16-1049130.
Applicant
City oiFedeop Way
BELMOR HOLDINGS LTD
Community Development Dept.
IL
33325 8th Ave S
ELECTRIC INC
Federal Way, WA 98003
VANCOUVER BC
Ph: (253) 835-2607 Fax: (253) 835-2609
COPPECE984KP (5/18/18)
Project Name: BELMOR MOBILE HOME PARK LOT 102
Project Address: 2101 S 324TH ST
Project Description: Add wiring for shed & new street light.
Electrical
Permit #:16 -104913 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 162104 9037
Owner
Applicant
Contractor
BELMOR HOLDINGS LTD
GAVIN LUMSDENCOPPER CREEK
COPPER CREEK ELECTRIC INC
1571 BELLEVUE AVE W SUITE 210
ELECTRIC INC
VANCOUVER BC
PO BOX 1773
COPPECE984KP (5/18/18)
CAN
ORTING WA 98360
PO BOX 1773
ORTING WA 98360
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Circuits - Residential 1
PERMIT EXPIRES Saturday, 7 October, 2017
Permit Issued on Friday, October 7, 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.
Owner or agent: Date:
FINAtED
VA� THIS CARD IS TO REMAIN ON-SITE;4
Fecffy deral WayConstruction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 16104913 00 Address: 2101 S 324TH ST Space 102
Project: BELMOR HOLDINGS LTD FEDERAL WAY WA 98003
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.
®
UFER Ground (42
®
Ditch cover (4030)
0
Slab/Concrete Floor (4255)
0
Approved
I
Approved
Approved to place concrete
By
Date
By
Date
By
Date
® Pool Bonding (4195) 0 Temporary Power (4275) ® Service (4235)
Approved Approved Approved
By Date By Date By Date
El
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
0
Approved
Approved
Approved
By
Date
By
Date
By
Date
® Final - Electrical (4055)
Approved
Date
Rough Electrical
0
Final Electrical
0
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
4%L DECEIVED
CITY OF ELECTRICAL
Federal Way OCT o7 Rots PERMIT APPLICATION
CITY OF FEDERAL WAY %�
CDS PERMIT NUMBER) K� -) 0 q q)
3 _ <,--% v
SITE ADDRESS: �
o
SUITE/UNIT/SPACE -
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL � {�j
G _2,1
2 1 V %'� v -_
CURRENT/PROPOSED USE
PROJECT NAME
Homeowner Last Name)
�De\Mcy- 4
(Tenant or
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
-a r<
PROPERTY OWNER
NAME
6ei n, It(
PRIMARY PHONE
MAMING ADDRESS
�iL) "
E•MA U.
CITY,,019
STATE
ZIP
FAX
NAME C��"
9
PRIMARY PHONE
ONE
V.- 10
MAILING ADD i
C� a�'
E -MAD.
7 : ' L�Re
ELECTRICAL
CONTRACTOR
CITY,,,>,'if
SLTT/
zIP
FAx
WA BT TE CONT CTOR'8 LICEN8 N - EXPIRATION DATE„
FEDERAL WAY BUSINESS LICENSE M
NAME C'S
PRIMARY PHONE
APPLICANT
MAII.IN DDRE88
CY-N7 1`773
E-MAIL
CITY
STATE
ZIP �. _
FAX
PROJECT CONTACT
NAME()PRIMARY
PHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I cert fy that to the best of
my knowledge, the Wormation 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 flied 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 sunolied to the cite as a oart of this nonlication.
SIGNATURE:
PRINT NAME:
PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permiteenter(i cityoffederalway.com
Bulletin # 160 — April 14, 2016 Page 1 of 1 UflandoutsTlectrical Permit Application