16-100376 . , r
. lectrica
` City of Federal Way
Community&Econ.Dev.Services Permit ermit #: 1 6-100376-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
FILE
Project Name: COOPER
Project Address: 35614 4TH AVE SW Parcel Number: 302104 9141
Project Description: New construction electrical wiring
• `
Owner Applicant Contractor
JAY&DAWN COOPER JAY&DAWN COOPER OWNER IS CONTRACTOR
35726 4TH AVE SW 35726 4TH AVE SW ('c,,,—N„S „ 1 �4-r
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
C1,44-P-. b tC 1 '9°10 c-
Additional Permit Information ' `—`�'� , `� �' �
Electrical Work Valuations
9000 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No -
• Electrical Fixtures
New Service:Residential 1
PERMIT EXPIRES Sunday, July 24, 2016
Permit Issued on Tuesday, January 26, 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: ° :' l C k.i\ -e-- Date: 112Ap ( I to
-� Sze
THIS CARD IS TO REMAIN ON-SITE
i?OF • Way Construction Inspection Record
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16-100376-00-EL Address: 35614 4TH AVE SW
Project: JAY & DAWN COOPER FEDERAL WAY, WA 98023-7309
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 iris 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 LIFER Ground (4295) 4030ver Ditch co
A roved ❑ ( ) 0 Slab/Concrete Floor(4255)
pp Approved Approved to place concrete
Date 2_4,_ 'co, . `B Date _5-- 1 By Date
+
0 Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved
Approved
By Date By Date
By 16, Date . _l 1
Feeders/Sub-panels(4045) 0 Rough Electrical(4225) .El Ceiling Cover(4020)-1
Approved Approved Approved
Date 0____/ (b By 0_'4
6.
-� Date % _`L. By Date
fl Final-Electrical(4055)
Approved
\tkazDate q_a1-)
Rough Electrical .0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
N2 6 2016 ELECTRICAL
CITY OF ti ITY t3F FEDERAL WAY
Federal Way CDS PERMIT APPLICATION
PERMIT NUMBER — ) 0 e , -7 _
SITE ADDRESS: (5 ( 1`/ 'pin // 1
five S , - 1 SUITE/UNIT/SPACE�f
PROJECT VALUATION ASSESSOR'S TAR/PARCEL/* ' 1�J CURRENT/PROPOSED USE
$ 9,000.00 3 0 2 1 0 4 - 9 1 4 1 New Construction
PROJECT NAME -(Tenant or Homeowner Last Name) Cooper Custom Home
Electrical for new home
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Jay&Dawn Cooper (253 ) 332 - 4650
MAILING ADDRESS E-MAIL
35726 4th Ave SW,Apt B masonsoarentals@gmail.com
CITY STATE ZIP FAX
Federal Way WA 98023 (253 ) 517- 3210
NAME PRIMARY PHONE
Owner contractor ( )
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE/ EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
NAME PRIMARY PRONE
APPLICANT same as owner
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT John Wilkerson(Vision Builders) ( 253 ) 332- 4677
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.
SIGNATURE: a� -^-L`_ C&„ '— DATE 1/22/2016
PRINT NAME: Dawn Cooper
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application