17-105979 Electrical
City°fFederal Way Permit #:17-105979-00-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: HOLLINS
Project Address: 29834 4TH AVE SW Parcel Number: 720500 0190
Project Description: Electrical work to include replacing all wiring in garage.
Owner Applicant Contractor
RACHAEL HOLLINS MARV OWENSSOLARSIDE ELECTRIC SOLARSIDE ELECTRIC LLC
29834 4TH AVE SW LLC SOLAREL8650Q(9/18/18)
FEDERAL WAY WA 98023 5307 72ND ST E 218 125TH ST S
TACOMA WA 98443
TACOMA WA 98444
Additional Permit Information
Is this an Online or O.T.C.application? Yes
PERMIT EXPIRES Saturday, 15 December,2018
Permit Issued on Friday,December 15,2017
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
Washingto
n
and7the City of Federal Way.
Owner or agent: - jASIJ Date: /2-/r- -17
FINAWJ .
THIS CARD IS TO REMAIN-ON-SITE
Federal Way Construction Inspection Record ' " `
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 105979 00 Address: 29834 4Th AVE SW
Project: RACHAEL HOLLINS FEDERAL WAY WA 98023-3513
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.
1❑ UFER Ground(4295) 0 Ditch cover(4030) i ❑ Slab/Concrete Floor(4255)
Approved I Approved i Approved to place concrete
By Date i By Date By Date
® Pool Bonding(4195) E Temporary Power(4275) ® Service(4235)
Approved Approval i Approved
By Date ! By Date
By Date
,El Feeders/Sub-panels(4045) ,,• Rough Electrical(4225) „® Ceiling Cover(4020) '
I
Approved Approved Approved
By Date A By Date By
Date
El Final-Electrical(4055)
Approved
By Ile Date 1216 11
Rough Electrical 0 Final Electrical ❑ Right of Way
Approved Approved Approved
By Date
By Date By - Date
' .. RECEIVED ELECTRICAL
CITY OF
Federal Way DEC 1 5 2017 PERMIT APPLICATION
CITY OF FEDERAL WAY 0
COMMUNm DEV I p MBER l .1 - l S q 7 _
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SUITE/UNIT/SPACE#
SITE ADDRESS: J 7 �Jf( !�J //.,L
PROJECT VALUATION ASSESSOR'S TAX ARCEL# CURRENT/PROPOSED USE
$ /000 .0-0 __1_ 2._ 5 0 v - 0 l ei 0
PROJECT NAME
(Tenant or Homeowner Last Name)
Rep/arm Ail avfi' ( /&.Ln,ca ( c.,ri is ,ire Camey€
PROJECT DESCRIPTION 0r/�/a ntt (.vicici job- -f anr�" //VeSl Aelo
Detailed description of work to AC* r L e q R"rnsvrtlare riLee, (
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER A etC IA 21 Ho 11 (n f (323) g a3-O 6002.
MAILING ADDRESS
Vigil yam'' /}yrs w
CITY STATE ZIP FAX
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( )
-
NAME ` p 1 PRIMARY PHONE
Solcv'f,' tf2E-tfi`L (2 ) ) P - 11-932-
MAILING ADDRESS c
T3O7 7Z 5 I /E-MAIL
ELECTRICAL c`J vats-AltaPec71/'I coq�o 11.C�
CONTRACTOR CITY. STATE ZIP FAX .J
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W TA E CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME PRIMARY PHONE
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APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT -Clc kco-1 -- 5I-efz Cc s f, (�S3 )10S-_3730
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 arty 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 i ity as a part of this ap• 'cation.
0
SIGNATURE: / , / 2^ g
DATE /
PRINT NAME: A0111:10.1' a lji/ e/4
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application