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17-105813 , 'P 4 t � Electrical City of Federal Way Permit #:17-105813-00-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: CORNELL Project Address: 1134 SW 296TH ST Parcel Number: 119600 4830 Project Description: Electrical permit to close out 16-102719-00 for full rewire and new 200amp service Owner Applicant Contractor JIM CORNWELLSLIPPAHS LLC JIM CORNWELLSLIPPAHS LLC OWNER IS CONTRACTOR PO BOX 12828 PO BOX 12828 MILL CREEK WA 98082 MILL CREEK WA 98082 Additional Permit Information Is this an Online or O.T.C.application') Yes � � E✓��"''ft�rb��`�siv��l,:�l'�/s�bkf � €,': 5 a n E�fz� ifs u t�hr' � '�C€�S'�EN�E � � X ,� r" r r/y�� / ,�y�e y ru : s i €Es S r�<.„ ��a E Z ✓��ar.� fEE €4€�I,?w€E��a,r,u-_ Alt.Serv./Feeder:0 to 200 am] 1 Circuits-Residential 16 PERMIT EXPIRES Wednesday,5 December,2018 Permit Issued on Tuesday,December 5,2017 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: Date: /2 - S — 7 THIS CARD IS TO REMAIN ON-SITE , c,,, , .4 CRY OF Construction Inspection Record Federal . • INSPECTION ESIIIE 'FTS:.(2553).835-305Q PERMIT#: 16-102719-00-EL Address: 1134 SW 296TH ST Project: JIM CORNWELL FEDERAL WAY,WA 98023-3456 Scheduled inspections may be failed if this card is not on-site. PO 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) .Q Ditcher(4030) 0 Slab/Concrete Floor(4255) Approved Approved to place concrete By Date By Date By Date O Pool Bonding(4195) [3 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 33 -----TS S Date I 0.-S t67 By Date ® Final-Electrical(4055) Approved By Date • Rough Electrical1-1 C Final Electrical Right of Way Approved Approved L.J Approved By Date By Date By Date f e � THIS CARD IS TO REMAIN ON-SITE curO l Wa Construction Inspection Record Way INSPECTION REQUESTS:(253)835-3050 PERMIT#: 17 105813 00 Address: 1134 SW 296TH ST Project: JIM CORNWELL FEDERAL WAY WA 98023-3456 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) ill Ditch cover(4030) ID Slab/Concrete Floor(4255) Approved Approved Approved to place concrete By Date By Date By Date • .. ./ . ® Pool Bonding(4195) El Temporary Power(4275) ® Service(4235) Approved Approved Approved By Date 1 By Date By04 Date • El Feeders/Sub-panels(4045) ® Rough Electrical(4225) 9❑ Ceiling Cover(4020) Approved Approved Approved By Date By Date By Date . El Final-Electrical(4055) Approved •)g Date( 6 Rough Electrical El Final Electrical Right of Way Approved Approved Approved By Date By Date By Date RECEIVED ELECTRICAL CITY OF 41/11 Federal Way DEC 0 5 2017 PERMIT APPLICATION COMMUNIIYFDEVE OPMEfYTj PERMIT NUMBER I I 1 0 SUITE/UNIT/SPACE# SITE ADDRESS: //31/ S(,v / Q 1p $r PROJECT VALUATION ASSESSOR'S T PARCEL# 0 0 n ^ CURRENT/PROPOSED USE PROJECT NAME �� i (Tenant or Homeowner-Last Name) ,v CLO aur J ,m/i /6- ,oZ7/F- 00 - E '- PROJECT DESCRIPTION '/NAL L /N gO6-L7l N WeE,1)CD Detailed description of work to be included on this permit only NAME C Y,)76i/ /44 PRIMARY PHONE PROPERTY OWNER PPA«SLCc - TAM&S" COaevo-A c (2 )y -8 '3ea MAILING ADDRESS E-MAIL PO 30) /2-S22-) sc/oPA/7/Si-ec. X644,1 #6C34-' CITY STATE ZIP FAX ck6-Er� 147,4 9&' NAME PRIMARY PHONE 014/NO-C.-- MAILING ( ) - ADDRESS E-MAIL ELECTRICAL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# NAME PRIMARY PHONE APPLICANT 074Mi✓5 eOQ,/ V\✓e�t� (Zo(n ) `/4' ' p'V3�0 MAILING ADDRESS E-MAIL PO 8o' /282-e CITY STATE ZIP FAX !y/LL c2&&-e- W4 9808 z ( ) - NAMEPRIMARY PHONE PROJECT CONTACT 7.p ,l�S l../In 0eN w6 64 _ (z®C, ) 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. •e SIGNATURE:/ DATE /Z -S- /2 PRINT NAME: cl ft i e---S Ce-14A11"/"--t7 L (-- Bulletin Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application