17-102151 •
Electrical
City of Federal Way Permit #:17-102151-00-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 Name: HOME&HOME
Project Address: 31515 PETE VON REICHBAUER WAY S Parcel Number:092104 9302
Project Description: Add power pole for register& outlets.
•
Owner Applicant Contractor
YOUNG JAE KIMBROADWAY-32ND STREET CHRISTY MONTENEGROTHE JUICE THE JUICE COMPANY INC
REALTY COMPANY INC JUICECI933BP(1/17/19)
1610 BOUNDARY BLVD 11407 SE 326TH PL
AUBURN WA 98087 AUBURN WA 98092 11407 SE 326TH PL
AUBURN WA 98092
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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PERMIT EXPIRES Thursday, 10 May,2018
Permit Issued on Wednesday,May 10,2017
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 agen . � �%�-j Date:Sl/ `l 7
THIS CARD IS TO REMAIN ON-SITE "
� Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 102151 00 Address: 31515 PETE VON REICHBAUER WAY S I
Project: 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(4295) ® Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date 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 DateBy Date
rEl
Final-Electrical(4055)
Approved
1(� Date'
CI Rough Electrical 111Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED ELECTRICAL
CITY OF
Federal Way MAY 1 U 2017 PERMIT APPLICATION
CITY OF FEDERAL WAY /+�
COMMUNITY DEVELORA� Ni
NUMBER t 1 _ / a Z ) i _ - L,
SUITE/UNIT/SPACE#
SITE ADDRESS: 3(5f 5 P 7L: v oN t i 1I? 66 0 Y
vi
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
s 30(9 . ct_ 0 q 1- i d I4 _ 1 3 0 2-
PROJECT
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER '-•ft: )\,K -A- /Ll c ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
--nile sjU.ke_e CAD► 1-ean i -Ell c� (AS3) &' -J-• r'2)-3
MAILING ADDRESS E-MAIL
ELECTRICAL I 14 V1 .Se ,D1,o P C— Jo i C_ eA:m <ny r c rocart
CONTRACTOR CI STATE ZIP FAX nct
1\O ik vv) W/f- g?Q'd (2S 3)-73-7 -4c LI
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
<,\U l_ ' C' C1 f�i� O i / v i /
N(" E 1 .714 PRIMARY PHONE
APPLICANT /h✓�-S I\I "1 v r)-t,ncele O T (A5 ),.-43�j ---W,)-3
MAILING ADDRESS
l 19 01 S � n" E-MAIL
CIAY (�r!f ,N0 1 le<vM r o,r�y �,c�asvl�.<oS�f had
STATE ZIP FAX
fillt (4,v1^ M yc 2- ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 'bef.-w r, A INA an \-1 cN vi 'i ,1 *--),-.1,) -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 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 suppli--'to iI a city as a part of this application.
SIGNATURE: Al2- . & Afi '� DATE l///o/ 1 7
40
PRINT NAME: n5
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Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application