14-104499 Electrical
City of&FederalWay Permit #: 14-104499-00-E L
CommunityEcon.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: ERICKSON
Project Address: 36031 3RD AVE S Parcel Number: 113780 0250
Project Description: Adding up to (7)circuits for associated addition
Owner Applicant Contractor
KIMBERLY ERICKSON ACCEL ELECTRIC LLC ACCEL ELECTRIC LLC
TRENT ERICKSON 802 4TH AVE SW ACCELEL982RE(12/14/14)
36031 3RD AVE S PUYALLUP WA 98371 802 4TH AVE SW
FEDERAL WAY WA 98003 PUYALLUP WA 98371
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 7
PERMIT EXPIRES Monday, March 2, 2015
Permit Issued on Wednesday, September 3, 2014
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 w. - the laws, rules and regulations of the State of Washington
nd ity of Federal Way.
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Owner or agent: 1. , Date:
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THIS CARD IS TO — IN ON-SITE;
CITY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 14-104499-00-EL Address: 36031 3RD AVE S
Project: KIMBERLY ERICKSON FEDERAL WAY, WA 98003-8622
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) ❑ 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) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
•
0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By V4 Date 1 1 I t I I at. By Date
Final-Electrical(4055)
O Approved ((T '
By It&4.5 Date 1121, ,
N t
i
t so
T/ Acv-
Vic _.
Rough Electrical Final Electrical Right of Way
ElApproved ❑ Approved ElApproved
By Date By Date By Date
.
44._.h, E C'TRICAL
CITY OF
Federal Way PERMIT APPLICATION
4 1 (_ aeceiv�
PERMIT NUMBER ( ` 0 4 9 ��
— — — — SEP 03 2014
j1'� A CITY OF FED 'iL� cE#
SITE ADDRESS: / 3 O 3 / 7 1 /,�� co, CDS
PROJECT VALUATION ASSESS R'S TAX/PARCE # 0 O c z 5_C� CURRENT/PROPOSED USE
S ' 3 _
PROJECT NAMEC-12((:-.4R�-~
(Tenant or Homeowner Last Name)
7 , d2�' L4 j ' S
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME }, { PRIMARY PHONE
PROPERTY OWNER .1 Z- i C�'kW ( ) -
MAILING ADDRESS _ E-MAIL
i
3 - 31 �'' thy` 4.�
CITY / STATE ZIP FAX
r p t✓W Gt/ ?7 ( ) -
NAME / PRIMARY PHONE
fed i_I�- ( 1716 ( ) �:I 1 ' /
MAILING ADDRESS E-MAIL
ELECTRICAL �) If/ s
CONTRACTOR CI STATE ZIP FAX
741/at, a,� gX37/ ( ) -
WA S 1 NTRA OR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
' 7
/ /
NAME PRIMARY PHONE
'- Ji'� 1��,///1/4.' ( ) - -
APPLICANT MAILING ADDRESS E-MAIL
CITY /� STATE ZIP FAX
(,!/��g W4 9 '371 ( )
NAME / PRIMARY PHONE
PROJECT CONTACT ISD ( ) �o / '
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 cityyas a part of this app jication.
SIGNATURE: 6,,,,,, /.„2, /
5
DATE ?"-3 ^ /',/
PRINT NAME:
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application