17-100056 f.
..
Electrical
City of Federal Way Permit #:17-100056-00-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: SIDES
Project Address: 1324 S 291ST PL Parcel Number: 516210 0080
Project Description: Re-wire of lower level,altering(2)circuits
Owner Applicant Contractor
JOHN D SIDES B B ELECTRIC B B ELECTRIC
1324 S 291ST PL17404 MERIDIAN i Clc" -- BBELEBE950P1(10/22/17)
FEDERAL WAY WA 98003 PUYALLUP WA 98375 17404 S MERIDIAN
PUYALLUP WA 98375 ,
Additional Permit Information
Is this an Online or O.T.C.application? Yes
foY
lectr><cl' xxtures ' 3 "
Circuits-Residential 1 Low Voltage-Other(Resident 1
PERMIT EXPIRES Thursday,4 January,2018
Permit Issued on Wednesday,January 4,2017
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 a ordance with the laws, rules and regulations of the State of
Washing and the City of Federal Way.
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Owner or agent: 7
Date:
fttk..1 r '
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection
Ins ec i n R
ecordFederal Way INSPECTION REQUESTS:
(253)835-3050
PERMIT#: 17 100056 00 Address: 1324 S 291ST PL
Project: JOHN D SIDES FEDERAL WAY WA 98003-3777
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) ® 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 4 Date 1, .4 I7 sBy Date
O Final-Electrical(4055)
Approved
By ice, Date •p.3,j i_I
E Rough Electrical
0 Final Electrical0 Right of Way
Approved Approved Approved
By Date By Date # By Date
CITY OF ,.,._,....
ELECTRICAL
,
Federal Way PERMIT APPLICATION
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' G �dl `^wwo t rr. PERMIT NUMBER _
SUITE/UNIT/SPACE#
SITE ADDRESS: /3 2 l� S o Gq/ 5 1 t
PROJECT�DATION _... ASSESSOR'S TAX/PARCEL# � O - O 0 � ,.^ CURRENT/PROPOSED USE
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PROJECT NAME
(Tenant or Homeowner Last Name) J.-6k^
de s
PROJECT DESCRIPTION `•r� 6,`/'U DO)^ 6` ., r S t3 F4
Detailed description of work to (w 1.4._), re- U ^ 4 1,
be included on this permit only w [� � ��
NAME PRIMARY PHONE
PROPERTY OWNER JJh/\ $ de S ( ) -
MAILING ADDRESS E-MAIL
CIT,. STATE ZIP FAX
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NAME PRIMARY PHONE
%feCfr' 013 i4) i3,3 I�� -I c _ ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL PM C q /9110t-1 i'l.i--r .a-`. !%
CONTRACTOR C I STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
13 tel_b e i''J c.,\ l of l it i
NAMEPRIMARY PHONE
APPLICANT `5�e 61 v\cfer`5 )` ( )
MAILING ADI;RESS hZ 6 E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT Jt t/L\ ( )
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 reii,nce of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this •.plication. !
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SIGNATURE: i' 0 DATEer)
PRINT NAME: 1% - efei/ 5 t-----
Bulletin/1160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application