16-105975 lectr>Ical,.
City of Federal way Permit #:16-105975-00-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
t t`
Project Name: CROSS
Project Address: 2035 S 308TH ST Parcel Number: 053700 0390
Project Description: Alter 200 AMP Service.Add (21)plugs and(14)lights.
Owner Applicant Contractor
CAROL H CROSS CAROL H CROSS OWNER IS CONTRACTOR
2035 S 308TH ST 2035 S 308TH ST
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application Yes
Alt. Serv./Feeder: 0 to 200 ami 1
PERMIT EXPIRES Tuesday, 19 December,2017
Permit Issued on Monday,December 19,2016
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: cl_azeLe (!4_B4 L. i Date: id / q —1(0
FIAIALEO
• :- THIS CARD IS TO REMAIN ON-SITE
CITY of
Federal Way Construction Insrection ection Record
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16 105975 00 Address: 2035 S 308TH ST
Project: CAROL H CROSS FEDERAL WAY WA 98003-4822
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) „El Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) D Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) El Rough Electrical(4225) ® Ceiling Cover(4020)
ApprovedApproved Approved
BaDatee -�_ , By Date` --2_ by Date
El Final-Electrical(4055)
Approved
Date ST: ` l7
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
ELECTRICAL
CITY OF
Federal Way 0Er, 1 2)1S PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS ( / 0 5 75-
PERMIT NUMBER (0. _
' SUITE/UNIT/SPACE#
SITE ADDRESS
• 2d S 5-�- lac
PROJECT VALUATION�� ADSSESSOR'S TAX/PARCE #� � - O � 0 CURRENT/PROPOSED USE
PROJECT NAME ,
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION A 1.M17,eci ?CO c. e—
c
Detailed description of work to I/LI ( j 01-S-
be included on this permit only ll
2i f (vti9S
NAME (11.0d70/
� PRIMARY PHONE
PROPERTY OWNER of C (ZS 3) Zif - (2_05
MAILING ADDRESS E-MAIL
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CITY�`�//�`%`-� STATE ZIP FAX CCW\
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NAME PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME - PRIMARY PHONE
APPLICANT �� ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
PROJECT CONTACT NAME PRIMARY PHONE
car ct-�( ( ) _
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 t part of this application.
SIGNATURE: 46
DATE I
PRINT NAME: .. C'I C G'DraS
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application