11-104520 %,.. _ f 0 4 520
CITY OF
Federal Way ELECTRICAL t.( .)-- i e,/ii-w )
PERMIT APPLICATION
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** 1oa�t Iec'ccalNN4 permits may be obtained online at www cityoffederalway com*_r Lpp to t
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SITE ADDRESS:
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME t l i �u
(Tenant or Homeowner Last Name) �r elle
PROJECT DESCRIPTION 1�e P l Cr e�[tS'i-)n, .e Je )-�t o,(",� _pat) /
Detailed description of work to I / �"" '
be included on this permit only
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NAME rPY PHRNE
PROPERTY OWNER ' '-)Ci ..)-u h4er ( ) ',-!(Q - 16, ,7__`f
MAILING ADDRESS ��� EE-MAILi/. U - -)) c2
CITYSTATE ZIP, ,, FAX
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NAME PRIMARY PHONE
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MAILING ADDRESS E-MAIL
LECTRICAL
CONTRACTOR CITY STATE ZIP FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME PRIMARY PHONE
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APPLICANT
MAILING ADDRESS E-MAIL
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/ STATE
NAMEPRIMARY PHONE
PROJECT CONTACT i)Qf 5 f�Ci(A) ' - 70-f ,
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: - ;— ' _ DATE /1—
�
PRINT NAME: ,,/�{2/1 V. l
33325 8th Avenue South •Federal Way•WA 1 98003-6325♦253-835-2607♦fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 1 of 2 k:\Handouts\Electrical Permit Application
, E1ec it al
City Federal .WayS Permit #: 11-104520-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,wA 98003 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 reti p q
Project Name: HUNTER
Project Address: 29014 22ND AVE S Parcel Number: 422270 0270
Project Description: Replacing 0-200 amp service/panel
Owner Applicant Contractor
EUGENE HUNTER EUGENE HUNTER EUGENE HUNTER
PO BOX 25752 PO BOX 25752 PO BOX 25752
FEDERAL WAY WA 98091 FEDERAL WAY WA 98091 FEDERAL WAY WA 98091
Is Use Educational or Institutional? No
£, • itt „ ,
7 kry i:
Alt. Serv./Feeder: 0 to 200 amps(F 1
PERMIT EXPIRES Thursday, November 8, 2012
Permit Issued on Wednesday, November 9, 2011
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 theCityof Federal Way. (r" 9-1/
Owner or agent: ' L Date: / /
4116. THIS CARD IS TO REMAIN ON-SITE 4 .
CITY OF Construction Inspection`Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 11-104520-00-EL Address: 29014 22ND AVE S
Project: EUGENE HUNTER FEDERAL WAY, WA 98003-3846
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) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
.0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
By Date
.
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
AlkCITY OF r Building Division
33325 Eighth Avenue South
oallik/-,
Fed a ra I WayFederal Way, x 98003-6325
Phone 253 835 2607 Fax 253-835-2609ion
CORRECTION NOTICE
ADDRESS: R-1, e ►r a_` 1Y��-+- PERMIT#: 4 S �� 3
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IF YOU HAVE QUESTIONS CALL (253) 835- D.Jes).-77
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE-INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
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