17-105096 t , Y
Electrical
City of Federal Way Permit #:17-105096-00-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: MOD PIZZA
Project Address: 2042 S 320TH ST Parcel Number: 092104 9271
Project Description: Installation of(2)1-v thermostats.
Owner Applicant Contractor
JERRY KESSELRINGMOD PIZZA JEREMY MOELLERC F M HEATING AND C F M HEATING AND COOLING INC
2035 158TH CT NE SUITE 200 COOLING INC (ELECTRICAL)
BELLEVUE WA 98008 PO BOX 3205 CFMHEFM953QT(11/30/17)
KIRKLAND,WA 98083 PO BOX 3205
KIRKLAND WA 98028
Additional Permit Information
Is this an Online or O.T.C.applications Yes
Ami 3 7W
Thermostat 2
PERMIT EXPIRES Tuesday,23 October,2018
Permit Issued on Monday,October 23,2017
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 accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Owner or agent: . ,e,t. ��171. ` Date: /P Z3`t
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THIS CARD IS TO REMAIN ON-SITE
Federal Way Construction Inspection Record
y INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 105096 00 Address: 2042 S 320TH ST
Project: JERRY KESSELRING FEDERAL WAY WA 98003-5416
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.
i
CI UFER Ground(4295) ® Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
® Pool Bonding(4195) CC Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
'
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) t® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•0 Final-Electrical(4055)
Approved
By Date '' I" !'-'
El Rough Electrical El Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
ELECTRICAL
CITY OF OCT 2 3 2017
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER /' _ / 0 5 0 9 O -
1 SUITE/UNIT/SPACE#
SITE ADDRESS: 2, 0,4 rj 3 0it, S T,
PROJECT VALUATION ASSESSOR'S TAX/PARCEJ CURRENT/PROPOSED USE
SOO -O L d c/- ot / Re-ka,�____
PROJECT NAME M
(Tenant or Homeowner Last Name) Q I as P 2.74:k
PROJECT DESCRIPTION 1".'1 carte 2 eAz. 5 4i(15 ` \€ Ob f6t}5
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAMEPRIMARY PHONE
C'FM1 1ewh acIi++ Coo ki•nr (4125 )
MAIILING ADDRESS E-MAIL
ELECTRICAL 1 • O. 6Dl( 320
CONTRACTOR CITY STATE ZIP FAX
Loci WA 96(43 (BIZ )82-1 - (3k3
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
CFM 4EF11953Q1` t� / 3) / /7
NAME n(� PRIMARY PHONE
APPLICANT Im, Mod�►� (4125) 021 - 12 3
MAILING ADDRESS E-MAIL
x 3201 Tue hy@GFAX
OA-HII/AC(2- *IAACIT}')`1 4"1 '� ZIP� /3 (1125") ezt
60€)
NAME PRIMARY PHONE
PROJECT CONTACT Tommy Mocjtev' 25
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,o the city as a part of this application.
SIGNATURE: �7" DATE /0" Iy `/
7
PRINT NAME: - 1/4„TQXpI l — –
PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
253-835-260'7 4- FAX 253-835-2609 + permitcenter@cityoffederalway.com
Bulletin#160 -April 14,2016 Page 1 of 1 k:AHandouts\Electrical Permit Application