13-102972 t I
Y
• Electrical
Community&Econ.DeCity of Federal
v.Services Permit #: 13-102972-00-EL
33325 8th Ave S
Federal Way,WA 98003 tion InS eC Request Ph:(253)835-2607 Fax (253)835-2609 p Line: (253)835-3050
Project Name: OSTERHOLT
Project Address: 2730 SW 330TH ST Parcel Number: 894520 0390
Project Description: 0-200 amp panel change
Owner Applicant Contractor
DAVID ALLEN OSTERHOLT CEDAR GROVE ELECTRIC INC CEDAR GROVE ELECTRIC INC
11226 116TH PL NE 16825 230TH AVE SE CEDARGE955BC(1/21/15)
KIRKLAND WA 98033-4541 MAPLE VALLEY WA 98038 16825 230TH AVE SE
MAPLE VALLEY WA 98038
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Wednesday, January 1, 2014
Permit Issued on Friday, July 5, 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: a/tJP '/"' "' Date: 7/5-7/3
Q�ti
THIS CARD IS TO 'MAIN ON-SITE .
CITY OF A • Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 13-102972-00-EL Address: 2730 SW 330TH ST
Project: DAVID ALLEN OSTERHOLT FEDERAL WAY, WA 98023-2830
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) ❑ Ditch cover(4030) Ei Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) .❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By ciocfrDate x al
El Feeders/Sub-panels(4045) ,El Rough Electrical(4225) CI Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
By � � Date i.~:3y k3
❑ Rough Electrical Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
cin of
ECTRICAL
Federal Way PERMIT APPLICATION
q (� RECEIVED
(PERMIT NUMBER I 3 _ ' 2 ` Z _ v 0 O�%
- - - - JUL 05 2013
-� _., CITY OF FEDERAL /UNIT/SPACE
SITE ADDRESS: #
; 3 S w 3 30 +', CDS
PROJECT VALUATION ASSESSOR'S T AR #2 0 - Q O CURRENT/PROPOSED USE
$ iVVQ — — (7t-}
PROJECT NAME I
(Tenant or Homeowner Last Name) C)S-f C r a 1-1 o �
Y .� swc P a CG,"In 2
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME ' `` PRIMARY PHONE
PROPERTY OWNER t- d`� vs�- Quo k01,1- ( ) -
MAILING ADDRESS E-MAIL
( 3S-oY !G o 1' s- St✓
CITY STATE/� ZIP
p`� FAX
WA 1 0S ( ) -
NAME PRIMARY PHONE
e-C-.c r mat= e� r;c_ 1 A G (t(U) 8OZ _ 18 7-
MAILING
MAILING ADDRESS E-MAIL
ELECTRICAL ( (s. ZS "7. pc- e_
CONTRACTOR CITY STATE ZIP FAX
Wv ,pty ' 111-1 w A 0 38 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
C€ ,(..- (s) e olj Sc__ / / 20 06- 10'3'198-oo- 13L
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )NAME
PRIMARY PHONE
PROJECT CONTACT Com`
(4(7_51 got - Zig Z 9
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
�tothe
/city as aappart of this application.
SIGNATURE: � ��i'�u/"`1 DATE 7/5-1/3
PRINT NAME: & )it-h /i'tcti r-14
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application