITE/UNIT/SPACE#
SITE ADDRESS: 2.:C/ (...1 Ur 01,-,,-o- (
PROJECT ALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PRO ECT NAME S C7
(Tenant or Homeowner Last Name) e R-
s of pry i' L
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Iv c ?la_tf r ( ) -
MAILIf ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME 7 PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL a C) <? S
CONTRACTOR CITY STATE ZIP FAX
t,, "re:� ,i ( ) -
1 F^�k I„ I WA STATE CONTRACTOR'S LICENSE## EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
w 1/)/ 7 �%S'
NAME PRIMARY PHONE
APPLICANT ` 'A as I,c ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT �`:70-uf)-47 (Z.C3 ) 45s/- IE).7G,1,.'
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 Iaws 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 as a part of this application.
SIGNATURE: DATE h I C'
PRINT NAME: , S
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application