13-100347 • /� Electrical
Ci hof Federal Way Permit #: 1 3-100347-00-EL
Communi &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 )
Project Name: LO '2701'21
Project Address: 28921 5TH AVE S Parcel Number: 515298 0240
Project Description: Installation of interlock switch for portable generator.
Owner Applicant Contractor
HERBERT K LO AZTEC ELECTRICAL SERVICES LLC AZTEC ELECTRICAL SERVICES LLC
28921 5TH AVE S 25314 45TH AVE S AZTECES021DT(3/30/14)
FEDERAL WAY WA KENT WA 98032 25314 45TH AVE S
98003-4312 KENT WA 98032
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 1
PERMIT EXPIRES Sunday, July 21, 2013
Permit Issued on Tuesday, January 22, 2013
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: (734A4
Date: Z 2.//
ft
r"4
Ivo ;
444—i'-' THIS CARD IS TO MAIN ON-SITE
of `' Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 13-100347-00-EL Address: 28921 5TH AVE S
Project: HERBERT K LO FEDERAL WAY, WA 98003-4312
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.
O UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) El Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
•
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
,
O Final-Electrical(4055)
Approved
C� Date 1— Z4,--
O Rough ElectricalEl Final Electrical Il Right of Way
Approved Approved Approved
By Date By Date By Date
' " • i r
EL CTRICAL
CITY OF *'s Si
Federal Way PERMIT APPLICATION
RECEIVED
PERMIT NUMBER 2 / 3 / 0 0 . 7 "_ [E
V C' JAN 22 2013
SUITE/} Q 2� �_; /� ,,,?._(/ 5 CITY OF FADE k WAY UNIT/SPACE#
SITE ADDRESS: 7 (�
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# p CURRENT/PROPOSED USE
5 / 5 9 a _ 0 dl- `( U
PROJECT NAME �j� /�
(Tenant or Homeowner Last Name) l-k-K8( "(-- L V
PROJECT DESCRIPTION `1-7 �� TD t.0 P
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER f--"E14162 7 4-0 ( .) q_77- 7
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
f 2At i,v'A " vv e1 nL,G,j ( )
NAME PRIMARY PHONE
2' c .11.-- L.&c-7724 L c2 O.u ( ?04 7I - ?/D v
MAILING ADDRESS E-MAIL
t"'
ELECTRICAL
CONTRACTOR CITY (57A..._, ` TAT /' FAX
�► ( ) _
WA STATE CONTRACTOR'S LICENSE# r EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT
--S-Ig-I ( ) t /L/ ( ) -
MAILING ADDRESS E-MAIL
2 31 Cf 41 A-vv-
CITY / �� STATE ZIP FAX
— 144 r 01- '7; )) 2-- ( ) -
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 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: /,tl; a .J kJ DATE (7.7Z /
PRINT NAME: l 'V S 4-13n,fliLi
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application