15-106081 TM _ 4. 'Electrical
City of FeWay Permit #: 15-106081-00-EL
Community&Econ.on.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: MOTA
Project Address: 2426 SW 347TH ST Parcel Number: 011470 0100
Project Description: Upgrading electrical box and components to 220-amp
Owner Applicant Contractor
GUADALUPE MOTA EDGAR MOTA OWNER IS CONTRACTOR
GLORIA MOTA 2426 SW 347TH ST
2426 SW 347TH ST FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Electrical Work Valuation? 1000.00 Is this an Online or O.T.C.application? No
Is Use Educational or Institutional? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Monday, May 30, 2016
Permit Issued on Wednesday, December 2, 2015
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: .7.1..4 /
L / Date:/2 -O Z /,
THIS CARD IS TO REMAIN OPT-SITE -
CITY OF '"� Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-106081-00-EL Address: 2426 SW 347TH ST
Project: GUADALUPE MOTA FEDERAL WAY, WA 98023-3035
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.
El UFER Ground (4295) El Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) 10 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) 0 Rough Electrical(4225) '❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
'0 Final-Electrical(4055)
Approved
Date .-_ ,(` (7
`
0 Rough Electrical El Final Electrical
ID
Right of Way
Approved Approved Approved
By Date By Date By Date
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RECE.ED E&CTRICAL ,6_Pe"':+-
CITY OF
Federal Way DEC 02 2015 PERMIT APPLICATION
1CITY OF FEDERAL WAY /74q
PERMIT NUMBER /
- U 0 / —
2 6/ ` 5u)36/14k/74M ¶ SUITE/UNIT/SPACE#
SITE ADDRESS: -te aV `7-1A- `���-
PROJECT VALUATION ASS STi ^a'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 00
PROJECT NAME
(Tenant or Homeowner Last Name) MO
LAT"G 5 c cl. r. Clic `O
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER v e,d. /°Pe- /446. (Z0(0)32.._2.- - 2(o0
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
eGsiWet W - gg� c ) -
NAME. PRIMARY PHONE
)
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT {iR )ESS E-MAIL
24 26 3�i)41' 5
CITY STATE ZIP FAX
cue`-G r�1� id 9 8c)23 ( ) -
NAME / PRIMARY PHONE
PROJECT CONTACT ect j L , M04-c (2.06.)32----2...t,6 7
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. e
SIGNATURE: G
CJ a� L /'Li C� DATE — 62 //
PRINT NAME: l=k 4 Y . 1 o /5
Bulletin#160—January 1,2013 Page 1 of 2 k:'Handouts\Electrical Permit Application