15-101000 i •
.111
` Electrical
City
&Econ.of FedeWay
S
Communityervices Permit #: 15-101000-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line:
Ph:(253)835-2607 Fax:(253)835-2609F111-4Ens p q (253)835-3050
•
Project Name: BASSETT
Project Address: 4120 SW 322ND ST Parcel Number: 873196 0430.,
Project Description: Installation of rooftop PV system.
•
Owner Applicant Contractor
BYRON F BASSETT JEREMY HOWLETT SMART ENERGY TODAY
4120 S 322ND ST SMART ENERGY TODAY SMARTET870BS(1/10/17)
FEDERAL WAY WA 98023-2417 1001 COOPER PT RD SW 1001 COOPER POINT RD SW
OLYMPIA WA 98502 OLYMPIA WA 98502
•
Additional Permit information
Is this an Online or O.T.C.application? No Is Use Educational or Institutional? No
Service greater than 999 Amps" No
Electrical Fixtures
Circuits-Residential 1
PERMIT EXPIRES Sunday, November 1, 2015
Permit Issued on Tuesday, May 5, 2015
I hereby certify that the above information is correct and that the co�ii struction 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
a e City of F eral Way.
Owner or agent �i� Date:
-., , to let. •G �r
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s
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` - THIS CARD IS TO . ON-SITE
CITY of • Construction In ection Record -
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT#: 15-101000-00-EL Address: 4120 SW 322ND ST
Project: BYRON F BASSETT FEDERAL WAY, WA 98023-2417
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) - 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
. . . . .
0 Pool Bonding(4195) ❑ Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
By i Date 5I'l lc"
El Rough Electrical El Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
mem
!R032015 EtCTRI A
CITY OF
C L
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
PERMIT NUMBER 1 — I C� 0 6 0 --
'34 1 }
666 - -
SITE ADDRESS• G�' x(� d�+`I 7 2 Z + ,�u,Q l Wc,�1 , (�,J�}� 3 SUITE/UNIT/SPACE#
PROJECT VALUATION 0 / ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ yb00 e -7 3 1 4 x - o Y s v
PROJECT NAME
(Tenant or Homeowner Last Name) ?DG.S .+
?If 5 //ae fir 1l�41a
PROJECT DESCRIPTION 14.32- J`'
Detailed description of work to ) 6 t'f c. 1 T 27O -14-e , )
-
be included on this permit only 2 A f� F S.*)..r Attu Pb 1/'� j' y4.5-06A - "IAA)
NAME - PRIMARY PHONE
PROPERTY OWNER Alrbet. � �
SS4T 43,6(2S>) b - 02(0'9
MAILING Af)DRESS E-MAIL
W2v Sc.) 322' S'f lois.bwstfivi.cr-rlka,;I•c6
CITY STATE ZIP FAX
1 .(1106,1111, ( 1.6).7 tJ14 ?g0 2 3 ( ) -
NAME PRIMARY PHONE
Sitiara' Fawn l
(a6° )z93 - 2-7,1
MAILING ADDRESS E-MAIL
ELECTRICAL /O01 ect r 'Pa;n - Rol `Jt.) srE No pivot SMMLTEMERS,110D44-tj41
CONTRACTOR CITY STATE ZIP FAX
dI t a. LtrPr F ron- ( ) -
WA STATECONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
e r S'70 l3S O! / /G //6
PRIMARY PHONE
APPLICANT � V s /C/ttiticr" 6teRGIY 7 ( b )2 3 - 2,99 CiekS'
MAILING ADDRESS E-MAIL
/oat Cour P; f got Su) Sk j SFO Dwipe shaft-Fain,yrbtAt m
CITY STATE ZIP FAX
OJY/Mpiba. * 4'$,S,''0"Z ( ) -
NAM c
PROJECT CONTACT PRIMARY PHONE
y1,U ' EATS (340) - 17>-
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
*formation supplied to the city as a part of this lication.
SIGNATURE: DATE 3) I
PRINT NAME: V ID13 E/27 S
Bulletin#160–January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application