15-105558 • ` Electrical
City of Federal FILE
Community s Econ.DeWayv.Services Permit #: 15-105558-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: RECORD REAL ESTATE
Project Address: 2012 S 320TH ST Unit A Parcel Number: 092104 9297
Project Description: Install(26) receptacles and(20)data rings relamping existing 2x4 lights and reuse existing
circuits; add voice& data cable
•
Owner Applicant Contractor
DOLORES CAVADA M C H ELECTRIC M C H ELECTRIC
A&D HOME SERVICES 407 S 306TH ST MCHELEL856LP(6/17/17)
1036 S 325TH ST FEDERAL WAY WA 98003 407 S 306TH ST
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Commercial 30
PERMIT EXPIRES Saturday, April 30, 2016
Permit Issued on Monday, November 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: / / �-/, u/ 4, ,d Date: (1---(a /F
--FINALED
THIS CARD IS TO AIN ON-SITE
44%.
n
c, cn � ! Construction Ins ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 15-105558-00-EL Address: 2012 S 320TH ST Unit A
Project: DOLORES CAVADA 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) 0 Ditch cover(4030) El Slab/Concrete Floor(4255
Approved Approved Approved to place concrete
By Date By Date By Date
idPool Bonding(4195) ® Temporary Power(4275) ri Service(4235)Approved Approved Approved
ByDate By Date Date
ID Feeders/Sub-panels(4045) ® Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
y Date Date k — k.4— (0 By 1,',41, Date II ""12.3, t
1���,____ Final-Electrical(4055)
Approved
LTV V'Y2 Dat l- 21 (y,
Rough Electrical ---I Final Electrical Right of Wav
Approved Approved Approved
r
Date By Date By Date ____
•
CITY OF "�� ELECTRICAL
Federal Way PERMIT APP ON
PERMIT NUMBER ( S _ / Q �� 5,6 1 _ Off,/ N O• 012015
��JJ CITY OF FED RAL WAY
SUITE/Uf! (SPACE#
SITE ADDRESS:
135 C 2 S .3 204-'4 e,t 1 �A� cam., A
PROJECT VALUATION ASSESSOR'S TAX/PARCEL� - � CURRENT/PROPOSED USE
5 , 2_ , ec - °U C'
2
PROJECT NAME
(Tenant or Homeowner Last Name) CO 12. {U R S A L ,NT
I- .212cex�A-v1cL3 -a 20 Q( 0, (a\ CjS
PROJECT DESCRIPTION l'L�Z AKS 1" 2 x LA LA CE \+ 5
Detailed description of work to lA- k t ti C 1 (Z c V l t S
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 22 z_S A . eL J U (253) 6s3- c)`rr
MAILING ADDRESS E-MAIL
1467- L (2c- STT�2 c
CITY STATE ZIP XLC�"f Aye
FAX
>, NLS ULA A q8( 22 (�`d�c�.s')2c( - '2 o 44 (
NAME PRIMARY PHONE
i-�e�i L LLz C i21/4 c 13 , (L53) 2.30_ s ct
MAILING ADDRESS E-MAIL
ELECTRICAL LA0-1 -` 3 oC -c- C l.4 -1=tuc .,
CONTRACTOR CITY STATE ZIP
FAX
(z r� 2ra L u-' `e O c°3 1_04)6!)" ( - 7_70(
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT 132N ' v\ (2\JN �` J Q-Y 0 (253) -Z-50 - S S
MAILING ADDRESS E-MAIL
u 7 S 5-kV222-1
CITY STATE ZIP FAX
r e ILA e_ w N e cc 3 (- ) ----
NAME PRIMARY PHONE
PROJECT CONTACT cO R p tIA L ,C r - (2,3) G 5 5-7 c?q
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: I /1/ DATE l I/2 ( / S
PRINT NAME: (ty) 'V\
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application