16-102088 r "
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• S Electrical
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City of FederalWay Permit #: 16-102088-00-E L
Community&Econ.
Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: LASHBAUGH
Project Address: 2405 SW 322ND ST Parcel Number: 932431 0100
Project Description: 0-200 AMP PANEL CHANGE
Owner Applicant Contractor
CHARLES LASHBAUGH D&A ELECTRIC LLC D&A ELECTRIC LLC
2405 SW 322ND ST 11909 VICKERY AVE E DELEC*E897D5(4/5/17)
FEDERAL WAY WA 98023 TACOMA WA 98446 11909 VICKERY AVE E
TACOMA WA 98446
Additional Permit Information
Electrical Work Valuation? 1800.00 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 Tuesday, May 2, 2017
Permit Issued on Monday, May 2, 2016
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: .5-
' • THIS CARD IS TO MAIN ON-SITE ,�
CITY OF - Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 16-102088-00-EL Address: 2405 SW 322ND ST
Project: CHARLES LASHBAUGH FEDERAL WAY, WA 98023-2517
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.
❑ UFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
, �� Date _z„t_I .
r
0 Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED EL CTRI CAL
CITY OF
Federal Way MAY 02 2O PERMIT APPLICATION
CITY OF FEDERAL WAY PERMIT NUMBER /� _ /0 KO 8 C C
CDS - - -
SUITE/UNIT/SPACE#
SITE ADDRESS: � / \ ' A 1
PROJECT VALUATION lJ ASSESSOR'S TAX/PARCE # CURRENT/PROPOSED USE
$ 24f _ / 00
PROJECT NAME
(Tenant or Homeowner Last Name) (
PROJECT DESCRIPTION
Detailed description of work to �, { ov� ( f/-) ,n
be included on this permit only
NAME // PRIMARY PHONE
PROPERTY OWNER j� e e-) / c h c k (ZCG, )ZZ'/ -/7/7
MAILING ADDRESS E-MAIL
)(1& 32z- y-}-
CITY STATE ZIP FAX
NAME % PRIMARY PHONE
0414/ 5-7(.--7-H--in (Z&3 )x`71-
MAILING ADDRESS E-MAIL
ELECTRICAL V /'Ck
CONTRACTOR CITE_ / STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
7O
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT619 nr) ( ,, ?)4 3/- ?75-c-7
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 the city as a p of this application.
SIGNATURE: - DATE
PRINT NAME:
Bulletin#160 April 14,2016 Page 1 of 1 k:AHandouts\Electrical Permit Application