15-105995 * Electrical
Community of Econ Dv.Services Permit #: 15-105995-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: BERG
Project Address: 29603 22ND AVE S Parcel Number: 879800 0060
Project Description: Install T-stat.
Owner Applicant Contractor
DAVID BERG M M COMFORT SYSTEMS(GENERAL) M M COMFORT SYSTEMS(ELECTRICAL)
29603 22ND AVE S 18103 NE 68TH SUITE C-200 MMCOMMC925C5(2/25/16)
FEDERAL WAY WA 98003 REDMOND WA 98052 18103 NE 68TH SUITE C-200
REDMOND WA 98052
Additional Permit Information
Electrical Work Valuation 250 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No
Electrical Fixtures
Thermostat. I
PERMIT EXPIRES Monday, May 23, 2016
Permit Issued on Wednesday, November 25, 2015
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 ora agent:,Y --- /' / ' 77c,2-.5—
;45-
.' ----‘
�/5-
g �'` Date: `-
iL
` �' 0 THIS CARD IS TO RE ON-SITE _ ,
CITY OF "'..� ,y
Federal WayConstruction Inspe ion Record
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-105995-00-EL Address: 29603 22ND AVE S
Project: DAVID BERG FEDERAL WAY, WA 98003-4251
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.
0 UFER Ground (4295) '0 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) �� 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
EI g Final-Electrical(4055)
Approved
By Date �-15 15
Rough Electrical ❑ Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date 1 By Date
, 1 U2 ID REjVEWAY -g' _ZO .5.: .? 47 ._i__-
ALcarr ofC NOV 2� 5
- Federal Way ELECTRI0
FEDERAL
PERMIT APPLICATi 3N
**Most electrical permits may be obtained on-lme at www.cityoffederalway.com**
SITE ADDRESS: 29603 22ND AVE S
-. -' . / ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
879800-0060 _
PROJECT NAME
(Tenant or Homeowner Last Name) BERG RESIDENCE
PROJECT DESCRIPTION GAS FURNACE REPLACEMENT, LIKE FOR LIKE IN SAME LOCATION
Detailed description of work to
be included on this permit only AND INSTALL NEW THERMOSTAT
NAME PRIMARY PHONE
PROPERTY OWNER DAVID BERG (253 )839 - 4726
MAILING ADDRESS E-MAIL
29603 22ND AVE S
CITY STATE ZIP FAX
FEDERAL WAY WA 98003 ( ) -
NAME PRIMARY PHONE
MM COMFORT SYSTEMS (425 ) 881- 7920
MAILING ADDRESS E-MAIL
ELECTRICAL 18103 NE 68TH ST C-200
CONTRACTOR CITY STATE ZIP FAX
"IS
REDMOND WA 98052 ( ) -
v WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
MMCOMMC925C5 02 / 25 /16 20-07-100701-00-BL
NAME PRIMARY PHONE
SAME AS CONTRACTOR ( ) -
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 supportof 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 oft reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part his •. -
SIGNATURE: DATE 11/23/15
PRINT NAME: ' ''
�:...... ISTE m.
NIMPF-
33325 8th Avenue South♦Federal Way♦WA♦98003-6325♦253-835-2607♦fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160—January 1,2011 Page 1 of 2 k:\Handouts\Electrical Permit Application