17-104219 Electrical
City of Federal Way Permit #:17-104219-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project : JONES
Project Address:Name3141 SW 302ND PL Parcel Number:012103 9109
Project Description: Adding(1)circuit to convert septic system to sewer system
Owner Applicant Contractor
NICOLE A JONES NICOLE A JONES OWNER IS CONTRACTOR
3141 SW 302ND PL 3141 SW 302ND PL
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Y'
Circuits-Residential 1
PERMIT EXPIRES Friday,31 August,2018
Permit Issued on Thursday,August 31,2017
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.
Owner or agent: . Date: l3 1/17
, . ,
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 104219 00 Address: 3141 SW 302ND PL
Project: NICOLE A JONES FEDERAL WAY WA 98023-2342
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) 1=1 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By ��� Date q t 17 By Date
'® Pool Bonding(4195) ,•® Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
I:1 Final-Electrical(4055)
Approved
By r2 -..r--, Date q - t - 1.1
0 Rough Electrical ❑ Final Electrical E Right of Way
Approved Approved Approved
By Date By Date By Date
111.
REc ELECTRICAL
CITY OF E I VED
Federal Way AUG 3 1 2017 PERMIT APPLICATION
CITY OF
,OM UN11Y DEVELOPMENT I !
- 1 0 4 2 I L _00PERMIT NUMBER
14-1 �, _ / 30 „ e p I SUITE/UNIT/SPACE#
SITE ADDRESS: ,V(+"/ `///•Y_�-N�i
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 100. °r'' 0 __I__. i l 0 3 - q i 0 y gl11
PROJECT NAME Me.-- OH /'�
(Tenant or Homeowner Last Name) S 14 ate'/ tAA A0 t a 0--dX e` . (-" t CIL/
PROJECT DESCRIPTION G --6 cc_., 'tit/ 1ecd--i -/v'
Detailed description of work to 1(rAgtf.
Y V c
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Ni (.6C Tii&e-S' (7 3) X36 - 4q/
MAILING ADDRESS E-MAIL 1
3G+ So 3O2Aa( PI �b>�es.U lct?3Z7eq k
CITY STATE ZIP FAX
Fewed
V alW q023 ( ) -
NAME IN j/1 PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP
FAX
( )
WA STATE CONTRACTOR'S LICENSE it EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT C4.44 ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT ( \t Tie c (Zs3) 736-
4-6 I/
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 ci a part of this application.
SIGNATURE: DATE O /
\---( I
PRINT NAME: �1 `' -Q 12
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application