17-105677 Electrical
City of Federal Way Permit #.17-105677-00-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: LILLY
Project Address: 120 SW 305TH ST Parcel Number: 556000 0220
Project Description: Adding(2)circuits for existing septic system
Owner Applicant Contractor
EDWARD LILLY AFFORDABLE ELECTRICAL LLC AFFORDABLE ELECTRICAL LLC
120 SW 305TH ST 30449 103RD CT SE AFFOREL842B2(01/22/18)
FEDERAL WAY WA AUBURN WA 98092
98023-3948 30449 103RD CT SE
AUBURN WA 98092
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Circuits-Residential 2
CONDITIONS:
Inspection approval is required prior to covering or concealing any portion of the septic electrical system,
including the pump.New septic & effluent tanks containing electrical wires and equipment MUST be
inspection and approved PRIOR to being loaded with sewage. (Per 296-46B-501-001(b)(7)WAC)
PERMIT EXPIRES Tuesday,27 November,2018
Permit Issued on Monday,November 27,2017
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. Ain `�
Owner or agent: /AV\-/-\--a'e
Date: A V V —2 ` —`o7
THIS CARD IS TO REMAIN ON-SITE
c vo Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 105677 00 Address: 120 SW 305TH ST
Project: SZERENE L LILLY FEDERAL WAY WA 98023-3948
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.
Q UFER Ground(4295) ® Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) Q Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
.0 Final-Electrical(4055)
Approved
By --- Date `Z t C1
r r
❑ Rough Electrical '❑ Final Electrical 11 Right of Way
Approved Approved Approved
By Date By Date By Date
CITY of RECEIVED ELECTRICAL
° RECEIVED
Federal Way Nov 2 7 2017 PERMIT APPLICATION'
CITY OF FEDERAL.WAY i 7 [ 0 S QQ
COMMUNITY DEVELOPMEI�f PERMIT NUMBER
SUITE/UNIT/SPACE#
SITE ADDRESS: /2,0 51,v '30 C,, i7?oz 2
7
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# ^ CURRENT/PROPOSED USE
S goy 5- (e000 _ C� 0
PROJECT NAME l
(Tenant or Homeowner Last Name) L-1 Ly
(5_efti-c? c.:vc,(4 )-1-5 , 241)4-c-or
PROJECT DESCRIPTION e4"(-51))7)) r S�
Detailed description of work to
be included on this permit only
NAME f PRIMARY PHONE
PROPERTY OWNER L L j (t5 , ) Z19 - 3 z‘j,
MAILING ADDRESS E-MAIL
Cre Pal w k STW4-ATE Z9'OIP 2 5 ( ) FAX
NAME PRIMARY PHONE
,4P.o►rdabce (teoft,ari C CCC- (253) 2 - 3Z
MAILING ADDRESS. 1 E-MAIL
ELECTRICAL 3 c i t q )0 3 k ( Co u - S 5
CONTRACTOR CITY STATE ZIP FAX
n-� vv. wa /12 oft 2_ ( ) -
WA STAT CONT CTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
fo ELxg 2132_ t2 / � t /2a1�'
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PRIMARY PHONE
APPLICANTMA � S Kip y/� ( )
310 vLING (S /0 ! 1-0( � ,t 1 S E-MAIL
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
PROJECT CONTACT nal h (25-3) 2�q_ ?c 6O
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 t e city as a part of this application. /
SIGNATURE: ,//�' — `' DATE — 2 7— /7
N (� R 6 v z� i s K ,'1/
PRINT NAME: A .!✓ � 7
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application