16-105980 A
Electrical
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City of Federal Way � . , Permit #:16-105980-00-EL
Community Development Dept. f
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33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609
Project Name: GONZALES
Project Address: 2212 SW 330TH ST Parcel Number: 894500 0840
Project Description: Upgrade 200-amp service.
Owner Applicant Contractor
THELMA GONZALES JOE VINCENT GONZALES OWNER IS CONTRACTOR
2212 SW 330TH ST 2212 SW 330TH ST
FEDERAL WAY WA 98023-2827 FEDERAL WAY WA
98023
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Electrical Fixtures
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: Date: /2 - /7 -/(,,
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THIS CARD IS TO REMAIN ON-SITE
CITY OF
teaConstruction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16 105980 00 Address: 2212 SW 330TH ST
Project: JOE VINCENT GONZALES FEDERAL WAY WA 98023-2827
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.
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® 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 /7—Z?---/,LDate
M Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
pproved
. I ate ( 2 �7-7 - ( (,,,,
CI Rough Electrical D Final Electrical fl Right of Way
Approved Approved Approved
By Date By Date By Date
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CITY OF ROC , ELECTRICAL
Federal Way y7 PERMIT APPLICATION
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MY OF Fe a: L WA PERMIT NUMBER / _ / 1..�' s5- �- & 0
CDS
SITE ADDRESS: SUITE/UNIT/SPACE#
1,12 �,� 5�v 3�°7 It T t 1 ��« � wj�v ;�;rrv. 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
o o _ 0 K y c)
PRO E T NAME
(Tenant or Homeowner Last Name) C7(2 52( '/
PROJECT DESCRIPTION 2-6eV Q�G2fc•�E
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ,dCt 60(0-2A 5 ( ) -
MAILING ADDRESS E-MAIL
-z) )2 32'C(11 I
CITY STATE ZIP FAX
TiIL12-t}l,- 1..4)/!(-7, k•f.-. c15z-10;3 ( ) -
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 )4-C-.)) )(7-11..-� . ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT
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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 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: ��tDATE / 2 /`( - /<
PRINT NAME: L\IC1-0 63.17NZ L
Bulletin#160—April 14,2016 Page 1 of 1 k:AHandouts\Electrical Permit Application