15-104147 444k., Vc
RECEIVED ELECTRICAL
CITY OF
Federal Way SEP 01 2015 PERMIT APPLICATION
CITY OF FEDERA AY
PERMIT NUMBER l 5 _ I O L/ LCD _ � L.
SUITE/UNIT/SPACE#
SITE ADDRESS: 2_52.)91 Lit! 1 01A woo 5
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ `7 2 0 S 0 _ O b (o 0
PROJECT NAME
(Tenant or Homeowner Last Name) G L
10
,-
PROJECT DESCRIPTION , ' if:-. )�`� j
Detailed description of work to I , l Z__, ,
be included on this permit only \ J
NAME PRIMARY PHONE
PROPERTY OWNER £r I c.. e in ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
A' oft €�`ef-574,r'..-C 1 int ( 25 7) �a� _ 5c:
MAILING • •.RESS E-MAIL
ELECTRICAL 1' q 2-5- U y' 61- CT
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAMEy/�. PRIMARY PHONE
APPLICANT
ECAO\4? E 1 k / 1 Y1 C ( )
MAILING ADDRESS E-MAIL
1 k`12 5— (-V2 ( 61 5'i'- CT -
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ( )
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 an person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, i hiding its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
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SIGNATURE: LA . - zi G ��/ 1 Z DATE ` .'
411
PRINT NAME: A
i
Bulletin#160—January 1,2013 Page 1 of 2 k:\landouts\Electrical Permit Application
• RECEIVED Electrical
r
City &Econ.
al Dev. y SEP 0 1 2015 Permit 15-104147-00-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 CITY OF FEDERAL WAY rn 0 r
CDS
Project Name: HANSEN
Project Address: 28844 11TH AVE S Parcel Number: 720580 0060
Project Description: Wire remodel in kitchen that consist of adding(5)circuits.
**REVISION-9/1/2015 Wire remodel in Kitchen,Bathroom,Bedroom and Closet that
consist of adding(5)circuits***
Owner Applicant Contractor
ERIC HANSEN VINCE ROSCELLI EDGEWOOD ELECTRIC INC
28844 11TH AVE S EDGEWOOD ELECTRIC INC EDGEWEI950CW(2/16/17)
FEDERAL WAY WA 98003 11925 43RD ST CT E 11925 43RD STREET CT E
EDGEWOOD WA 98372-2373 EDGEWOOD WA 98372
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional" No
Electrical Fixtures
Circuits-Residential 5
PERMIT EXPIRES Sunday, February 14, 2016
Permit Issued on Tuesday, August 18, 2015
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: it , S ( t) 1.,`k, \ t`-.., Date: " \ L i 1
•
• Electrical
City of Federal Way ;
Community&Econ.Dev.Services Permit #: 15-104147-00-E L
33325 8th Ave S
Federal Way,WA 98003
Inspection Request Line:
Ph:(253)835-2607 Fax:(253)835-2609' p Q (253) 835-3050
Project Name: HANSEN
Project Address: 28844 11TH AVE S Parcel Number: 720580 0060
Project Description: Wire remodel in kitchen that consist of adding(5)circuits.
Owner Applicant Contractor
ERIC HANSEN VINCE ROSCELLI EDGEWOOD ELECTRIC INC
28844 11TH AVE S EDGEWOOD ELECTRIC INC EDGEWEI950CW(2/16/17)
FEDERAL WAY WA 98003 11925 43RD ST CT E 11925 43RD STREET CT E
EDGEWOOD WA 98372-2373 EDGEWOOD WA 98372
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 5
PERMIT EXPIRES Sunday, February 14, 2016
Permit Issued on Tuesday, August 18, 2015
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 th s, rules and regulations of the State of Washington
and the City o eral Way.
Owner or agent: Date:
•
THIS CARD IS TO EMAIN ON-SITE .
"Y of • Construction I ection Record i
Federal•Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 15-104147-00-EL Address: 28844 11TH AVE S
Project: ERIC HANSEN FEDERAL WAY, WA 98003-3705
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.
El UFER Ground (4295) El Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) 0 Temporary Power(4275) * El Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) El Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date B S Date c - - - S ByQ-� , Date z_ S
.® Final-Electrical(4055)
Approved
- Date .
�l l2- 1S- 1cc-
0 Rough Electrical111 Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date