17-105136 Electrical
City of Federal Way Community Development Permit #:17-105136-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: CAPELL
Project Address: 30447 12TH AVE SW Parcel Number:515320 0620
Project Description: Adding/altering(2)circuits,including(4)outlets and lights for associated remodel
Owner Applicant Contractor
CAROLYN CAPELL DENNIE CAPELL OWNER IS CONTRACTOR
30447 12TH AVE SW 30447 12TH AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
USA
Additional Permjt Information
Is this an Online or O.T.C.application? Yes
Circuits-Residential 1
PERMIT EXPIRES Wednesday,24 October,2018
Permit Issued on Tuesday,October 24,2017
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:
Electrical
City of Federal Way Permit #:17-105136-00-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: CAPELL
Project Address: 30447 12TH AVE SW Parcel Number:515320 0620
Project Description: Adding/altering(1)circuit and(4)outlets for associated remodel
Owner Applicant Contractor
CAROLYN CAPELL DENNIE CAPELL OWNER IS CONTRACTOR
30447 12TH AVE SW 30447 12TH AVE SW
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
USA
Additional Permit Information
Is this an Online or O.T.C.application? Yes
E6llt€�6�
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Circuits-Residential 1
PERMIT EXPIRES Wednesday,24 October,2018
Permit Issued on Tuesday,October 24,2017
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy - d - 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: (II Date: 'o/e i//
-
41ATHIS CARD IS TO REMAIN ON-SITE
Federal Way Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 105136 00 Address: 30447 12TH AVE SW
Project: CAROLYN CAPELL FEDERAL WAY WA 98023-3424
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.
•
I
I❑ UFER Ground(4295) ' D Ditch cover(4030) , 1:1 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
• r
® Pool Bonding(4195) ' 5❑ Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date `By Date By Date
El Feeders/Sub-panels(4045) • ® Rough Electrical(4225) [3 • Ceiling Cover(4020)
Approved Approved Approved
By Date •By (, VikklDate 1, . 1. `--i ..BY Date
CI Final-Electrical(4055)
Approved
By Q.A..> , Date t-t L s lit
o Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF
RECEIVED ELECTRICAL
Federal Way OCT 2 4 2017 PERMIT APPLICATION
CITY OF FEDERAL WAY`,p, i
SUITE/UNIT/SPACE#
/ 0 5 / .3 Co
COMMUNITY DEVELOPMENTERMIT NUMBER
Aihh,
SITE ADDRESS:�'"
4� t ,nuc way
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) 2e N, Y•e,,,,,cz)c
PROJECT DESCRIPTION (4Ccce Sk rct
Detailed description of work to
be included on this permit only CI ) Ct rw(T-
) a-97-te
NAME PRIMARY PHONE
PROPERTY OWNER �\ GA pe ,1 (69 ) Z7'3- c C2
MAILING ADDRESS E-MAIL
'30L&4 121-4. b41OE SL
CITY STATE ZIP FAX
ka 7 Jay C 2O 2% ( ) -
NAME PRIMARY PHONE
A\O ocit S-e lP ( ) -
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 ' ( )
MAILING ADDRESS E-MAIL
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 • the C , of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defe - of sue aim, which may be made by any person,including the undersigned,and filed against the city,
but only where such cl•' arise- •ut of he reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to he ci • • pa •f this application.
SIGNATURE: � DATE t o f 1 ,1-
PRINT NAME: ' -0Vl1'1I. QG 2 1
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application