16-105659 e �- a
Electrical
CityotFederalWay FILE Permit #:16-105659-00-EL
CommunityDevelopmentDept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: FISHER
Project Address: 30348 13TH AVE S Parcel Number:250160 0010
Project Description: Full house rewire,adding(1)service and(1)0-200 amp panel for associated remodel work
Owner Applicant Contractor
DAVID R FISHER DO IT RIGHT ELECTRICAL DO IT RIGHT ELECTRICAL
28342 52ND AVE SE 11544 NISQUALLY PARK LOOP SE DOITRIR842Q1(11/21/18
AUBURN WA 98001-1922 OLYMPIA WA 11544 NISQUALLY PARK LOOP SE
USA
OLYMPIA WA
USA
Additional Permit information
Is this an Online or O.T.C.application? Yes
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Alt.Serv./Feeder:0 to 200 ami 2 Low Voltage-Other(Resident 1
PERMIT EXPIRES Wednesday, 17 January,2018
Permit Issued on Wednesday,November 30,2016
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy nd 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: arC; Date: /---e2 6 -19
DATE INSPECTOR AREA, !AND TYPE OF INSPECTION
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THIS CARD IS TO REMAIN ON-SITE
� � Construction Inspection Record
FeCler"av Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 105659 00 Address: 30348 13TH AVE S Unit A
Project: DAVID R FISHER FEDERAL WAY WA 98003-4145
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.
0 UFER Ground(4295) El Ditch cover(4030) Q 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 3 Date 3110111
,1=1 Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
.By try Date ‘_2.-l`--( ,.By Cum.- Date C_a,-„_t1 ,.By Date
.
El Final-Electrical(4055)
Approved
is Date �"`�7,0,
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
41111166
RECEIVED ELECTRICAL
CITY OF
Federal Way Nov 30 2016
BER P7(oRMIT
APPLICATION
CITY OF FEDERAL WAY _ 0 G `_ q _ ocJ
CDS PERMIT NUM
SUITE/UNIT/SPACE#
SITE ADDRESS: �Q'3[/ pi 13'Z ,4 / rate " ��„j j� v 3 / c Z
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PROJECT VALUATION ASSESSOR'S TAXO
RC�# O CURRENT/PROPOSED USE
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PROJtCT
NAME
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PROJECT DESCRIPTION eeiW>^i' Z°y$,74) lose W/ Nle �O2nGt5
Detailed description of work to v
be included on this permit only
NAM5‘ PRIMARY PHONE
PROPERTY OWNER IJGt�/l`d S (70k) VP/ -3310
MAILING ADDRESS E-MAIL
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CONTRACTOR c/iy( ,S?AT zlr�� FAX
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WA ATE ONT CTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME PRIMARY PHONE
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NAME , ^ PRIMARY PHONE
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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 arty 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:_ ,.A7 At.0,, DATE 60/04
PRINT NAME: ( '" /e• 4,
Bulletin#160—April 14,2016 Page I of 1 k:\Handouts\Electrical Permit Application